Organ transplants
Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) each cover different parts of the care you need for an organ transplant
Description
An organ transplant is a type of surgery that puts someone else’s healthy organ into your body.
Coverage details
Medicare Part A (Hospital Insurance) covers necessary tests, labs, and exams, and generally also covers:
- Services for heart, lung, kidney, pancreas, intestine, and liver transplants.
- The costs of finding the proper organ for your transplant surgery.
Medicare Part B (Medical Insurance ) covers:
- Doctors’ services associated with heart, lung, kidney, pancreas, intestine, and liver transplants.
- Immunosuppressive (transplant) drugs in certain circumstances.
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 .
Costs
For your transplant and related services, you pay:
- 20% of the Medicare-approved amount for Part B services after you meet the Part B deductible .
- Nothing for the services provided to the donor for a kidney transplant.
- Nothing for Medicare-certified laboratory tests.
Medicare doesn’t pay for transportation to a transplant facility.
Facility
You must get an organ transplant in a Medicare-approved facility.