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Health Line
5 days ago
- Business
- Health Line
Does Medicare Cover a Kidney Transplant?
Key takeaways Medicare covers most services related to organ transplantation performed in approved hospitals, including heart, intestine, kidney, liver, and cornea transplants. Medicare Part A covers inpatient services during hospitalization. Part B covers doctor's services related to the transplant, and Part D helps cover prescription drugs needed for transplantation, including immunosuppressant drugs. Medicare generally covers almost all costs related to Medicare-approved organ transplants, including pre-transplant services, surgery, follow-up care, immunosuppressant drugs, and medical care for the organ donor. In this article, we'll discuss when Medicare covers organ transplants, what you need to know about Medicare coverage, and what out-of-pocket costs you can expect for organ transplantation. Which Medicare part covers a kidney transplant? Medicare Part A is hospital insurance. It covers any necessary services related to the following transplants: heart lung kidney pancreas intestine liver In addition, Medicare also covers other transplants that aren't organ transplants. This includes the following transplants: cornea stem cell bone marrow Under Part A, covered services include most inpatient services during hospitalization, such as laboratory testing, physical exams, room and board, and pre-and post-op care for you and your organ donor. On the other hand, Medicare Part B is medical insurance, which means it covers any doctor's services related to your transplant. Services covered under Part B include those related to your diagnosis and recovery, such as doctor's or specialist's visits, laboratory testing, or certain prescription drugs. Part B will also cover these services for your organ donor when necessary. Part C Medicare Part C (Medicare Advantage) covers all the services listed above in Part A and Part B. Some Part C plans also cover prescription drugs and possibly additional health perks, like fitness memberships and meal services. Medicare Advantage Special Needs Plans (SNPs) are plans that offer coordinated services for people with chronic or disabling conditions. These plans can be especially beneficial to people who have certain conditions that may require an organ transplant, such as end stage renal disease and chronic heart failure. Part D Medicare Part D helps cover prescription drugs needed for organ transplantation. While Part D coverage varies by plan, all Medicare prescription drug plans must cover immunosuppressant drugs. These medications, which weaken your immune system to make it less likely that your body will reject a new organ, are required for transplantation. Most prescription drug plans also cover other medications that may be necessary for organ transplant recovery, such as pain relievers, antidepressants, and others. When does Medicare cover organ transplants? Once a doctor has determined that a Medicare beneficiary requires a covered organ transplant, the program should cover the procedure. Medicare doesn't set any criteria for covered organ transplants, but exceptions to this are people undergoing intestine or pancreas transplants must have their transplants at a hospital with a Medicare-approved liver and kidney transplant program, respectively. In addition, organ transplant programs generally have eligibility requirements. What these requirements are depends on the type of transplant and may involve limitations on age or people living with certain health conditions. How much does an organ transplant cost with and without Medicare? According to a 2020 research report on transplant costs in the United States, the average costs for organ transplants include: Heart transplant: $1,664,800 Lung transplant: $1,295,900 (double lung) or $929,600 (single lung) Intestine transplant: $1,240,700 Liver transplant: $878,400 Kidney transplant: $442,500 Pancreas transplant: $408,800 Medicare pays for most services and costs associated with Medicare-approved organ transplants. Services include: pretransplant services, such as testing, lab work, and exams surgery follow-up services immunosuppressant and other necessary prescription drugs, in some cases Medicare also pays for all costs related to finding a donated organ and all medical care for the organ donor, such as doctor's visits, surgery, and other necessary medical services. While Medicare covers almost all organ transplantation costs, you'll still owe out-of-pocket costs. Out-of-pocket costs for organ transplant in 2025 Type of cost Medicare Part A Medicare Part B Medicare Part C Medicare Part D Monthly premium $0 to $518, depending on your work history $185, depending on your income depends on the plan you choose depends on the plan you choose Deductible $1,676 per benefit period $257 per year depends on the plan you choose $0 to $590, depending on the plan you choose Copay and coinsurance coinsurance of 0% to 100% per day, depending on how many days you stay 20% of the Medicare-approved amount for covered services depends on the plan you choose coinsurance or copays depend on the plan you choose You may have other costs associated with your organ transplant surgery that Medicare doesn't cover. These out-of-pocket costs may include: transportation and lodging for the surgery child care or other expenses at home potential loss of income What if you can't afford a kidney transplant? Your Medicare coverage should significantly lower your out-of-pocket cost for your transplant. In addition, you may be able to lower your remaining out-of-pocket costs by enrolling in a Medicare supplement plan or Medigap. Medigap helps cover Original Medicare deductibles, copayments, and coinsurance. Some Medigap plans also cover Part B excess charges and foreign travel costs. That said, you cannot use Medigap with Part C. Your transplant provider may also offer a payment plan so that you can spread the cost over a longer period of time. In addition, if your income falls below a certain threshold, you may also qualify for Medicaid. In addition, the American Transplant Foundation lists several organizations that offer resources on fundraising for a transplant. Are liver transplant patients eligible for Medicare? If you are not eligible for Medicare but anticipate that you require an organ transplant, your eligibility for Medicare depends on either your age or the type of transplant that you need. Anyone ages 65 and over is automatically eligible for Medicare, and by law, no insurance plan can deny you based on a preexisting condition. That said, if you are younger than 65 and you need a transplant, you can only qualify for Medicare if you are living with end stage renal disease (ESRD) and are undergoing dialysis. Other types of needed organ transplants do not count for this exception. Takeaway An organ transplant can be an expensive surgery, but Medicare generally covers beneficiaries for almost all services under their plan. Part A covers most hospital-related services, while Part B covers most medical-related services. Part D can help cover prescription drug costs for immunosuppressants you may need to take before or after the transplant, while Medigap can help tackle some of the out-of-pocket costs associated with each Medicare plan. Contact your doctor or healthcare team for more information on what Medicare will cover for your organ transplant surgery and what to expect. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
Khaleej Times
20-05-2025
- Health
- Khaleej Times
US surgeons perform world's first bladder transplant
Surgeons at a hospital in Los Angeles, California have successfully performed the world's first human bladder transplant, hospital officials said. The surgery, performed May 4 at Ronald Reagan UCLA Medical Centre, is a promising development for other patients suffering from serious bladder disorders. The recipient of the innovative procedure was Oscar Larrainzar, 41, a father of four who had a large portion of his bladder removed due to cancer several years ago, the University of California, Los Angeles, said in a statement Sunday. Larrainzar later had both of his kidneys removed due to cancer and end-stage kidney disease and was on dialysis for seven years. He received both a bladder and a kidney from an organ donor and had them successfully transplanted in an eight-hour operation. "The surgeons first transplanted the kidney, followed by the bladder; they then connected the kidney to the new bladder using the technique they had pioneered," the UCLA statement said. Dr. Nima Nassiri, one of the surgeons involved in the historic transplant, said the procedure yielded positive results almost instantaneously. "The kidney immediately made a large volume of urine, and the patient's kidney function improved immediately," Nassiri said. "There was no need for any dialysis after surgery, and the urine drained properly into the new bladder." Nassiri and fellow surgeon Inderbir Gill said full bladder transplants had not been performed previously due to the complex vascular structure of the pelvis, making it a technically difficult procedure. "This first attempt at bladder transplantation has been over four years in the making," Nassiri said. Previously, patients in need of bladder reconstruction could have one artificially created using a part of the intestines or have a stoma bag inserted to collect urine. Those techniques had several short-term and long-term risks that doctors hope will be circumvented with the full bladder transplant, Nassiri said.
The Sun
19-05-2025
- Health
- The Sun
World's first bladder transplant marks ‘historic moment' as man, 41, able to pee again for first time in 7 years
SURGEONS have performed the first-ever human bladder transplant - a game-changing procedure with the potential to help thousands living with deadly organ failure. The first person to undergo the operation is 41-year-old Oscar Larrainzar, a father of four who had previously lost most of his bladder during a tumour removal process. 3 The remainder of his bladder was too small to work and both his kidneys were subsequently removed due to cancer and end-stage kidney disease. He'd been on dialysis for seven years. The complex procedure carried out by surgeons from UCLA Health and Keck Medicine of USC involved the transplantation of both a new bladder and a new kidney, recovered from a donor, and lasted approximately eight hours long. UCLA urologic transplant surgeon Dr Nima Nassiri and Dr Inderbir Gill, assisted by a surgical team, said the results were quickly evident. 'The kidney immediately made a large volume of urine, and the patient's kidney function improved immediately,' Nassiri said. 'There was no need for any dialysis after surgery, and the urine drained properly into the new bladder.' 'Despite the complexity of the case,' Gill said, 'everything went according to plan and the surgery was successful. "The patient is doing well, and we are satisfied with his clinical progress to date.' It's not known how well the transplanted bladder will function over time and how much immunosuppression will be needed to prevent rejection of the transplanted organs. But to date, Larrainzer has been stable. I haven't peed in SIX YEARS and never will again - I live in constant agony and it could kill me 'This surgery is a historic moment in medicine and stands to impact how we manage carefully selected patients with highly symptomatic 'terminal' bladders that are no longer functioning,' said Gill, who is also a distinguished professor and chair of urology at the Keck School of Medicine of USC. 'Transplantation is a lifesaving and life-enhancing treatment option for many conditions affecting major organs, and now the bladder can be added to the list.' Bladder transplants haven't been carried out previously because of the complicated vascular structure of the pelvic area and the technical complexity of the procedure. Current treatments include the replacement or augmentation of the urinary reservoir - a procedure that uses part of a patient's intestine to create a "new" bladder or a pathway for urine to exit the body. While these surgeries can be effective, they come with many short-and long-term risks that compromise a patient's health, such as internal bleeding, bacterial infection and digestive issues. 'A bladder transplant, on the other hand,' Nassiri said, 'results in a more normal urinary reservoir and may circumvent some short- and long-term issues associated with using the intestine.' Organ transplants currently available Organ transplants, which replace failing or damaged organs with healthy ones from donors, are now available for a variety of organs. They've become possible due to advancements in surgery, medicine (including immunosuppressant drugs), and a better understanding of the donor process. Available organs include: Kidneys: The most commonly transplanted organ, helping patients with end-stage kidney disease. Liver: Treats various liver diseases, including cirrhosis and liver cancer. Heart: Addresses heart failure and other heart conditions. Lungs: Treats conditions like cystic fibrosis, pulmonary fibrosis, and other lung diseases. Pancreas: Transplants are used to treat diabetes and some pancreatic cancers. Intestine: Transplants are performed for patients with severe gastrointestinal disorders. 3
Daily Mail
19-05-2025
- Health
- Daily Mail
World's first bladder transplant hailed as 'groundbreaking moment in medical history' - op gives hope to cancer patients
Surgeons in the US have performed a 'miracle' bladder transplant for the first time — giving hope to thousands of patients living with deadly organ failure. The first ever patient to undergo the groundbreaking operation is Oscar Larrainzar, a 41 year-old from Los Angeles with a rare form of cancer who lost nearly all function of his bladder. Now, following the successful procedure, he is not only able to use the toilet independently again, but doctors said the surgery also saved his life. Doctors have hailed the procedure a 'groundbreaking moment in medical history' and 'the realisation of a dream'. Dr Inderbir Gill, the urologist who performed the transplant, said: 'There is no question: A potential door has been opened for these people that did not exist earlier. 'Transplantation is a lifesaving and life-enhancing treatment option for many conditions affecting major organs, and now the bladder can be added to the list,' he told the New York Times. Following treatment for tracheal adenocarcinoma, a rare type of bladder cancer, and a surgery to remove the tumour four years ago, Mr Larrainzar had 'been left without much of a bladder at all.' A normal bladder can hold more than 300 cubic centimeters of fluid. But Mr Larrainzar's could hold 30, according to his medical team. The patient had also been dialysis-dependent for seven years after both of his kidneys were subsequently removed as part of his cancer treatment. To address these deficits doctors performed a combined kidney and bladder transplant, allowing the patient to immediately stop dialysis and produce urine for the first time in seven years. First the kidney, then the bladder, were transplanted. The new kidney was then connected to the new bladder. The entire procedure took approximately eight hours. 'The kidney immediately made a large volume of urine, and the patient's kidney function improved immediately,' Dr Nassiri, who was part of the team of surgeons who performed the procedure, added. 'There was no need for any dialysis after surgery, and the urine drained properly into the new bladder.' 'Despite the complexity of the case, everything went according to plan and the surgery was successful,' said Dr Gill, who is chairman of the urology department at University of Southern California. 'The patient is doing well, and we are satisfied with his clinical progress to date.' 'Of course, this is very, very early. Let's see how everything goes,' Dr Gill cautioned. 'But it's the first time he has been able to pee in seven years. For all of us, this is huge.' Typically, rather than a transplant, patients with a failing bladder are fitted with what's known as a neobladder—a bag that collects the urine outside the body. Some patients will have their intestine repurposed by surgeons to enable the organ to pass urine. Experts say that patients suffer complications up to 80 per cent of the time when the intestine is used to replace the bladder, which Mr Larrainzar had been living with for four years. They say it can lead to digestive issues, kidney failure and cause deadly bacteria to spread in the body. 'While these surgeries can be effective, they come with many short-and long-term risks that compromise a patient's health such as recurrent infections, compromised kidney function and digestive issues,' said Dr Gill. 'A bladder transplant, on the other hand, delivers a more 'normal' urinary reservoir and may circumvent some of the challenges associated with using the intestine,' said Dr Nassiri. The doctors plan to perform bladder transplants in four more patients as part of a clinical trial to get a sense of outcomes like bladder capacity before pursuing a larger trial to expand its use. The biggest risks of organ transplant are the body's potential rejection of the organ and side-effects caused by the immunosuppressive drugs given to prevent organ rejection. Dr Gill added that the best current candidates are those who've coped with an organ transplant previously, or those who need a combined kidney and bladder transplant.
CNN
18-05-2025
- Health
- CNN
Pigs may be the solution to the human organ shortage
CNN's Dr. Sanjay Gupta explores how pigs could help address the human organ shortage through xenotransplantation. Learn how both a pig's similarities and differences make their organs a good match for humans. 'Dr. Sanjay Gupta Reports: Animal Pharm' airs Sunday at 8pm ET/PT on CNN.
