Kidney transplants
and
cover the cost of different items and services related to kidney transplants.
Part A provides coverage for kidney transplant services and pays part of the costs for these:
- Inpatient services in a Medicare-certified hospital
- Kidney registry fee
- Laboratory and other tests needed to evaluate your medical condition and the medical condition of potential kidney donors
- Finding the proper kidney for your transplant surgery (if there's no kidney donor)
- The full cost of care for your kidney donor (including care before surgery, the actual surgery, and care after surgery)
- Any additional inpatient hospital care for your donor in case of problems due to the surgery
- Blood (whole units of packed red blood cells, blood components, and the cost of processing and giving you blood)
Part B provides coverage for kidney transplant services and pays part of the costs for these:
- Doctors' services for kidney transplant surgery (including care before surgery, the actual surgery, and care after surgery)
- Doctors' services for your kidney donor during their hospital stay
- Transplant drugs, also called immunosuppressive drugs (for a limited time after you leave the hospital following a transplant)
- Blood
Medicare will only pay for your kidney transplant drug therapy for 36 months after the month of the kidney transplant surgery if you're entitled to Medicare only because of permanent kidney failure.
This is because your Medicare kidney transplant coverage will end 36 months after a successful kidney transplant surgery if you only have Medicare due to permanent kidney failure.
Medicare will continue to pay for your transplant drugs (also called immunosuppressive drugs) with no time limit if either of these apply:
- You were already entitled to Medicare because of age or disability before you got .
- You became eligible for Medicare because of age or disability after getting a transplant.
You pay:
- 20% of the .
- Various amounts for transplant facility charges.
- Nothing for a living donor for a kidney transplant.
- Nothing for Medicare-approved laboratory tests.
These services are covered if they’re done by the Medicare-certified hospital where you’ll get your kidney transplant or another hospital that participates in Medicare.