HomePlanDoes Health Insurance Cover Transplants

Does Health Insurance Cover Transplants

Who Can Be An Organ Donor

Does Medicare Cover Dental Implants Video

Most people can be organ donors. If you are interested in donating an organ, contact the United Network for Organ Sharing at 1-888-894-6361 or go online at www.unos.org to get more information and to locate the nearest transplant center.

Many people choose to donate an organ upon their death. But a person can donate certain organs while he or she is still living. These people are called “living donors.”

Plan For What Youll Have To Pay

After you learn about your insurance coverage, you will have a better idea of the transplant costs you will have to pay, so you can make a plan. There are some financial assistance grants that you may qualify for. Its also a good idea to consider fundraising.

If youre worried about how much money youll have to pay, talk to your transplant center team about your concerns. You can also call or email the Be The Match Patient Support Center for help.


How To Pay For An Organ Transplant

Surgery can be very expensive and organ transplant surgery is among the most costly procedures. For people facing an expensive procedure, whether or not it’s a transplant, you may need to raise funds in advance for treatment.

The initial testing required for a patient to be placed on a waiting list for a transplant or to be cleared for surgery can alone cost tens of thousands of dollars, even if the patient is not hospitalized during the process.

It is not uncommon for the cost of major surgery and subsequent extended hospitalization to result in a bill that exceeds $500,000. Unfortunately, the expenses do not end with surgery the cost of medications in the year after surgery can be thousands of dollars a month.

Ideally, a patient will have primary insurance to pay the majority of the expenses and a secondary form of insurance to pay the remaining expenses.

Even with excellent insurance coverage that pays 80% of the total bill, the remaining 20% can exceed $100,000 from the surgery alone. With secondary or supplemental insurance coverage, the remaining 20% may be paid by the insurance company rather than the patient.

You May Like: Can I Buy Health Insurance Outside Of Open Enrollment

Treatment Options And Coverages:

Scleral Contact Lenses: These specialty contact lenses are the best way to maximize vision in cases of keratoconus and other corneal disorders. Most health insurance plans do not cover scleral contact lenses but Vision Service Plan and EyeMed will usually cover most of the cost of scleral lenses when prescribed for keratoconus and other corneal disorders. Care Credit, HSA, and FSA funds can be used for any out of pocket costs for scleral contact lenses

Glasses and Standard Contact Lenses for Keratoconus: Standard health insurance rarely cover glasses or contact lenses for any eye condition medically necessary or not. Vision insurance plans will often pay for some of the costs of eyeglasses and standard contact lenses however these options are rarely effective for keratoconus. Rigid gas permeable contact lenses are usually not covered by standard health insurance but are sometimes covered by vision insurance plans.

Corneal Crosslinking: Unfortunately, crosslinking is not covered by most health insurance at this time, but coverage is currently being debated. This is ironic as crosslinking can be very beneficial in stabilizing keratoconus and avoiding the much more expensive corneal transplant which is covered by most health insurances. VSP and EyeMed do not cover corneal crosslinking but Care Credit, HSA and FSA can be used for these procedures.

Please refer to our treatments tab for full descriptions of treatment options:

Fortunately Where There Is A Problem There Is A Solution

Twofold Benefits of Organ transplants in Health Insurance

The fact that donors might have to cover the cost on their own is a major deterrent. It is one of the major reasons why donors do not come forward, and as a result many individuals fail to get help in time. The organ donor cover can be a blessing in such instances. This benefit covers the medical and surgical expenses of the organ donor when harvesting a major organ transplant for the insured. It ensures that expenses of the donor are covered, and the insured gets the organ that is required in time, and without any unwanted complications!

Don’t Miss: Where To Go To Apply For Health Insurance

Experimental And Investigative Procedures

If your transplant center asks you to be involved in any experimental procedures or studies, be sure to ask your center or insurance company if your insurance policy will cover the payment. It is important to know that you do not have to agree to be involved in any experimental procedures or investigational studies. If you still have questions, contact your employers benefits office or your state insurance commissioner.

I Have An Employer Group Health Plan

  • If you are eligible for Medicare, your EGHP will be your primary insurance for 30 months after starting dialysis or having a kidney transplant. This is called a coordination period. After 30 months, your EGHP will become your secondary insurance and Medicare will become primary.
  • When should I apply for Medicare?

    You can apply for Medicare when you first start dialysis or wait and apply closer to the end of the 30-month coordination period. Once you apply you will be responsible for the monthly Part B premiums.

    If you are planning to have a transplant and want Medicare to help pay for your immunosuppressant medications you will need to apply for Medicare part A and B when you become eligible.

  • Insurance Choices for Dialysis and Transplant Patients with Private Insurance

Recommended Reading: How Much Does Private Health Insurance Cost In California

Organ Donation Health Insurance Claim Case Study

Mr. H suffered from chronic liver failure and was advised to undergo liver transplant surgery. He had to wait for some time before the right donor was available but was lucky enough to soon find a candidate. The liver transplant went successfully, and now was the time to file the health insurance claim. The overall cost of a liver transplant was around Rs. 25,00,000, which Mr. H paid and then filed a claim for reimbursement.

The insurance company approved the claim for liver transplant under the ‘Donor Expenses’ cover of Mr. H’s Group Health Insurance policy as the following conditions were met.

  • The original claim for Mr. H’s condition – Cirrhosis was approved

  • Organ donation was in accordance with the Transplantation of Human Organs Act, 1994.

  • The transplant took place under the medical advice of the treating medical practitioner.

The claim of Rs. 25,00,000 was partially admissible as the insurance company rejected the cost of medical screening of the donor under the exclusions of the policy. However, a significant part of the liver transplant expense was borne by Mr. H’s health insurance company, greatly reducing his financial burden.

About Organ Transplant Expenses Cover In Health Insurance

Dental Implants 3 – Gundersen Health – Are implants covered by insurance?

Organ transplant requires a large amount of money just for performing the surgery. Next comes the hospital stay and follow-up procedures. The overall costs mount up to lakhs of rupees. These expenses can be covered under health insurance if you have the right plan. The related expenses can be covered under the donees health insurance policy.

You May Like: How Do I Know Which Health Insurance I Have

Tips For Talking To Your Insurance Company

  • Ask to talk to a case manager from your insurance company. Write down their name and phone number. Take notes about what you discuss, including the date of your conversation.
  • Ask for a copy of your health insurance policy and for information about how much your insurance pays for transplant.
  • You may want to ask these questions:
  • Does my health plan pay for transplant for my specific disease?
  • Does my health plan pay for the donor search?
  • Does my health plan pay for finding and shipping cord blood?
  • Does my health plan cover all parts of the transplant process? If not, what doesnt it cover?
  • Does my health plan pay for all of the prescription medicines I will need before and after a transplant?
  • Does my health plan require use of a special pharmacy company or store?
  • What is my maximum out-of-pocket cost?
  • Does this include prescription medicines?
  • Does my health plan provide travel or lodging benefits for me or for my caregiver?
  • If you have not chosen a transplant center yet, here are some more questions to ask your insurance company:
  • Do I have a case manager assigned to help me?
  • Where can I find a list of in-network transplant centers?
  • If I dont have a transplant center in-network, does my plan provide any coverage for me at an out-of-network transplant center?
  • How Do I Prepare Myself Financially For My Upcoming Bone Marrow Transplant

    If you have been approved for a bone marrow transplant, you will need to prepare yourself financially and clarify your insurance coverage while you wait for your transplant.

    A transplant financial counselor is available to answer your questions and concerns.

    The following questions will help you sort out your insurance coverage and will help you plan for the expenses of transplantation.

    Questions for your insurance company:

    Questions for your transplant financial counselor:

    • What financial coverage is accepted by the hospital ?
    • How much will the transplant cost? How much will I have to pay?
    • Should I inform you if I am an active or retired veteran?

    Don’t Miss: How To Sign Up For Health Insurance

    Does Health Insurance Cover Hair Transplants Surgery

    It is important that you understand your health insurance policy in detail. Every policy is different however, many policies make you pay a limited amount periodically and will only cover a portion of whatever treatment you require. The insurance company covers expenses of any kind related to unforeseen illness or health-related issues. However, these normal health insurance policies do not cover health-related aspects which are not that life-threatening. This includes elective and cosmetic procedures such as hair transplant surgery. Hair loss May affect men and women psychologically however, there are no real health problems associated with normal thinning hair and balding due to androgenetic alopecia.

    However, as previously mentioned, if hair loss is a result of a burn or another life threatening illness or injury, how is insurance companies may cover treatments in these unusual, rare cases. This includes surgical hair restoration. You are advised to speak with a representative from your health insurance company and consult a recommended hair restoration doctor for more information.

    Will My Insurance Cover A Transplant

    Does Dental Insurance Cover the Cost of Dental Implants ...

    Planning ahead and being well informed will help a patient to maximize their coverage for transplant services. Often there are limitations or exclusions for certain services. Patients should discuss their coverage for transplant services with their insurance company.

    Note: The information on this page is intended to assist patients in understanding some basic insurance information as it relates to transplantation. This website is not intended to cover all aspects of insurance requirements for transplantation, but to provide a helpful overview of things to consider.

    Financial Coordinators begin working with the patient and the insurance company during the pre-transplant evaluation phase to verify patient coverage. Transplantation is a very complex and costly treatment for organ failure. It is important for each patient to understand their coverage, their potential out of pocket expenses, and have a long term plan to cover transplant services.

    While patients may have adequate health insurance coverage, there may be services their insurance will not cover, such as:

    • Transportation to and from the transplant center for frequent follow-up visits
    • Temporary lodging and meals for family members during and after the transplant
    • Parking fees for visits to the transplant center
    • Insurance premiums, co-pays, and deductible amounts
    • Possible loss of income while out of work for the transplant
    • Child care

    Also Check: Does Farmers Insurance Sell Health Insurance

    Organ Donation Facts In India

    Here are some facts and figures related to organ donation in India.

    • Only 0.01 per cent of Indian people donate organs after death as per the WHO

    • Religious beliefs, superstitions, and lack of awareness are major reasons behind the low number of organ donation

    • Around 2 lakh people need corneal donation each year in India, according to Organ India. However, only 25% of the requirement is fulfilled.

    • More than 5 lakh people need organ transplants each year, but most of them die due to a lack of donors

    • Of total deaths in 2017, only 0.0009% of people donated their organs

    • Roughly for every 160,000 patients, only 12,000 donors are present

    Avoiding A Cheap Alternative

    Genetics, medical conditions, trauma, and injuries can affect the shape and thickness of a mans beard. There are treatments available at drugstores and online claiming to improve facial hair growth, but unfortunately, these treatments often provide minimal to no results. If results do occur, they are usually temporary and typically appear unnatural.

    Beard transplants are the only reliable method for permanent, natural-looking facial hair growth. Beard transplantation transforms a mans face to create a more masculine and healthy appearance. The treatment with a qualified surgeon may appear costly when you first look at average prices but beware of cheap alternatives.

    Underqualified doctors offer dangerous treatments claiming to be effective for hair restoration. Creams and complicated processes like a flap and free-form flap, linear or line grafts, round or square grafts, and hair lifts may create lasting side effects, which cost far more in the long run. Webmd.com explains risky hair-loss procedures and the dangers they pose, including visible scars and additional hair loss.

    The results and benefits of a beard transplant with a hair transplant specialist are permanent. The hair is taken from the scalps base using FUE technology and is transplanted to the beard, mustache, or sideburns. The surgeon strategically locates each hair follicle group to add fullness, conceal scars, fill in patchy areas, and redefine the shape.

    You May Like: How To Retire Early And Afford Health Insurance

    Okay But What About The Donor

    With an organ bank, this question does not arise. However, if a live donor is involved then there might be some complications. First, the donors health insurance policy might not cover his/her expenses. This is because providing an organ to someone else is not considered as a required medical procedure, and therefore the expenses incurred are not covered. Moreover, the receivers insurance only covers the policyholder, and not a third party.

    How The Policy Works

    Does dental insurance cover dental implants? | Dr. Ron Receveur, New Albany Implants

    Let us assume that you are an insured recipient in the hospital awaiting a kidney transplant, and your friend is the kidney donor. The policy will not only cover all your costs, including medical, surgical, and pre-and post-hospitalization expenses, it will also cover the expenses for your friends surgery and organ storage. While the health policy will completely cover your treatment expenses up to the sum insured, the coverage for your friends expenses can vary from insurer to insurer.

    Indraneel Chatterjee, co-founder, RenewBuy, an insurtech firm, said, Most health insurers cover organ transplants as part of their regular health insurance policies. Some also cover the organ donors expenses. The most commonly transplanted organs are kidney, lung, heart and liver. The cost of these can range from 5 lakh to 35 lakh.”

    Adding to it, Amit Chhabra, head – health insurance, Policybazaar.com, said the approximate package for a heart transplant costs 6 lakh to 10 lakh, and the figure for a liver transplant can range from 24 lakh to 28 lakh.

    Taking these alarming costs into account, some Indian insurers have taken the initiative to provide policyholders with an in-built cover for organ donor expenses,” said Chhabra.

    You May Like: How Much Does A Family Health Insurance Plan Cost

    Expenses In Organ Transplantation:

    Most insurers with organ donation cover will only cover the cost of hospitalization, which would work out to about 10% of the total expenditure involved in an organ transplant.

    Here are some of the broad headings under which youll be spending:

  • Organ screening. Before a person can be hospitalized for the purpose of an organ transplant, the right organ must be found. There are many factors involved in finding the right organ to replace the malfunctioning one, and finding the right donor is expensive.
  • Pre-hospitalization expenses. After finding the right organ to transplant from the right donor, the person undergoing the surgery will need to be brought to the right medical condition with drugs and pre-surgery preparation.
  • Hospitalization charges. These include the room charges, nurse and doctors fees, etc.
  • Organ transplant surgery. The complicated and risky process of actually transplanting an organ between the donor and recipient.
  • Post-surgery hospitalization, monitoring. After the surgery, its not like the recipient can just pick up his bag and leave the hospital. He or she will be monitored under various situations and the stability of the organ will be judged, in order for the patient to live a normal life.
  • There are a few companies that cover more than one of the above expenses. Star Health and Max Bupa cover the actual cost of the surgery in addition to hospitalization, but ICICI Lombard, HDFC Ergo and Apllo Munich have avoided the coverage of this huge expense.

    Does Health Insurance Cover Hair Transplant

    Looking for does health insurance cover hair transplant? Get direct access to does health insurance cover hair transplant through official links provided below.

    Follow these easy steps:

    • Step 1. Go to does health insurance cover hair transplant page via official link below.
    • Step 2. Find the official insurance at the bottom of the website.
    • Step 3. If you still cant access does health insurance cover hair transplant please leave a message below .

    Health insurance is by far the most popular form of this service and for a good reason. Our health is always our priority, but while health insurance will either pay for our medical service or reimburse us the money we pay, it doesnt cover every medical situation. Does health insurance cover hair transplants? Well, in most cases, it does not.

    The insurance company covers expenses of any kind related to unforeseen illness or health-related issues. However, these normal health insurance policies do not cover health-related aspects which are not that life-threatening. This includes elective and cosmetic procedures such as hair transplant surgery.

    Don’t Miss: How Does Short Term Health Insurance Work

    Popular Articles

    explore more