Does Medicare cover organ transplants?

What does Medicare cover for an organ transplant?

Medicare covers different parts of the care you need for an organ transplant. You must get the transplant in a Medicare-approved facility.

• Medicare Part A (Hospital Insurance) covers necessary tests, labs and exams, and generally also covers services for heart, lung, kidney, pancreas, intestine and liver transplants and the costs of finding the proper organ for your surgery.
• Medicare Part B (Medical Insurance) covers doctors' services for heart, lung, kidney, pancreas, intestine and liver transplants, and immunosuppressive drugs to prevent organ rejection in certain circumstances.
• Medicare also covers some transplants that aren't organ transplants under certain conditions: Part A and Part B may cover stem cell transplants (including bone marrow transplants), and Part B may cover cornea transplants.
• Medicare covers a pancreas transplant for people with End-Stage Renal Disease (ESRD) if it's done at the same time as or after a kidney transplant, and in some cases Medicare may cover a pancreas transplant even if you don't need a kidney transplant.

What does Medicare cover for a kidney transplant and the donor?

For a kidney transplant, Part A pays parts of the costs for inpatient services in a Medicare-certified hospital, a kidney registry fee, lab and other tests to evaluate you and potential donors, finding the proper kidney if there's no donor, extra inpatient care for your donor if problems arise from surgery, and blood. Part B covers doctors' services for the surgery, including care before, during and after it, and for your donor during their hospital stay.

Part A covers the full cost of care for your kidney donor, including care before surgery, the surgery itself and care after surgery. You and your donor won't pay a deductible, coinsurance or any other costs for the donor's hospital stay.

What do I pay for a transplant with Original Medicare?

For the transplant and related services, you pay:

• 20% of the Medicare-approved amount for Part B services, after the Part B deductible ($283 in 2026).
• Part A hospital costs for each benefit period: in 2026, the $1,736 Part A deductible for days 1 to 60, then $434 a day for days 61 to 90.
• Nothing for Medicare-certified laboratory tests.
• Nothing for the services given to the living donor for a kidney transplant.
• There's a limit on what your doctor can charge you for a kidney transplant, even if your doctor doesn't accept assignment.
• Medicare doesn't pay for transportation to a transplant facility.

Does Medicare cover anti-rejection drugs after a transplant?

Yes, if Medicare helped pay for your organ transplant. Part B covers transplant drug therapy, including standard and compounded immunosuppressive drugs, to prevent organ rejection. You must have Part A at the time of the covered transplant and Part B when you get the drugs. In most cases, you pay up to 20% of the Medicare-approved amount after the Part B deductible. Medicare drug coverage (Part D) covers immunosuppressive drugs if Part B doesn't.

If you have Medicare only because of ESRD, your Medicare coverage, including immunosuppressive drug coverage, ends 36 months after a successful kidney transplant. A separate immunosuppressive drug benefit can keep paying for these drugs (and nothing else) beyond 36 months if you had Medicare because of ESRD at the time of your kidney transplant and you don't have or expect to get certain other coverage, like a group or individual health plan, TRICARE or Medicaid that covers immunosuppressive drugs. It has its own monthly premium, which Medicare sets each year and is higher for some incomes, and a $283 yearly deductible in 2026; after that you pay 20% of the Medicare-approved amount. You can sign up any time after your Part A coverage ends, through Social Security. See how Medicare works with kidney failure.

Does Medicare Advantage cover organ transplants?

Medicare Advantage plans must cover all medically necessary services that Original Medicare covers, and Medicare says that if you're in a Medicare Advantage plan, Original Medicare covers kidney transplant costs. If you're thinking about joining a Medicare Advantage plan and are on a transplant waiting list or think you need a transplant, check with the plan before you join that your doctors, other providers and hospitals are in its network, and check its rules for prior authorization, covered drugs and living donors. See how Medicare Advantage differs from Original Medicare.