What is Transplant Insurance?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 22 May 2020
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Transplant insurance is health care insurance specifically covering costs associated with organ transplants. Some insurance plans have transplant coverage included, while in others, it may need to be purchased as a rider or separate policy. The exact nature of what is covered, along with the total limit on coverage, can vary. People concerned about the costs of organ transplants should investigate their insurance policies thoroughly to understand whether they are covered and how much coverage is provided.

Organ transplants can be quite costly. Costs include everything from blood testing to match tissue and blood types to the funds needed to pay for rejection drugs in the long term. The transplant surgery itself can be quite expensive, and there may be costs for securing and transporting the organ, as well as other matters. Transplant insurance usually carries a lifetime cap, not providing payment for costs above that cap. The higher the cap, the more expensive the coverage.

Some coverage is narrow, focused on costs like transplant surgery and hospitalization. This transplant insurance may not address the expensive drugs needed to prevent rejection, along with costs like housing and food while waiting for a donor organ, a common expense for people who are obliged to travel to a facility to wait once they become eligible for transplants. Costs associated with preparation may not be covered either.

Transplant insurance may provide complete coverage or have a deductible, depending on the structure of the plan. The features of the plan should be carefully evaluated when making a purchasing decision, and it is advisable to get competitive quotes from other insurers. People may also want to ask about discounted bundle pricing; an insurance company may offer lower prices for package insurance, including transplant insurance. Things like adjusting the deductible or lifetime cap can have a radical impact on the premium cost for transplant insurance.

Once someone is waiting for transplant, it can be harder to get transplant insurance. Insurance companies are more likely to provide low-cost, broad-coverage insurance to people who appear to be at a low risk for needing transplants. Thus, a healthy 25-year-old with no family history of medical problems resulting in transplant can usually pick from an array of plans, while a 40-year-old waiting for a donor kidney has fewer options. For this reason, it is advisable to purchase insurance ahead of time to make sure it will be available when it is needed.

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