Is PRP Covered By Medical Insurance?

PRP is a serum concentration of a patient’s own blood platelets. Platelets contain growth factors and chemical mediators that can help with inflammation, discomfort, blood flow, and the natural healing process.

Patellar, hamstring, and Achilles tendon injuries, golfer’s elbow, and moderate knee osteoarthritis are just a few of the indications for PRP.

A typical question is if PRP is covered by health insurance. Unfortunately, most health insurance plans and Medicare do not cover PRP, which costs between $1000-$2000.

Areas to be treated, the person administering the injection, and the facility are all factors that may influence the cost. PRP injections can be uncomfortable depending on a variety of circumstances.

Steroids and most local anesthetics should not be used in conjunction with PRP since they will affect the result, stem cell function, and cartilage.

Does any insurance cover PRP?

Because many health insurance companies consider PRP to be an experimental treatment, it is frequently not covered by insurance.

PRP is covered by some insurance carriers, although the amount of coverage varies depending on the condition or injury being treated. Tricare, for example, supports PRP injections for individuals suffering from tennis elbow and mild to moderate chronic knee osteoarthritis.

Patients who utilize the health insurance company WellCare Health Plans may be eligible for PRP if they participate in a study.

Check with your insurance provider to see whether and how PRP is covered under your existing plan.

What You Need To Know About PRP injections

Platelet rich plasma therapy may be beneficial if you have arthritis in your knee. It helps your body mend itself by using portions of your blood. PRP can improve the way your knee feels and functions. A sample of your blood is taken to start the process. In a centrifuge, it is spun around. Platelets, plasma, and red and white blood cells are all separated in this way. After that, the platelets are concentrated and combined with some plasma. This mixture is referred to as “plasma with a high concentration of platelets.”

This is injected into your injured tissues by the doctor. Your immune system (the part of your body that keeps you healthy) reacts fast. Species of white blood cells known as “macrophages” swarm the scene. They remove cells that have been harmed. They aid in the preparation of the wound for healing. The stem cells and other cells multiply after that. They repair and restore damaged tissues over time. You are free to leave after the injection. As you heal, you may require more injections.

What is platelet-rich plasma?

PRP is made by extracting blood, centrifuge-concentrating it, and then collecting the concentrated platelets. PRP is made up of a range of growth factors and signaling chemicals, as well as other natural substances that reduce inflammation and aid in tissue healing.

How long does the procedure take?

It takes 5 to 10 minutes to obtain the blood, plus time to concentrate the platelets. On the same day, PRP is reinjected into the afflicted area of the body.

The injection is usually done under imaging guidance, and the total procedure takes about 30 to 60 minutes in most cases. Joint discomfort, chronic tendon and ligament disorders, and other soft tissue injuries are the most typical orthopedic applications.

Will I need physical therapy?

Physical therapy is strongly advised for most patients beginning roughly two weeks after their injection. Your collaborating physical therapist will be provided a detailed description of an unique organized therapy program tailored to accompany your injection.

Will my insurance cover it?

Insurance companies now consider PRP injections to be “investigational/experimental,” thus they are not covered. As a result, clinics generally do not bill insurance companies for PRP injections; these services are accessible on a self-pay basis.

What follow up visits will I need?

One or two follow-up visits are required. Insurer will be billed for these visits, however your insurance may not pay the follow-up visit. Please check your insurance policy for specifics on coverage.

What are the next steps?

After you’ve scheduled your PRP injection, a representative from Patient Financial Services will contact you to discuss payment options. After you’ve received that, you’ll have your injection and be on your road to recovery!

How much does a PRP treatment cost?

A single PRP treatment will normally cost between $ 500 and $ 2,500. Treatments may need to be repeated in some cases.

The cost of a treatment varies depending on its location, facilities, and the expertise of the doctor performing it. It’s also worth noting that PRP treatment isn’t covered by many insurance policies.

Is PRP worth the money?

It’s quite effective. PRP microneedling, fortunately, has been proved to be a very successful treatment for hair loss in trials. Patients can experience improvements in their hair growth in the first few months after their initial set of treatments.

How painful is PRP injections?

PRP injections are generally painless; however, the level of discomfort varies depending on the portion of the body being treated. Injections into the joint cause very little pain.

After the treatment, there may be some little discomfort; however, this does not last more than a few days and may be managed with over-the-counter Tylenol.

Anti-inflammatory drugs such as Aleve, Motrin, Celebrex, Naprosyn, and Mobic must be avoided. These medications may slow down the healing process.

How Does PRP Actually Work?

At first, alternative medications and treatments may appear to be difficult to accept. The confusion about whether or not to try stems from a lack of knowledge about whether the operation will succeed or have negative consequences for one’s health. There is also concern that they will be in a far worse state than when they began treatment.

These days, however, a growing number of alternative techniques are being developed with the goal of reducing anxiety as a top objective. Platelet-Rich Plasma, or PRP in layman’s terms, is one of these therapies.

To put it simply, it is a method that involves extracting your own platelet from your blood, altering it, and concentrating it to obtain optimal effects before injecting it back into the location you wish to cure.

This is, of course, with the aim of facilitating speedier healing and reducing discomfort during the healing process. While this may sound ideal, without a thorough understanding of what plasma and platelets are and what they do for the body, it is impossible to appreciate the benefits of this therapy and how successful it is.

Plasma is – you guessed it — your blood. It’s what makes your blood liquid, to be precise. Plasma is a yellowish liquid that contains white and red blood cells, proteins, and platelets, among other blood components. Although these components have various use, the platelet is the most significant component being created for PRP.

When it comes to mending, the platelet is your blood’s main soldier. When you bleed, platelets are the first to rush to the open wound to form a blood clot, which helps to slow down potentially lethal bleeding.

Platelets also transport a lot of protein called growth factors, which is important for healing. Hair growth and tissue repair are both possible thanks to the growth factors found in platelets.

Platelets can help to speed up healing and minimize inflammation. Platelets can help with healing in all regions of the body, from facial treatments to mobility injuries like sprains, etc. Platelets can help with healing in all parts of the body, from facial treatments to promoting the growth of collagen and elastin. The list of conditions it can treat is infinite.

However, the body can only manufacture so many platelets at a time, so recovery may take longer. Platelets in large quantities and high concentrations injected directly into the treatment area might produce astonishing results in a short period of time, but it is impossible to promote the abundance of plasma precisely in the treatment area.

As a result, the PRP (Platelet-Rich Plasma) technique was created.

In contrast to other minimally invasive procedures used in the face, such as dermal fillers, PRP uses your own blood to treat your own problems, making it 1) organic 2) highly effective because your blood works well with your own body and 3) not prone to allergies, given that the blood came from your own body.

Dermal fillers work by injecting a gel containing Hyaluronic Acid, which helps to add volume to the skin. HA in dermal fillers is a lab-formulated and created chemical that is injected into your skin, despite the fact that it is a naturally occurring substance in the body. By elevating and shaping the face, these fillers refine facial features.

Fillers can be used to fill in the spaces under your skin that cause face lines and wrinkles. These fillers contain hyaluronic acid, or HA, which promotes collagen and elastin formation. HA also helps to keep skin hydrated by binding water.

The ability of the skin to manufacture hyaluronic acid and sustain it for extended periods of time decreases as it ages, necessitating the development of a treatment to assist sustain HA and retain the skin’s suppleness. When wrinkles are smoothed and skin is tightened, this is what gives your skin a revitalized appearance.

PRP, on the other hand, uses your own platelets’ natural capacity to mend and reduce inflammation from beneath the skin to help your skin heal from injuries and recover from symptoms of age, giving you a more naturally youthful glow. Reintroducing the platelet to your body is safe because it was yours to begin with.

The PRP technique usually begins with the introduction of anesthetic medications to the location where blood will be taken, either topically or through injection. Following the extraction, the blood will be centrifuged to separate the platelets from the other blood components. Platelets will become more concentrated and potent if separated from the rest of the blood and in abundance.

After that, the concentrated platelets will be injected into the face or other areas that require treatment. Platelets act by filling in and wrapping around damaged cells and tissues beneath the skin while healing takes place. This is what helps to reduce inflammation and accelerate healing, which can be up to 10 times faster than platelets that aren’t treated with PRP.

It could take up to 30 minutes or more to draw blood and inject PRP. Because the technique is minimally invasive, there is no downtime, and those who have had PRP treatment can return to their normal routine immediately.

Although the treatment is safe, it is not without risk due to the possibility of discomfort, irritation, bleeding, or soreness surrounding the injection site. Apart from this risk, people who get PRP injections in their faces usually return to their normal routine immediately after the treatment.

The effects of PRP are not permanent, however they can last up to 18 months on average, with the longest documented effect being 2 years. Most people, however, may need a retouch of the therapy once a year. Each PRP treatment may require three sessions over the course of 4-6 weeks, with the best results appearing after 4-6 months.

PRP has been generating excitement since its inception, but more celebrities and athletes are speaking out about their use of PRP technology as a treatment. In fact, when Kim Kardashian received the now-famous Vampire Facial, which is also a PRP procedure, she marketed it on live television.

How long is PRP effective?

PRP treatment was first identified to improve hair quality and encourage hair growth. However, the duration of the consequence is determined by your body’s ability to heal. By taking care of your body, you can extend the treatment’s effectiveness.

However, you can reap the benefits of the procedure for up to a year. To keep the effects of hair growth, you’ll need to have PRP treatments on a regular basis.

Is PRP FDA approved?

While PRP is not ‘FDA-approved,’ it can be legally offered ‘off-label’ in the clinic for a variety of musculoskeletal reasons in the United States. Recent meta-analyses have shown statistically significant improvements, implying that PRP may have clinically important effects in some situations.

However, because clearance does not imply approval, PRP is a pricey treatment that isn’t covered by insurance, and clinical trials haven’t shown conclusive efficacy, we advocate medical practitioners to advise their patients of this before using PRP ‘off-label.’

Who should not get PRP?

Injections of platelet-rich plasma may not be acceptable for a patient who:

  • Has a medical condition that could be exacerbated or spread by injections, such as an active infection, metastatic disease, or certain skin diseases?
  • Has a number of blood and bleeding issues.
  • Is receiving anticoagulant treatment (and cannot temporarily suspend treatment)
  • Is anemia a problem?
  • Is she expecting a child?

Patients who are allergic to cow products should also inform their doctor. If the platelet-rich plasma is coupled with a cow-derived ingredient called bovine thrombin, these patients may develop an allergic reaction.

Post-PRP Care

You will be kept lying down and under observation for a few minutes to 30 minutes after the treatment.

Afterwards, maintain a clean and dry PRP site. Replace the bandage with a Band-Aid and leave it on for 12 to 24 hours until the wound heals.

Showering is permitted, but if the bandage becomes wet, it must be replaced.

Because ice lowers swelling, DO NOT apply it on the PRP site. The technique is designed to create swelling, which aids in the healing process. Swelling and bruising may occur for three to seven days.

For the next 24 to 48 hours, you may have significant discomfort at the PRP location. Use Tylenol or Ultram (tramadol) as needed, but do not exceed 3,000 mg of Tylenol in a 24-hour period.

You may be prescribed opioid pain relievers. NOTE: Tylenol is found in certain narcotic pain relievers. Include such medicines in the 3,000 mg Tylenol maximum for 24 hours.

Constipation is a side effect of narcotics. Please take a stool softener such as Colace if you are taking a narcotic. Please drink more water and eat more fiber-rich foods as well. DO NOT GO FOR MORE THAN TWO OR THREE DAYS WITHOUT GOING TO THE BATHROOM. When necessary, use a laxative or an enema.

For the next two weeks, do not use any medications that contain the following ingredients:

  • Aspirin
  • Ibuprofen
  • Naproxen
  • Anti-inflammatory (anti-swelling) medications (Motrin, Advil, Aleve, Voltaren, Mobic, Daypro, Feldene, Lodine, Orudis or Ansaid)

You’ll be told which activities you’re allowed to undertake and which you’re not, although in most cases:

  • For six weeks after receiving PRP in the arm, wrist, or shoulder, do not pull, tug, grasp, hoist weight, or grip the arm, wrist, or shoulder. Also, refrain from repeating any motion.
  • Use crutches for a day or longer until you can walk without the pain getting worse if you have PRP in your hip, knee, ankle, or foot.
  • After undergoing anesthesia or taking narcotic pain relievers, DO NOT DRIVE for at least 24 hours.
  • Please have someone drive you home if you have PRP in your hip, knee, ankle, or foot.
  • If you had PRP in your wrist, arm, or shoulder and did not have a nerve block, you may drive home in an automatic transmission car.

It takes time for PRP therapy to take effect. It’s not like taking a steroid shot and feeling great right immediately.

Because we are producing swelling in an already uncomfortable location, you may experience additional discomfort at initially. Swelling is required for blood cells to begin assisting you in long-term healing.