How Can The Personal Out-Of-Pocket Costs for Kidney Transplant Be Defrayed?

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Preparing and undergoing a Kidney Transplant is incredibly stressful for the patients and their family. But by planning for your part of the financial portion of your transplant procedure will be better able to focus on your recovery rather than worrying about the mounting out-of-pocket debt you will be facing. It is generally accepted that the medical costs for Kidney Transplant are extremely high. In fact, Kidney Transplants are typically the most expensive type of surgery performed. They are also the most common type of transplant since donors can be deceased or living. As a result, costs associated with Kidney Transplants tend to be fairly consistent Nationwide.

Recommended Reading: Why is a Significant Portion of the Dialysis Patient Community Refusing Kidney Transplantation? suggests that before your transplant, it is important that you work closely with your insurance company and Social Worker to clearly under the benefits that come with your specific plan. Ask you insurance company about: coverage, deductibles, co-payments, lifetime and annual maximum amounts for transplant services? If your plan is a Medicare supplement, does it cover Medicare parts A and B deductible and does it offer an option for Medicare Part D coverage?

Recommended Reading: CKD Community should support Medicare and Medicaid Drug Rebate

Even patients covered by health insurance, out-of-pocket costs for a kidney transplant typically consist of doctor visits, lab and prescription drug co-payments, as well as co-insurance of 10-50% for surgery and other procedures, which can easily reach the yearly out of pocket maximum. However, your health insurance will typically cover the Kidney Transplant itself. Bear in mind that afterward, it costs about 17,000.00 a year for anti-rejection drugs.

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The most common combination of anti-rejection drugs which are used for life, is Prograf which can cost $400.00-$2000.00 or more, depending on dose. Callcept costs more than $1000.00 and Prednisone costs $10.00 a month.
Again when you are contemplating kidney transplant surgery you need to be aware of the out-of-pocket expenses prior to embarking on your transplant journey such as:

  • Anti-rejection drugs
  • Food and lodging for you and your family if you need to travel to a center away from home. Some centers do have low cost hospitality housing for transplant patients and their families.
  • Transplantation to and from the transplant center before and after the transplant surgery, including plane fare if the center is a considerable distance from your home.
  • Child care, if needed
  • Lost wages if you work and are not covered by disability insurance or sick time from your employer or Social Security or those incurred by family members who take time off of work to be with you.

Recommended Reading: How to Deal with the High Priced Kidney Transplant Anti-Rejection Drugs

You should note that financial assistance is available for End-Stage Renal Failure (ESRD) patients. Those on dialysis of any age are eligible for Medicare, which might pay up to 80% of the costs of your transplant. However, Medicare covers only 36 months of anti-rejection drugs. The National Kidney and Urologic Diseases Information Clearinghouse offers information on Medicare and other financial resources such as HelpHOPELive which helps patients conduct community fundraising campaigns to pay for transplants. The organization will take a fee of 4%-7% for overhead purposes. Also, many hospitals give discounts of up to 30% or more to uninsured or cash-paying patients. For example, Washington Hospital Healthcare System in California offers a 35% discount. The Mayo Clinic has dedicated international patient account representatives who can assist you with questions regarding your costs and insurance.

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"Kidney Transplant Cost." CostHelper: What People Are Paying

"Kidney Transplant: Costs and Insurance Information." Mayo Clinic.  

"How Much Does a Kidney Transplant Cost?" How Much Does It Cost Me?: Use Our Cost and Price Research to Help Guide You before You Buy.