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.
Your costs in Original Medicare
For your transplant and related services, you pay:
- 20% of the deductible . for your doctor's services after you meet the Part B
- 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.
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.