Getting Ready for an Organ Transplant
Handling the Financing of an Organ Transplant
Whatever the organ, transplants are expensive. For instance, the billed costs for a heart transplant in 2011 (including organ procurement, immunosuppressant drugs, and hospital admissions) was $997,700, according to the United Network for Organ Sharing (UNOS), a nonprofit national organization that administers the country's Organ Procurement and Transplantation Network. In the same year, billed costs for a kidney transplant were $262,900, while a combined heart-lung transplant cost just over $1.1 million.
Insurance coverage for an organ transplant varies widely. But one thing's nearly certain, says Marwan Abouljoud, MD, director of the Transplant Institute at Henry Ford Hospital System in Detroit: Most patients will have some issue about insurance.
Abouljoud counsels patients to work closely with their center's transplant team, particularly the social worker and financial coordinator, to figure out the funding sources.
Typically, the transplant center officials tell you what is covered by your insurance. You should also check directly with your insurer to confirm your plan's benefits and any steps you'll need to take to ensure you are covered. Once you find out what part of the bill insurance covers, talk with your transplant team about other possible sources of coverage to help pay for your care. Medicare, for instance, could be available to those who are disabled or who have end-stage kidney disease.
You can also check with your state's insurance commissioner to see if any plans might help out. For instance, certain people, even with pre-existing health conditions, can qualify for high-risk pools. Be aware that the premiums are higher than other plans and the coverage typically more limited. You can ask about guarantee issue plans, available in some states. These require insurers to offer coverage to individuals even with pre-existing conditions.
In addition to the direct medical costs, an organ transplant is associated with other expenses, such as lodging if you are traveling away from home to a transplant center, your lost wages if you have been working, airplane costs if you are traveling to a center, and extra child care fees if you have young children.