Is Kymriah Covered By Insurance Or Medicaid?

Are you or a loved one battling cancer and exploring Kymriah as a potential treatment option? If so, the cost of this innovative therapy may weigh heavily on your mind. Fortunately, insurance and Medicaid may provide coverage for eligible patients seeking this breakthrough CAR-T cell immunotherapy. Read on to learn more about Kymriah’s availability through insurance and Medicaid programs and how you can navigate the process of securing financial assistance for your treatment journey.

What is Kymriah?

Kymriah is a CAR-T cell therapy. It’s a type of immunotherapy that uses genetically modified T cells to attack cancer cells. Kymriah is used to treat certain types of leukemia and lymphoma.

Kymriah is a “living drug.” That means it’s made from your own T cells, which are collected and then modified in a lab. The modified T cells are then infused back into your body, where they multiply and start attacking the cancer cells.

Kymriah is the first FDA-approved CAR-T cell therapy. It was approved in 2017 for children and young adults up to 25 years old with acute lymphoblastic leukemia (ALL) that has not responded to other treatments, or has returned after treatment.

How Much Does Kymriah Cost?

Kymriah, a new CAR-T cell therapy for cancer, can cost up to $475,000. Most insurance companies cover the treatment, but some patients may have to pay out of pocket. Medicaid covers the treatment for eligible patients.

Does Insurance Cover Kymriah?

When it comes to Kymriah, insurance companies are still trying to catch up. This is because Kymriah is a new CAR-T cell therapy, and as such, it is not yet included in most insurance plans. That said, some insurers are beginning to offer coverage for Kymriah on a case-by-case basis. Medicaid plans also vary from state to state, but some do cover Kymriah treatments.

Does Medicaid Cover Kymriah?

Yes, Medicaid covers Kymriah. However, coverage and eligibility vary by state. Medicaid is a government-funded health insurance program that provides coverage to low-income individuals and families. Each state has its own Medicaid program with different eligibility requirements. To find out if your state Medicaid program covers Kymriah, contact your state Medicaid office or visit the Centers for Medicare & Medicaid Services website.

How to Pay for Kymriah If You Don’t Have Insurance

If you or a loved one has been diagnosed with cancer, you may be wondering if Kymriah is covered by insurance or Medicaid. Kymriah is a new, personalized cancer treatment that uses genetically-modified T cells to target and kill cancer cells. The treatment is very expensive, costing around $475,000 for a single treatment.

If you don’t have insurance or Medicaid, there are still ways to pay for Kymriah. The Novartis Access Assistance program can help patients in the United States who do not have insurance coverage or who are underinsured. The program provides financial assistance for up to $100,000 of the cost of treatment. Patients must meet certain eligibility requirements to qualify for the program.

There are also a number of charities and non-profit organizations that may be able to help cover the cost of Kymriah treatment. The National Cancer Institute’s Financial Assistance for Cancer Treatment program offers financial assistance for people with cancer who need help paying for their treatment. The Leukemia & Lymphoma Society’s Co-Pay Assistance Program (CAPP) provides financial assistance to eligible patients with leukemia, lymphoma or myelodysplastic syndromes (MDS) who need help paying for their health insurance co-pays and premiums.


Kymriah is a powerful and innovative new treatment for different types of cancer that is becoming more widely available. While it’s true that it can be costly, many insurance companies and Medicaid programs are offering coverage for the drug. Before committing to any course of action, patients should check with their respective health plan providers to determine if they will cover Kymriah or not. With this knowledge in hand, you can move forward with confidence in your choice of treatment.