Medicare covers pancreas transplants under certain conditions. If you have
End-Stage Renal Disease (ESRD) and need a pancreas transplant, Medicare covers the transplant if one of these applies:
- It's done at the same time you get a kidney transplant.
- It's done after a kidney transplant.
In some cases Medicare may also cover a pancreas transplant even if you don't need a kidney transplant.
Your costs in Original Medicare
- 20% of the Medicare-approved amount for doctors' services.
- Various amounts for transplant facility charges.
- Nothing for Medicare-approved laboratory tests.
Things to know
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.