Meet with a Financial Counselor

An important part of your evaluation as a potential kidney transplant candidate is a meeting with a financial counselor. During this meeting, your counselor will walk you through the costs associated with a kidney transplant, and help you determine if and how your medical insurance covers transplantation.

Medical Coverage
Your financial counselor will help you understand the financial aspects of the evaluation, in-hospital transplant period, follow-up, and donor costs.

If you have a commercial insurance, a Preferred provider Organization (PPO) or a Health Maintenance Organization (HMO) it is important that you verify that your insurance company covers transplantation at Lankenau Hospital. If you have Medicare as your primary insurance, no verification is necessary.

Prescription Drug Coverage
Because the medications you will be taking after the transplant are so expensive, part of your financial evaluation will include an assessment of your ability to pay for these medications for as long as your transplanted kidney continues to function.

Currently, Medicare covers immunosuppressant medications for three years after a transplant at a rate of 80%. For patients who are deemed to be disable by the Social Security Administration at the end of 3 years, Medicare will continue to cover immunosuppressant medications at a rate of 80%. Also, if a patient receives a kidney transplant at a Medicare approved center and is enrolled in Medicare at the time of transplant, they are entitiled to 80% coverage for immunosuppressive medications through Medicare at age 65. (Patients need to check directly with Medicare regarding any changes in regulations). Other coverages include major medical plans, prescription plans, Medical Assistance, and private insurances.

Other Considerations
You will need to know whether there is a lifetime limit (or cap) on your particular plan. Your financial counselor will help you evaluate your coverage and inform you of the options available if you have limited coverage and financial resources. You will also be advised of the importance of planning ahead, especially if you will need to apply for assistance, since most organizations need at least a month to process applications.