Kidney transplants (children)

Part A usually covers these transplant services: 

  • Inpatient services in a Medicare-certified hospital 
  • Kidney registry fee 
  • Laboratory and other tests to evaluate your child’s medical condition and the condition of potential kidney donors 
  • The costs of finding the proper kidney for your child’s transplant surgery (if there's no kidney donor)
  • The full cost of care for your child’s kidney donor (including care before, during, and after the surgery)
  • Any additional hospital care for your child's donor, in case of problems due to the surgery
  • Blood (if a transfusion is needed)

Part B helps pay for these transplant services: 

  • Doctors’ services for kidney transplant surgery (including care before, during, and after the surgery)
  • Doctors’ services for your child's kidney donor during their hospital stay 
  • Blood (if a transfusion is needed)

Part B also covers immunosuppressive 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 continue to pay for immunosuppressive drugs beyond 36 months, if your child doesn’t have certain other health coverage. This benefit only covers immunosuppressive drugs and no other items or services. It isn’t a substitute for full health coverage. To sign up, call Social Security at 1-877-465-0355.

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

Your costs in Original Medicare

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).