When considering banking baby’s umbilical cord blood, the first questions are often "How can I pay for cord blood banking?" and "Does insurance cover the costs?”
We rounded up the top ten insurance companies for you to help clarify their reimbursement policies. Learn how you can pay for cord blood banking through insurance, Flexible Spending Accounts, Health Spending Accounts, and more!
Which insurance companies cover cord blood banking?
Some insurance providers will cover the cost of cord blood banking when collection is medically necessary. For example, depending on the provider, families with a history of leukemia or other blood disorders may be eligible for total or partial coverage of the costs of cord blood collection and storage.
Among the top ten insurance providers, coverage varies for both cord blood banking and stem cell treatments, as follows:
Anthem Blue Cross Blue Shield: Anthem’s website states that “Collection and storage of cord blood is considered medically necessary only when an allogeneic transplant is imminent for an identified recipient,”
Aetna Group: Aetna will consider cord blood collection medically necessary for “a member with a malignancy undergoing treatment when there is a match.”
UnitedHealth Group: United generally doesn’t cover cord blood banking, stating that “long term storage services do not meet the definition of a Covered Health Service.” However, some plans will cover the costs of using cord blood for medically necessary transplants.
Kaiser Foundation Group: Kaiser does not cover any cord blood banking services. However, they may cover allogeneic stem cell transplants, which can include cord blood collection.
Humana Group: Humana will cover autologous stem cell transplants for programs with a 90% 100-day survival rate, and allogeneic stem cell transplants with a 70% 100-day survival rate.
Cigna Group: Cigna will cover medically necessary autologous and allogeneic stem cell transplants.
Highmark Group: Highmark Group will cover medically necessary stem cell transplants for leukemia and blood disorders, but not for autoimmune diseases.
Wellpoint Group (Now Blue Cross): They will cover medically necessary stem cell transplants for blood disorders only.
Medicaid: Medicaid will cover stem cell transplants for leukemias, SCID, and Myelodysplastic Syndromes in clinical studies.
Families with a history of leukemia or other blood disorders may be eligible for total or partial coverage of the costs of cord blood collection and storage.
Are there other programs that help pay for cord blood banking?
Yes. FSAs (Flexible Spending Accounts), HSAs (Health Spending Accounts), and HRAs (Health Reimbursement Arrangements) are all special un-taxed accounts you can use to pay for out-of-pocket healthcare costs. FSA and HSA accounts will sometimes cover cord blood banking when medically necessary.
According to the FSA store, account holders are eligible for cord blood storage with a Letter of Medical Necessity from a physician. A Letter of Medical Necessity must state that the cord blood will be used to treat an “existing or imminently probable disease.”
Other things to consider when budgeting for cord blood banking
See if cord blood banking is tax deductible for you: if your child or a family member has a medical condition that could be treated by cord blood, then your expenses will be tax deductible.
Use a payment plan: some cord blood banking services will allow you to pay in installments. Americord offers a 24-month payment plan to families who would prefer not to pay the entire cost upfront.
How much should I expect to pay for banking cord blood?
Prices vary among cord blood banks, so make sure to comparison shop. There are so many options when it comes to cord blood banking that it can be overwhelming. That’s why we created our pricing calculator so that you can see where your dollars will stretch the farthest.
Quick Guide to Insurance Codes for Cord Blood Banking
If your insurance will cover your cord blood costs, there are several Current Procedural Terminology (CPT) codes you should know for billing. A CPT Code is used to report medical procedures to health insurance companies to aid with billing.
Insurance companies also use ICD code for cord blood collection. An ICD code stands for the International Classification of Diseases, and it’s a system used to classify all diagnoses and procedures in the United States.
Collection and Banking
CPT code 88240 is used for freezing and preservation of the stem cells.
CPT code 59899 is for an unlisted procedure, maternity care and delivery—this may be used if the cord blood collection is not specifically for an allogeneic transplant, so doctors can be clear about how you are billed.
ICD-10 code is used for cord blood collection. ICD codes are used by physicians and insurers to store and receive diagnostic information. Blue Shield Blue Cross lists the codes as: O34.211, O34.212, O34.219, and more. Talk to your doctor about which specific codes apply to your case.
Stem Cell Treatments
CPT code 38205 is used for bone marrow and stem cell transplants for a sibling (allogeneic transplant).
CPT code 38206 is for autologous transplants (cells from a child’s own cord blood).
Ultimately, banking your child’s cord blood worth the cost.
Stem cells from cord blood have been used to save countless lives for almost three decades, and doctors are discovering new ways that cord blood could potentially be used to treat diseases like Alzheimer’s and ALS. Today, more than 80 diseases, including leukemia and other blood disorders, can be treated with stem cells from cord blood. Since it can be frozen for up to 20 years, stem cells from your child’s cord blood will be on-demand in case your child—or their siblings—ever needs it. To find out the true costs of cord blood banking, please visit our Pricing Calculator.