Does Medicare Cover Kidney Transplants?

A kidney transplant is a surgical procedure that places a healthy kidney from a donor into a person whose kidneys have failed.

Medicare Part A (Hospital Insurance) covers transplant services and pays parts of the costs for:

• Inpatient services in a Medicare-certified hospital
• A kidney registry fee
• Laboratory and other tests to evaluate your medical condition, and the condition of potential kidney donor
• Finding the proper kidney for your transplant surgery (if there's no kidney donor)
• Any additional inpatient hospital care for your donor in case of problems from surgery
• Blood (whole units of packed red blood cells, blood components, and the cost of processing and giving you blood)

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

Medicare Part B (Medical Insurance) covers transplant services and pays part of the costs for blood, and doctors' services for:

• Kidney transplant surgery (including care before, during, and after the surgery)
• Your kidney donor during their hospital stay

If Medicare helped pay for your transplant, Part B also covers transplant drug therapy (including standard and compounded immunosuppressive drugs) to prevent organ rejection.

If you’re thinking about joining a Medicare Advantage Plan (Part C) and are on a transplant waiting list or think you need a transplant, check with the plan before you join to make sure your doctors, other health care providers, and hospitals are in the plan’s network. Also, check the plan’s rules for prior authorization.

For the transplant and related services, you pay:

• 20% of the Medicare-approved amount for Part B services, after you meet the Part B deductible.
• Nothing for Medicare-approved laboratory tests.
• Nothing for the services provided to the donor for a kidney transplant.

Important: There’s a limit on the amount your doctor can charge you, even if your doctor doesn’t accept assignment.

Get Part A hospital inpatient cost information.

If you’re in a Medicare Advantage Plan (Part C), what you pay may be different. Learn more about Medicare Advantage Plans if you have ESRD.