Does Medicare Cover Liver Transplants?

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.

Does Medicare Advantage cover transplant drugs?

Medicare Advantage plans provide the same hospital and medical benefits as Original Medicare. Most Medicare Advantage plans also offer additional benefits that Original Medicare doesn’t cover.

These extra benefits can include, but aren’t limited to:

• Prescription drug coverage (which can include transplant drugs that Part B doesn’t cover)
• Routine vision and dental coverage
• Hearing care coverage
• Wellness programs such as SilverSneakers

Some Medicare Advantage plans have monthly premiums as low as $0.

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 ($1,556 per benefit period in 2022), 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 ($233 per year in 2022), 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.

Compare Medicare Advantage plans in your area

If you’re eligible for Original Medicare, you are likely eligible for a Medicare Advantage plan. Our licensed agents can help you find Medicare Advantage plans in your area and get you enrolled in one that works for your health needs.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

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.

 

 

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