A financial strategy critical to planning for an organ transplant

Planning for an organ transplant can be overwhelming for patients and their families. An essential part of any planning should also include a financial strategy. Transplant costs vary across the country, typically determined by the hospital and type of transplant. According to estimates from the United Network for Organ Sharing (UNOS), a heart transplant can cost over $900,000. A multiple organ transplant, such as a heart-lung procedure, can cost more than $1.1 million dollars.

Transplant costs generally fall into three categories: pre-surgery expenses, surgery costs and post-surgery care. These costs can be medical or non-medical in nature.

Medical costs include insurance deductibles, pre-transplant evaluation and testing, fees for donor organ recovery, anti-rejection drugs and post-surgery rehabilitation.

Non-medical costs can include food and lodging for the patient’s family, plane travel, child care and lost wages for the patient or family members.

Questions to ask
So how can patients and their families plan for transplant costs to alleviate some of the stress associated undertaking such a financial burden?

  •  It’s important for patients and families to work closely with their transplant financial coordinator to understand the full costs of the surgery, their individual responsibility, and how much their insurance will cover. Patients should be aware that if they have a living donor, all of these costs may differ.
  •  Talking to the health plan is essential to understand who will be responsible for specific costs. Patients should have a clear picture of how much their insurance will cover, inquire about pre-existing condition clauses or pre-authorization, and determine if their insurance will cover non-medical costs. Patients should also be aware of ensuing responsibilities should their insurance coverage runs out.
  •  There are other resources patients may be able to turn to for financial assistance, such as fundraising campaigns, Medicare or Medicaid, and charitable or advocacy organizations.

Meet Mary
Mary felt very apprehension when she found out she would need a bone marrow transplant. Her first thought was, “I just can’t do this.” But Karen, an Optum transplant solutions nurse case manager, assured Mary that she would be there to help her manage her transplant, including its financial aspects.

Watch Mary’s story here.


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