Having a baby is a wondrous and joyful time filled with hope, dreams, and plans for the future — as well as legitimate concerns about the expense of raising a child. We understand that most (if not all) parents would bank the cord blood for all their children if they could afford to. It’s natural to wonder if one’s health insurance or health savings plan can help offset the costs. In cases where it’s medically necessary, they often do.
Is Cord Blood Banking Covered by Insurance?
Cord blood banking is generally not covered by insurance when there isn't an immediate or probable medical need for the stem cells; however, if there's a family history of leukemia or a heritable blood disorder for which stem cell treatment has proven effective, insurance may cover some or all of it.
In other words, health insurers won’t cover the costs of cord blood banking when the reason for banking is precautionary — as a way to treat a disease that might develop in the future, or for use in yet-to-be-discovered or trial therapies.
In instances where the stem cells will be part of an existing treatment plan or used for an imminently probable medical condition, insurance is more likely to cover some or all of the costs of cord blood banking.
Collection and storage of cord blood from a neonate may be medically necessary when an allogeneic transplant is imminent in an identified recipient with a diagnosis that is consistent with the possible need for an allogeneic transplant.
Families who meet the medical necessity requirements may need to obtain a Letter of Medical Necessity from their physician. Prior authorization may also be required.
Insurers also consider the efficacy of the treatment for which the stem cells will be harvested in their decision. Trial therapies may be effective — and sometimes the last or only hope — but until they are FDA-approved and proven, many insurers won’t cover the costs associated with them.
CPT Codes for Cord Blood
To determine if your insurer covers cord blood collection, storage, or stem cell transplant when medically necessary, it’s helpful to have the CPT (Current Procedural Terminology) or HCPCS (Healthcare Common Procedure Coding System) Code under which these procedures are billed. Autologous refers to the patient’s own blood; Allogeneic is from another matched related or unrelated donor.
|CPT 38205||Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic|
|CPT 38206||Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous|
|CPT 38207||Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage|
|CPT 88240||Cryopreservation, freezing and storage of cells, each cell line|
|HCPCS S2140||Cord blood harvesting for transplantation, allogeneic|
|HCPCS S2142||Cord blood-derived stem-cell transplantation, allogeneic|
|HCPCS S2150||Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre and post-transplant care in the global definition|
Can I Use My HSA, HRA. MSA or FSA for Cord Blood Banking?
Where the “imminently probable” standard is met, cord blood banking expenses not explicitly covered by your health insurance can be considered “qualified medical expenses” reimbursed through an HRA, FSA, MSA or HSA account or otherwise eligible for a tax deduction.
If the cord blood banking is a qualified medical expense, an HSA is likely to cover reimbursement, but an HRA or FSA may not.
For example, many HRAs are designed solely to reimburse out-of-pocket expenses incurred under the employer’s health plan, such as copayments and cost-sharing. In this case, cord blood storage would not qualify.
FSA arrangements are likely to be more liberal, but employers do have the flexibility to exclude certain benefits from FSA coverage.
Is Cord Blood Banking Tax Deductible as a Medical Expense?
According to the IRS, “expenses for banking cord blood to treat an existing or imminently probable disease may qualify as deductible medical expenses. However, banking cord blood as a precaution to treat a disease that might develop in the future does not satisfy the existing legal standard that at a minimum a disease must be imminently probable.”
While legislation has been introduced at various junctures (the latest being in 2015) to make cord blood banking tax deductible, it has not proven fruitful [*].
Cord Blood Banking Benefits
If your insurance won’t cover the costs of cord blood banking, we understand that it may make you wonder if the benefits of cord blood stem cells are worth the cost, or if cord blood banking is right for your family.
Every year, about 200,000 parents in the U.S. choose to bank their newborn’s cord blood for peace of mind. Here’s why:
- Cord blood stem cells are effective in the treatment of more than 80 conditions and diseases including sickle-cell anemia, leukemia, lymphoma, and many types of cancer. By banking your baby’s cord blood and cord blood tissue you ensure that you and your immediate family have access to viable and immediately available stem cells.
- Families of mixed race or ethnic background are underrepresented in public cord blood banks. In scenarios where matched stem cells are needed urgently for a child or other family member, private cord banking makes sense.
- There are many procedures where the cord blood of one child is used to save a sibling. These allogeneic transplants are used when the patient’s own cord blood carries the disease. Banking the cord blood of all your children will increase the odds of having an ideal match in these scenarios, and a clean donor in the event of a heritable disease [*].
How Much Does Cord Blood Banking Cost?
The cost of cord blood banking starts at around $1,000 for collection, processing, and initial storage. For annual storage plans, yearly dues range from $150 - $370, depending on the company. Families may see significant savings by paying a flat rate for a 20-year or lifetime plan.
Whether covered by your insurance or not, MiracleCord works to keep the costs of cord blood banking affordable while still providing the highest quality of service. We work hard to ensure that cost isn’t a factor that will prohibit you from making this important decision for your family’s future.
We offer all-inclusive pricing with no hidden fees. Our transparent cost and convenient one-time or 12-month payment plans make cord blood banking accessible and affordable for many families.
Why Bank with MiracleCord?
MiracleCord was awarded Best U.S. Cord Blood Bank by Global Health & Pharma, an independent biotechnology rating organization, in 2021 and 2022. We were recognized for the value we deliver, our state-of-the-art technology, and the quality of our customer service.
We stand behind our industry-leading TimeCritical® Processing and AXP® II Automated Processing system to ensure the viability of your baby’s umbilical cord stem cells. We back our service with a $100,000 quality guarantee. If your child’s cord blood stem cells are used in a stem cell transplant and fail to engraft, MiracleCord will pay up to $100,000 to procure an alternative source of stem cells.
We also offer special savings for families having multiple births (twins, triplets, etc.), as well as discounts for returning customers. There are many diseases for which a child cannot use its own cord blood and a sibling is the best option. Because not all stem cell transplants require a 100% tissue match, it makes sense to bank cord blood for all your children so you have it on hand should the need arise.
Call us at 888.743.2673 for a custom discount and quote.
The Bottom Line
We realize that even in cases of immediate need, people without health insurance or otherwise underinsured may face greater hurdles to cord blood banking and stem cell therapies.
Both public and certain private cord banks may offer “case of need” programs to families where a person has been diagnosed with a condition that can be treated with cord blood and they do not have the means or insurance to pay for cord blood banking.
Even for those who are insured, the industry is loath to cover cord blood banking services except in cases of immediate need. They expect people to rely on public banks when the need arises.
MiracleCord was founded by someone who lost a family member to leukemia because a stem cell match could not be found in a public bank in time to treat the patient.
We offer the industry’s most affordable pricing so our customers won’t have to face a loss when a stem cell treatment could save a life. For many customers, the peace of mind far exceeds the costs.
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