Pancreas transplants

Pancreas transplants

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 cover a pancreas transplant even if you don't need a kidney transplant. 

 

Medicare Part B (Medical Insurance)

 will pay for your transplant drugs (also called immunosuppressive drugs) with no time limit if either of these apply:

  • You were entitled to Medicare because of age or disability.
  • You became eligible for Medicare because of age or disability after getting a transplant.

Part B will only pay for your transplant drug therapy for 36 months after the month of the kidney transplant if both of these apply:

  • You're entitled to Medicare only because of permanent kidney failure.
  • You have the pancreas transplant after the kidney transplant.

This is because your Medicare coverage will end 36 months after a successful kidney transplant if you only have Medicare due to permanent kidney failure.

Your costs in Original Medicare

You pay:

  • 20% of the Medicare-approved amount for doctors' services.
  • Various amounts for transplant facility charges. You pay nothing for a living donor for a kidney transplant.
  • Nothing for Medicare-approved laboratory tests. 

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

Note

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).

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