Financial Resources
Financial Planning
Transplantation involves costs before, during, and after
the actual transplant surgery. Costs include laboratory tests;
transplant surgeons and other operating room personnel; organ
procurement; inhospital stay; transportation to and from the
transplant hospital for surgery and for checkups; rehabilitation,
including physical or occupational therapy; and medications,
including immunosuppressive or antirejection drugs, which
may cost up to $2,500 per month. The average cost of transplantation
in 2005 ranged from $210,000 for a single kidney to over $800,000
for multiorgan transplants such as liver-pancreas-intestine.
Planning for transplant surgery requires financial planning.
Health insurance may cover some or most of these costs, but
insurance policies vary widely. You should call your insurance
company or your employer’s benefits office to get detailed
information about how your insurance company handles the costs
related to your specific situation. For a list of essential
questions to ask your insurance company visit transplantliving.org
 .
In general, you are responsible for any costs not covered
by insurance. You need to think about what resources you will
use to pay the costs not covered by insurance. These resources
may include savings, sale of property, or other sources. Fortunately,
you do not need to face these decisions alone. Members of
the transplant team, such as the transplant center’s
social worker and financial coordinator (discussed below),
can help you develop a financial plan and may be able to put
you in touch with organizations that give financial assistance
to transplant recipients.
Medicare and Medicaid Services in Transplantation
Medicare is a Federal program, and Medicaid is operated by
individual States. Both are health insurance programs that
can help eligible people pay for the costs of transplantation.
Medicare is available for people age 65 or older, people
who have certain disabilities, or people who have end-stage
renal disease (ESRD). The Medicare Part A insurance plan is
available free to those who qualify and covers inpatient hospital
care and some nursing home care. People who wish to participate
in the Medicare Part B insurance plan pay premiums; Part B
covers outpatient care, doctor bills, some home health care,
and prescription medicines including, in some cases, immunosuppressive
(antirejection) drugs. Medicare certifies transplant programs
throughout the country, and you must use a Medicare-approved
transplant facility in order to receive full Medicare benefits.
To find out more about Medicare-approved transplant centers
or Medicare benefits for transplantation, visit the Medicare
website or contact your local Social
Security office.
Medicaid is an insurance program for low-income persons and
is funded jointly by the Federal Government and the States.
States determine who is eligible and what benefits and services
are covered. Some States’ Medicaid plans cover only
transplant procedures performed within the State (unless there
is no transplant center for that organ in the State). Some
States’ Medicaid programs do not cover transplantation.
For more information on Medicaid, contact your financial coordinator,
local Social Security office, the Social Security information
line at 800-772-1213 or the financial coordinator at your
transplant center.
Know Your Financial Coordinator
The financial coordinator at the transplant center is a member
of the transplant team. Financial coordinators have detailed
information and experience with health care financing and
hospital billing. It is helpful to speak with the financial
coordinator before making financial decisions related to your
transplant and to keep the coordinator up to date as your
financial plans evolve. The financial coordinator can help
you
- Understand how your insurance company’s benefits
apply to transplant surgery;
- Make a financial plan for paying for your transplant;
- Make a financial plan for nonmedical (for example, living
expenses) costs;
- Locate additional sources of funding, if necessary; and
- Understand (and, if necessary, correct) bills from hospitals,
doctors, pharmacies, and other providers.
Important questions to ask the financial coordinator are
on pages 23-38 of What
Every Patient Needs to Know and
at transplantliving.org
Learn More
More detailed information on finding financial resources
for a transplant may be found at:
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