Medicare.gov

Kidney transplants (children)

Part A usually covers these transplant services: 

  • Inpatient services in an approved hospital 
  • Kidney registry fee 
  • Laboratory and other tests to evaluate your child’s medical condition and the condition of possible kidney donors 
  • The costs of finding the proper kidney for your child’s transplant surgery
  • The full cost of care for your child’s kidney donor 
  • Blood (if a transfusion is needed)

Part B covers these transplant services: 

  • Doctors’ services for kidney transplant surgery
  • Doctors’ services for the kidney donor during their hospital stay 
  • Blood (if a transfusion is needed)

Part B also covers immunosuppressive drugs (transplant drugs) if Medicare paid for the transplant. Your child must have Part A at the time of the covered transplant, and must have Part B at the time they get immunosuppressive drugs.

If your child has Medicare because of End-Stage Renal Disease (ESRD), their Medicare coverage, including immunosuppressive drug coverage, ends 36 months after a successful kidney transplant. Medicare offers a benefit that may help, if your child loses Part A coverage 36 months after a kidney transplant, and doesn’t have certain other health coverage (like a group health plan, TRICARE, or Medicaid that covers immunosuppressive drugs). This benefit only covers immunosuppressive drugs and no other items or services. It isn’t a substitute for full health coverage. If your child qualifies, you can sign them up for this benefit any time after their Part A coverage ends. To sign up, call Social Security at 1-877-465-0355. TTY users can call 1-800-325-0788.

Important: Find out if your child is eligible for Medicare.

Your costs in Original Medicare

  • Inpatient hospital services — Part A usually pays for these services after you pay a one-time yearly deductible. 
  • Doctor's services — Part B usually pays 80% of the Medicare-approved amount, after you pay the Part B yearly deductible [glossary] . You pay the remaining 20% coinsurance .
  • For Part B-covered dialysis services, your costs will vary based on your child’s age and dialysis type. 
  • If your child has other insurance, your costs may be different.
  • In 2023, you’ll pay a monthly premium of $97.10* and a $226 deductible if you sign your child up for the immunosuppressive drug benefit. Once you’ve met the deductible, you’ll pay 20% of the Medicare-approved amount for their immunosuppressive drugs.

*You may pay a higher premium based on your income.

If your child has ESRD, you can choose either Original Medicare or a Medicare Advantage Plan when deciding how to get Medicare coverage. If your child is in a Medicare Advantage Plan, what you pay may be different. Learn more about Medicare Advantage Plans if your child has ESRD.

Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • If your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and if, or how much, Medicare will pay for them.

Things to know

Medicare will cover your child’s kidney transplant only if it’s done in a hospital that’s Medicare-certified to do kidney transplants. 

Note

If you have a problem finding a dialysis facility that’s willing to take you as a patient, you have the right to file a complaint (grievance).

Related resources

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