Organ Transplant Insurance Coverage

covers doctor services for certain organ transplants.

covers these organ transplants under certain conditions at Medicare-certified facilities:

Heart
Lung
Kidney
Pancreas
Intestine
Liver

Part A also covers some stem cell transplants under certain conditions. Part B covers cornea transplants, under some conditions. Stem cell and cornea transplants aren't limited to Medicare-approved transplant centers.

Organ transplant coverage includes:

Necessary tests, labs, and exams before surgery
Transplant drugs also called immunosuppressive drugs (under certain conditions)
Follow-up care
Procurement of organs

Your costs in Original Medicare

You pay:

20% of the Medicare-approved amount for your doctor's services, and the Part B Deductible [glossary] applies.

Various amounts for organ transplant facility charges.
Nothing for a living donor for a kidney transplant.
Nothing for Medicare-certified laboratory tests.

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
Whether your doctor accepts assignment
The type of facility
Where you get your test, item, or service

Things to know

Transplants must be performed in Medicare-approved facilities to qualify for organ transplant coverage. Stem cell and cornea transplants aren’t limited to Medicare-approved transplant centers.

If you have a problem with the care that you’re getting for your transplant or with getting a referral for a transplant work-up, you have the right to file a complaint (grievance).

Related resources

Organ transplants

Organ transplants

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