1 Johns Hopkins Medicine. Liver transplant — The surgery, recovery and quality of life [Video transcript]. (May 27, 2011). Retrieved from www.hopkinsmedicine.org/transplant/news_events/media/transcripts/liver/liver_transplant_surgery.html.
Does Medicare Cover Liver Transplants?
Medicare Advantage plans cover liver transplants, as does Original Medicare. Medicare Advantage plans include an out-of-pocket spending limit, which Original Medicare doesn't offer.
Medicare does cover liver transplants and other organ transplants that are considered medically necessary. The surgery itself is covered by Medicare Part A (hospital insurance), and doctors services related to your transplant are covered by Medicare Part B (medical insurance).
Medicare Advantage (Medicare Part C) plans also cover liver transplants when they are medically necessary. Medicare Advantage plans also include an annual out-of-pocket spending limit, which Original Medicare (Part A and Part B) does not cover.
This spending limit could save you from potentially paying thousands of dollars in out-of-pocket Medicare costs.
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Does Medicare cover transplant drugs?
Medicare Part D plans provide coverage for prescription drugs and may cover medications used for liver transplants.
Medicare Advantage plans provide the same hospital and medical benefits as Original Medicare and can also offer benefits that Original Medicare doesn’t cover.
How much do liver transplants cost with Medicare?
You must get your organ transplant in a Medicare-certified facility for it to be covered by Medicare.
- Once you pay your Part A deductible ($1,632 per benefit period in 2024), Medicare Part A will cover some of the hospital costs related to your liver transplant and you will pay your Medicare Part A coinsurance.
- Your Part A coinsurance amount is based on how long you are in the hospital. A typical hospital stay for a liver transplant is about 12 days.1 For days 1-60 spent in the hospital, the Part A coinsurance is $0.
- Once you meet your Medicare Part B deductible ($240 per year in 2024), Medicare generally pays 80 percent of the Medicare-approved amount for the doctor’s services related to your liver transplant, and you pay the remaining 20 percent.
In addition to the charges above, you may have to pay various transplant facility charges. Medicare covers all Medicare-certified lab tests.
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About the author
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
