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How to Pay For an Organ Transplant Surgery

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Updated September 12, 2013

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Using Medicare and Medicaid to Pay for an Organ Transplant

Medicare

This type of government-funded insurance pays for transplants, but not everyone qualifies for coverage.

Patients over the age of 65, the disabled, and those who have been diagnosed with end stage renal disease (ESRD) qualify for Medicare. Additionally, patients may qualify if they or their spouse have paid into the Medicare system. The Medicare website www.medicare.gov provides detailed information about qualifying for coverage, and what coverage is available in each state.

Medicaid

Medicaid is government-sponsored insurance for low income patients that is administered by individual states. The coverage, as well as qualifications for coverage, can vary between states. The income limit to qualify varies based on the size of the family and income level, but a low income does not necessarily mean a patient will qualify for coverage.

If a patient does not qualify for Medicaid due to income level, he or she still may qualify for “spend down” Medicaid, which takes into account the amount of money being paid for health care. The financial planner at the transplant center should be able to help patients navigate dealing with the social security office that administers Medicaid.

Centers for Medicare and Medicaid Services Website

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