If you or a loved one needs an organ transplant, understanding Medicare coverage is crucial. Organ transplants can be lifesaving but come with significant medical costs. The good news is that Medicare does cover organ transplants, including surgery, hospital stays, and post-transplant care. However, coverage details depend on the type of Medicare plan you have.
Skyline Benefit is a trusted Medicare insurance broker, We help you understand what Medicare covers for organ transplants in 2025, including costs, eligibility, and important considerations before your procedure.
Does Medicare Cover Organ Transplants?
Yes, Medicare covers organ transplants if they are medically necessary and performed at a Medicare-approved transplant facility. Coverage is provided under both Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
What Types of Organ Transplants Does Medicare Cover?
- Heart transplant
- Lung transplant
- Kidney transplant
- Pancreas transplant
- Liver transplant
- Intestine transplant
Medicare does not cover experimental or elective transplants that are not considered medically necessary.
Medicare Part A: What’s Covered?
Part A covers hospital-related costs, including:
- Hospital stay for transplant surgery
- Pre-transplant tests and lab work
- Surgical costs for removing and implanting the organ
- Care for the organ donor (if it’s a kidney transplant)
- Post-surgical hospital care
What You Pay Under Part A:
- Medicare Part A deductible applies ($1,676 in 2025)
- After the deductible, Medicare covers 100% of inpatient hospital care for up to 60 days
- Beyond 60 days, daily copayments apply
Medicare Part B: What’s Covered?
Medicare Part B covers doctor-related and outpatient services needed for your transplant, including:
- Surgeon and physician fees
- Medical tests and imaging
- Follow-up care after the transplant
- Immunosuppressive drugs (in some cases)
What You Pay Under Part B:
- You must meet the Medicare Part B deductible ($257 in 2025)
- After the deductible, you pay 20% of Medicare-approved costs
Does Medicare Cover Immunosuppressive Drugs After a Transplant?
After an organ transplant, you’ll need immunosuppressive drugs (anti-rejection medication) to help your body accept the new organ.
- If you had Medicare at the time of the transplant, Part B covers your immunosuppressive drugs.
- If you didn’t have Medicare when you got the transplant, Medicare won’t cover these drugs.
- If you lose Medicare coverage after a transplant, you may qualify for Medicare’s limited immunosuppressive drug benefit to continue coverage for these medications.
Are There Any Costs for the Organ Donor?
For a kidney transplant, Medicare covers 100% of the costs for the donor’s hospital stay and surgery. However, Medicare does not cover donor costs for other types of transplants.
What Costs Does Medicare NOT Cover for Organ Transplants?
- Transportation to a transplant facility
- Lodging and meals for family or caregivers
- Experimental or non-approved transplants
- Post-transplant medications if you weren’t on Medicare at the time of surgery
For additional coverage, some people enroll in a Medigap (Medicare Supplement) plan or Medicare Part D (Prescription Drug Plan) to help with medication costs.
Need Help with Medicare and Organ Transplant Coverage iin 2025?
Skyline Benefit is an independent Medicare insurance broker in California specializing in affordable and flexible Medicare options. Understanding Medicare coverage for an organ transplant can be overwhelming. Skyline Benefit specializes in helping individuals find the right Medicare plan for their needs.
Schedule a consultation today. Call us at: (714) 888-5112