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Organ transplants

Medicare Part A (Hospital Insurance)  covers:

  • Necessary tests, labs, and exams

Generally, Part A also covers:

  • Services for heart, lung, kidney, pancreas, intestine, and liver organ transplants
  • Immunosuppressive (transplant) drugs, follow-up care, and procurement of organs
  • Stem cell transplants

  Medicare Part B (Medical Insurance) covers:

  • Doctors’ services associated with heart, lung, kidney, pancreas, intestine, and liver organ transplants 

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

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

Your costs in Original Medicare

For your transplant and related services, you pay:

  • 20% of the  Medicare-Approved Amount  for your doctor's services after you meet the Part B deductible .
  • Various costs for transplant facility charges.
  • Nothing to the living donor for a kidney transplant.
  • Nothing for Medicare-certified laboratory tests. 

In 2023, you’ll pay a monthly premium of $97.10* and a $226 deductible if you sign up for the immunosuppressive drug benefit. Once you’ve met the deductible, you’ll pay 20% of the Medicare-approved amount for your immunosuppressive drugs.

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

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

Things to know

  • You must get an organ transplant in a Medicare-approved facility. 
  • If you’re thinking about joining a Medicare Advantage Plan and are on a transplant waiting list or think you need a transplant, check with the plan before you join to make sure your doctors, other health care providers, and hospitals are in the plan’s network. Also, check the plan’s coverage rules for prior authorization.
     

Related resources

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