Thousands of liver transplants are performed each year for patients with significant complications from end-stage liver disease and liver failure. The surgical removal of diseased or damaged liver tissue (or the entire organ) and the replacement of a healthy one may be the best solution when all other treatment options have been ruled out. Liver transplants are the second most common type of transplant surgery, and the procedure has a high rate of success.
The liver is one of the body’s most complex organs and is responsible for necessary functions, including processing carbohydrates, fats, and proteins, and storing vitamins. The liver prevents infection, regulates immune responses, and makes proteins that help blood clot. Liver failure can be caused by genetic conditions, lifestyle choices, or infection.
When your doctor determines that a liver transplant is needed, a patient will be put on a donor list. According to the United Network for Organ Sharing (UNOS), people can wait years for a transplant. Most donated livers are from a deceased organ donor, but living donors can give a segment of their liver to someone in need if they are a match. Living donors must undergo blood tests to determine tissue matches.
Medicare Can Help Cover a Liver Transplant
Medicare can help cover the costs of the services and supplies you may need before, during, and after your transplant. Medicare Part B (Medical Insurance) covers doctor services, tests, and exams prior to surgery, and follow-up care visits after the transplant surgery. Part A (Hospital Insurance) will help cover the cost of the transplant surgery and related services and supplies necessary once you are formally admitted into a Medicare-approved hospital.
You will likely pay 20% of the Medicare-approved amount for doctor services, and the Part B deductible will apply. There is no cost for a living donor. Medicare Part D can help cover the costs of prescription medications necessary after transplant surgery, including anti-rejection medications. You will need to be enrolled in a Prescription Drug Plan (PDP). Compare plans before enrolling. Each PDP may have a different formulary, or list of covered drugs, and costs can vary.
Many recipients of Original Medicare choose to purchase a Medigap, or Medicare Supplement, policy. Medigap can help cover the costs that Original Medicare does not, such as copayments, coinsurance, and deductibles.
Some Medicare recipients choose to get their benefits through a Medicare Advantage (MA) plan. MA plans are offered by private insurance companies that contract with Medicare to provide your Part A and Part B benefits. MA plans are required to provide the same benefits as Original Medicare, but many offer additional coverage, including prescription drug coverage and an annual out-of-pocket maximum. If you are enrolled in a Medicare Advantage plan, check with your plan directly to find out exact costs of your liver transplant.