In general as far as I know from working on the civilian side of health care… PRP injections are not covered by insurance or Medicare.
Worked at the VA now 16 years and no patients that I have ever worked with in physical therapy has had them.
Now that isn’t a guarantee that no one in the VA does them. I always say… every VA is slightly different from each other. Different vendors, different items they supply or don’t supply.
Edit: if your knee is absolutely destroyed it sounds like you are headed towards a knee replacement.
They don’t do stem cell replacement either at my VA
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u/beekeeper727
You can get them but it is quite the journey in order to get approved. Each VAMC has different protocols on who gets approved and how many approvals they can give. I tried to get them for my lower back and it took almost a year of trying and advocating and they still denied me, but my neighbor was approval for a similar issue in about 6 months!
Keep advocating, hoping you get what you need.
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u/nurse-12345678
I’m sorry you’re dealing with this, sounds incredibly frustrating, especially when you’re trying to stay functional day to day.
A couple things to clarify that might help you advocate for yourself: • An MRI isn’t what’s used to diagnose osteoarthritis, X-rays show OA. MRI can show soft tissue detail, but it usually doesn’t change management in advanced OA cases. • If your OA is truly severe (“bone-on-bone” with significant functional limitation), relying on repeated injections, whether PRP, gel, or cortisone, is generally not considered a long-term solution. Even PRP, while helpful for some, isn’t strongly supported in advanced OA. • You’re absolutely right to be cautious with frequent cortisone injections. There is evidence they can accelerate cartilage breakdown over time, especially if done repeatedly. • If your knee is as bad as you describe, it may be time to have a serious discussion about total knee replacement (TKR). That’s typically the definitive treatment for end-stage OA and often gives much better, longer-lasting relief than injections.
PRP is one of those treatments that sits in a gray zone, some patients swear by it, but the clinical evidence is not strong, especially with advanced osteoarthritis.
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u/DBasUrMom
Or the “person” your wife spoke to lied…who randomly discusses their spouses medical issues with a stranger?
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u/DriftingtheDriftless
You have all the right answers already. Not all VA’s do it, maybe the other guy lied, or maybe they did do it at one point but the provider that did it left, etc…
As far as your question about Community Care though, the answer is No. Because PRP is not FDA approved to treat the condition it can not be authorized by CC. I have heard of it accidentally being covered in CC as the TPA erroneously has paid it, but the rule is CC can’t cover it if it’s experimental.
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u/FoxPast175
Not every VAMC will do it. Or has the ability to offer it. Mine would love to start offering them but it literally takes an act from Congress to make it happen.
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u/Fine_Researcher_15
I’ve received prp in my shoulder at a va hospital. This was within the last year.
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u/Thehaas10
Just go get a knee replacement. I am 39. I got my hip replacement 1 year ago. Best decision I ever made. I was service connected for it previously so that does help.
I live in Charlotte. Idk if community care could get you into a Neogenix style place but ultimately stem cells are going to be much longer lasting than any PRP injection is going to be. If you have deteriorating OA in your knee you should go see an orthopedic PT and go from there.
I am an orthopedic PT and I see twenty plus cases of knee OA every week. While I can't help all of them, I can make a difference in a lot of them. Also while an MRI is beneficial a plain X-ray is all you need to determine extent of OA. Unless you have some meniscal issue as well. If you have a meniscus tear PRP could help but also depends soley on the type of tear you have and the location of that tear. Blood flow in the menisci are not great and that's why most of them get debrided vs repaired.
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u/Dependent_Squash1602
VISN8 nfl offers it
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u/Admirable-Mud-3477
Stem cell therapy for arthritis in Mexico. The VA does a disservice to veterans loading them up with pills when there are extremely effective treatments that actually help you live a life free of pain. But we gotta travel outside of the U.S., spend countless hours doing research to find to best doctors and the best treatments abroad, and pay out of pocket, which compared to the US, everything is so much lower in costs. If not Mexico due to the current conflict, I highly recommend you do research on stem cell therapy in another country (Columbia, etc). Living in pain is just asking the VA for more medicine that doesn’t help you in the long run. Sadly.