This is Why Insurances Won't Cover PRP Injections

Do Insurances Cover Platelet Rich Plasma (PRP) Injections? I review reasons why insurances may not cover PRP injections and go over what it will take for them to do so.

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► ABOUT ME

Jeffrey Peng MD is a nonoperative orthopedist and sports medicine specialist. He created a YouTube channel and blog to translate cutting edge medical knowledge and clinical research to benefit all those looking to live an active and healthy lifestyle. He focuses on maximizing non-surgical treatments for sports injuries and orthopedic conditions. He specializes in using orthobiologics and ultrasound guided minimally invasive techniques to treat osteoarthritis, tendinopathies, and musculoskeletal disorders.

Dr. Peng is board certified in sports medicine and family medicine. He completed residency with the Stanford family medicine residency program and completed his sports medicine training with the Stanford primary care sports medicine fellowship in San Jose. He is an active faculty member for both programs and is excited about training the next generation of physicians.

Dr. Peng’s sports medicine clinic is located in Campbell, California.

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My content reflects my own opinion and does not represent the views or opinions of my employers or hospital systems I am affiliated with. They are meant for educational purposes only. They do not substitute for the medical advice of a physician. Always seek the advice of your physician with any questions you may have regarding your health.

[HarryCam-bs]

I had PRP injection (60cc) in my left shoulder over 12 months ago. I now have 100 % mobility and no pain!

[ltyr-mrif]

PRP has changed my life!
I seriously had trouble just walking with my bad knee. Old injury from my teens turned into bone on bone at 59.
The PRP was the last hope short of cortisone or a knee replacement.
This has turned out to be a miracle for me! My wife and I are avid hikers and outdoors people. We used to walk 3-4 mph and flew by people on the trails. We do it again!
I hope YOU try it! Hope it works for you too!

[heinborp]

Yes! PRP is a miracle for me. My knees and feet have really been helped

[maryuggen]

I have had both PRP and Stem Cell treatments in my knees and hips using the Regenexx Protocol starting in 2016. My knees were 100% successful. My hip is a work in progress.
I have always felt that the reason it isn't covered in because the Orthopedic Surgeons do not want it to be covered.

[jimhollenbeck]

Our health insurance agent who is with Untied Health, as of September of 2023 PRP is covered, she showed us the bulletin from Medicare that authorized insurance companies to cover PRP,

[pascalmcdonald]

I got PRP in my knees for the first time a few days ago and the first two days had me thinking I made a mistake. Nothing crazy yet because I’m still taking it easy. Got mine at West Point since I’m on active duty. Praying this gives me relief 🥲.

[Sunintheam]

The week before Christmas I broke my heel while baking Christmas cookies. Finally had an mri in January to discover my Achilles tendon was torn in two places. One tear was almost completely separated. Doctor had two options. First option was a surgery while lying on my stomach. Second choice was PRP therapy. I chose option two. I didn't have any pain during this treatment. At eight week recheck foot doctor said it was healed. Because UF hospital in Jacksonville, Florida does so many of these treatments it was only $500.00.

[Pookiegmaw]

I had many cortisone injections in my back, shoulders, neck, knee and I had 1 PRP. I was in lots of pain in my shoulder & neck and received trigger points along my neck and along the shoulder, plus I had one cortisone injected right in my shoulder but did not take the high pain away. 1 week later I had to go back and told the doctor they did not help. So he recommend PRP in my shoulder. I was so happy that the PRP took the high pain away. I think I should of gotten more PRP but didn’t. I had to pay $550.00 out of pocket because my insurance didn’t cover PRP’s.

[tconcotelli]

PRP is the best money I ever spent. Health insurance is a racket.

[shaunspellman]

(In Martin's voice)....You Go Boy!!! This should be brought to the senate!!! Some Insurance companies would rather you live sick and unhealthy lives than live a healthy life!! Keeping you on meds and being a vicious cycle!

[thetippingpoint]

The fact that this info is coming from an MD means there is hope for the future. The bigger question is why is Prolotherapy not included in Med school curricula.

[magicalwishes]

You’re the best doctor I learned a lot from you for the age of 76. I wish you had an office down here in Southern California. Take care and thank you so so much for your videos sharing with me and a lot of people. My age are suffering through knee problems and both knees and arthritis, but thank you and people out there looking at the video with the same problem. I have God bless you all.❤

[arlenepuntil]

I got PRP injection here in SYDNEY AUSTRALIA...THANKS GOD .
It's work..after 3 weeks....no more pain in my left knee..I can work properly...

[AM-plpt]

Am entering my 3rd week of a PRP injection for arthritis in my thumb. Pain level went from tears in the eyes while playing guitar( amateur play quit a lot) Still have pain but significantly less. I have to limit my playing time or take frequent breaks . Am trying to avoid a surgery that remove the trapezium bone and use a tendon in place of that bone. Both my orthopedic surgeon and my hand specialists surgeon stress that a surgery will result in less hand strength. Couple that with carpal tunnel issues. Am planning to have corrective surgery for the carpal tunnel. Carpal tunnel is rather severe. Dropping things and great difficulties opening jars or bottles. Have lots of kitchen aides to compensate for the carpal tunnel issues.

[warben]

Insurance companies only care about the bottom line meaning cost benefit analysis. I worked for several insurance companies in my career and so I know this to be true. There is also a lot of bureaucracy in most insurance companies. This is especially true for health insurance companies.
Thanks to Dr. Peng for a great explanation of the issue and of PRP in general as he has a number of other videos on PRP. I have golfer's elbow (medial epicondylitis) which so far has not responded well to physical therapy. I am considering trying the PRP therapy and finding Dr. Peng's videos is helping me decide. It will be expensive as it is not covered by insurance but it will be worth it if it works and I regain full use of my elbow without the pain I have had for months.

[Romo]

I bought a centrifuge for $300 and $60 in other supplies. I did my own prp injections and yes they work

[juliaferrera]

I am starting my PRP tomorrow. I am praying it will help, I have been struggling with DDD since my early 20s.

[shirlebetts]

My pain Dr plans to use this on me after I was in a car accident. I’m having issues with my back and neck. Worse is my neck. I’ve had my 2nd round of epidurals, steroids, nerve blocks. I’m looking forward to this. Thanks for the video. Sure helps.

[jairivasmen]

Dr Peng, fantastic lecture. thanks a lot. We already have so much evidence and consensus when it comes to PRP and OA, that I can't believe there are still people out there who criticize. Anyhow, intraosseous inj will come too, results are awesome, we have several studies already published and even a study explaining an in-office technique. Another study with many patients treated in office, coming :)
Biologic formulation is everything though. Centeno talks about personalized formulations because his business is preparing it for the clinics, but in vitro research does not agree with high platelet concentration and even less so with the presence of WBC, which lead the healing process to the fibrotic repair path

[johnscott]

They don’t cover it because it eliminates the problem