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View Full Version : Medicare paying for a Stem Cell Transplant


Data
Wed Jun 3, 2015, 03:27 PM
Has anyone had Medicare pay for a stem cell transplant or had problems getting them to pay for one? I have an appointment later this month to talk to the transplant team and wonder if Medicare will pay for it.

Thanks

Data

johnwc
Wed Jun 3, 2015, 08:34 PM
I went in Jan 1, 2015, for my SCT. I ended up costing me about $800 which was mostly my $40 copays to the doc who made the daily rounds. Seems like all fees I paid were the ones thru my Advantage plan (doc visits) and never saw a bill for Medicare.

rar
Wed Jun 3, 2015, 09:27 PM
Medicare pays for SCT if you were on an approved clinical trial. My provider was denied twice and approved on the third appeal. I was on an approved clinical study. Medicare and supplement paid the entire amount.

See
http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=45&ncdver=5&NCAId=10&ver=8&NcaName=Autologous+Stem+Cell+Transplantation+%28AuSCT%29+for+Multiple+Myeloma&bc=ACAAAAAAIAAA&

or google does Medicare pay for stem cell transplants

Ray

Data
Thu Jun 4, 2015, 05:24 PM
Thanks Ray and John,
At this point they are just talking about it. Hopefully I wont make it to the point I need a SCT.