Financial Considerations | Overview
The transplant process requires detailed financial planning, and our financial coordinators are available to help.
Many insurance companies require prior notification for all transplant services. Some of the charges to expect include:
- the evaluation process
- hospital stay
- follow-up care
Be sure to contact your insurance company about your child’s transplant. The insurance company will determine your individual coverage and benefits. You will be responsible for all co-pays and deductibles after charges have been processed. Assistance is available for families who cannot afford these out-of-pocket costs.
Our financial coordinators will work with your insurance company to get prior authorization for transplant care, will appeal any denials if turned down for the procedure, identify additional financial resources, navigate expenses, denied services, or general financial questions. Assistance is available if you have no insurance or limited benefits for transplantation.
Call one of our financial coordinators before your child’s evaluation if you:
- have any questions regarding your insurance
- do not have insurance
- do not have benefits for transplantation
- are denied coverage for a transplant
- anticipate your insurance will be changing during the process
For kidney and heart concerns, please call 617-355-8319. For lung, liver, and intestine concerns, please call 617-355-0137.
Medicare and Medicaid
Kidney transplant patients are automatically eligible for Medicare coverage. For patients who already have private insurance, Medicare becomes primary coverage 30 months post-transplant. Medicare Part A covers inpatient admission costs, and Part B covers 80 percent of charges that include outpatient clinic.
Medicaid may be an option for certain families with limited resources. Medicaid coverage is based on family household income, so some families who don't meet the program's income requirements may still be eligible for transplant coverage. Please contact your local welfare office to see what type of Medicaid category you may fall under.
Social Security income
If you're eligible, Social Security income can pick up out-of-pocket costs after Medicare payment; we can assist you in the application process and determining your eligibility. The Social Security information line can be reached at 800-772-1213. Find information online at ssa.gov.
Many local and national organizations provide information, support, and financial assistance to transplant recipients. Many pharmaceutical companies also help with medications.
Please contact your program’s social worker directly if you have questions related to these resources. Note: This list is not an endorsement of services.
General assistance programs
- Healthwell Foundation
- The Massachusetts Rehabilitation Commission
- Children's Organ Transplant Association
- National Living Donor Assistance Center
- National Transplant Assistance Fund & Catastrophic Injury Program: 800-642-8399
- Needy Meds
- Patient Access Network Foundation
Medication-specific assistance programs
- CellCept Medical Needs Program: 866-247-5084
- AbbVie Patient Assist (Gengraf): 800-222-6885
- Amgen (Aranesp, Epogen): 800-675-8416
- Novartis Patient Assistance Program (Neoral): 800-257-3273
- Prograf Patient Assistance Program: 800-477-6472
- RapAssist Patient Assistance (Rapamune): 877-472-7268 or 800-378-7645