What Are Your Costs For Transplants Under Medicare
You are responsible for certain costs coinsurance, deductibles and certain facility fees associated with your transplant in addition to what Medicare covers.
Your Transplant Costs Under Medicare
- 20 percent of the Medicare-approved amount for immunosuppressive drugs
- 20 percent of the Medicare-approved amount for your doctors services
- Various costs for transplant facility charges
- Your Medicare Part B deductible
You pay nothing out-of-pocket to the living donor for a kidney transplant and nothing for any Medicare-certified laboratory tests.
While most transplants have to be performed in a Medicare-approved transplant facility to be covered by Medicare, stem cell and corneal transplants can be performed in nontransplant facilities.
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How Can I Save Money
If you are one of those patients that suffer from a kidney problem and need dialysis, regardless of your age you will be eligible for Medicare, which may pay up to 80% of the expenses of a kidney transplant. Though, the anti-rejection drugs are covered by Medicover only for 3 years. You can find more information about Medicover and other financial resources at the National Kidney and Urologic Diseases Information Clearinghouse.
Cash-paying or uninsured patients may get a discount of up to 30% or even more from most hospitals. For instance, patients going to the Washington Hospital Healthcare System from California will get a discount of 35%.
HelpHOPELive is a nonprofit organization that helps patients raise money for transplants through community fundraising campaigns. The group charges 4%-7% as its fee, but it remains committed to helping those in need.
How Much Time Will I Be Away From Work
Please plan ahead of time for your absence from work. Think about how surgery and recovery might affect your employment or benefits. We will help you with the paperwork needed to receive any benefits your employer offers.
Before surgery, allow one to three days for pre-donor testing. After surgery:
Kidney donors may not return to work for 4 to 6 weeks.
Liver donors may not work for up to 3 months.
Lung donors may not work for up to 2 months.
Talk to your doctor and coordinator to plan your time off. The length of time away from work depends on your health, the type of surgery and whether you have problems after you donate.
The type of work you do will also affect your recovery time. If your job requires heavy lifting or is physically hard, you should plan on at least six weeks for recovery. If you work at a desk, you may be able to return sooner.
Some donors return to work part-time or request lighter duties at first.
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Living Kidney Donor Faqs
Who can be a donor?
Any healthy person can be a kidney donor. The donor does not need to be a family member. The donor can be a friend, an acquaintance, spouse, in-law, or even a stranger.
The donor must be:
At least 18 years old
Appropriate candidate for general surgery
Meet medical, social, and psychological criteria set by UNOS
Able to give informed consent
How long is the surgery, and how long will I be in the hospital?
Each surgery, one for the donor and one for the recipient, lasts approximately three – five hours. The donor is in the hospital for one to three days.
What is the long-term risk of being a donor?
There is very little risk to being a kidney donor, either short-term or long-term. Short-term, the risk of dying from the surgery is about 0.03% . Major complications are unusual. In the long term, having been a donor does not influence the risk of kidney failure, high blood pressure or diabetes. Recent studies show that kidney donors have longer life expectancy than predicted.
How will I live with one kidney?
It is safe to live with one kidney and you will be able to resume all of your regular activities after surgery. Your remaining kidney will grow slightly larger to compensate for the donation of the other kidney. You will have scheduled follow-up visits with the transplant team to monitor your kidney function after surgery and will have lab work done 6 months, 1 year, and 2 years after your donation.
Do You Have Advice For Making The Decision To Donate
The decision to donate can vary from person to person. Some people make the decision instantly with few worries or concerns. Other people need time to think and will talk with close friends or family before deciding if they will donate. It is normal for some people to be afraid of donating a kidney as well as to feel guilt about not wanting to be a donor.
People should not feel pressured to donate. The only right decision is the one that is comfortable for the donor. People considering donation are encouraged to speak with the living donor team for answers to their questions or to discuss their concerns.
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Can I Be A Kidney Donor
Both your kidneys can be donated after your death and potentially used for two kidney transplants. But, because you can live a healthy life with just one kidney, it is possible to donate one kidney as a living donor.
There are huge numbers of people needing a kidney transplant. For many of these it can be very difficult to find a suitable donor. We encourage everyone to be a donor for the following reasons:
- Your kidney will only be transplanted if it is healthy and suitable for the person who needs a transplant
Become A Living Kidney Donor
Living donor options include:
- Direct Donation: A donor who donates his or her kidney directly to their intended recipient
- Paired Kidney Exchange: A donor who donates his or kidney to another person and their intended recipient receives a kidney from another donor.
There are several types of transplant procedures:
ABO and HLA-Compatible Kidney Transplantation: The donor and recipient have the same or compatible blood type, and the recipients immune system is compatible with the donor.
ABO or HLA Incompatible Kidney Transplant: The donor and recipient have different or incompatible blood types or the recipient has antibodies against the donor, meaning the patients body would reject the donated kidney. In some cases, the recipient can be treated before and after the kidney transplant with medication or a treatment called plasmapheresis. Plasmapheresis removes antibodies in the recipient that would cause rejection of the kidney once transplanted.
Kidney Transplantation with Highly Sensitized Recipients are done for people with a high antibody load, mostly from past transplants, pregnancies, or blood transfusions. Patients can receive a kidney through paired exchange, desensitization procedures, or a combination of both.
Paired Kidney Exchange: For donors and recipients who are not blood type or HLA compatible, the paired exchange program provides a method to still be transplanted. Compatible pairs can also join the exchange for other benefits.
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What Are The Risks Of Donating A Kidney
Life expectancy after donation is the same as that of people with two kidneys. A single kidney is able to meet the bodys needs. Because the safety of the donor is of the utmost importance, donors are tested and retested prior to surgery to ensure overall good health for the best possible outcomes. Living kidney donation surgery is considered a relatively safe procedure, but it is still a major surgery with potential complications. It is also recommended that female donors wait at least six months after donation surgery before becoming pregnant.
Will I Be Able To Buy Long
Most living donors have no trouble getting insurance for long-term care. But we know of rare cases where donors had problems buying it. If you have insurance problems, we will help you appeal your case with the insurer.
You may wish to review your policy and discuss any questions you have with your agent.
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Paying For An Organ Transplant With Personal Funds
Many patients cannot afford to pay for the full cost of organ transplant surgeryor even an insurance deductibleusing personal funds. Most people waiting for an organ transplant have financial difficulties, especially if their illness has caused them to be placed on disability.
This is not uncommon, and many patients explore other options to help them fund their procedure.
Who Pays The Medical Bills
A donor does not incur any transplant-related medical costs. Evaluation, testing, surgery, and follow-up appointments are covered by the recipient’s insurance company. Insurance does not cover day-to-day costs that a donor, his or her employer, or insurance company would routinely incur . Any unrelated problems that might show up on pre-donor tests , would be the donors insurance companys responsibility.
Insurance does not cover non-medical expenses such as transportation, lodging, and meals. However, federal funding and other programs such as the National Living Donor Assistance Center and Kidney.org are available to recipients and donors who qualify. Funding is often made available by various organizations through the transplant center itself potential donors should ask the transplant center’s donor coordinator if such programs are available.
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Fundraising For A Kidney Transplant
Kidney transplants can be very costly, so lets take a look at how crowdfunding can help.
Kidney transplants are literally life-saving, but depending on where you live costs can be extremely high. People often turn to crowdfunding to cover their medical expenses in times of need. GoGetFunding has helped many people fund transplant surgeries.
Lets take a look at what a kidney transplant involves and how you can fundraise to cover the costs.
If Youre Younger Than 65 Years Old
If you are an adult who has ESRD and are under 65 years old, you must meet one of the following criteria to be eligible for Medicare:
- youve worked the required amount of time
- your already receive Social Security or Railroad Retirement Board benefits
- you have a spouse who meets either of the above criteria
Children with ESRD must have a custodial parent or guardian who has paid Medicare taxes for at least 40 quarters to be eligible for Medicare.
If you only have Medicare because you have ESRD, your coverage will end 12 months after you stop dialysis treatment or 36 months after you have a kidney transplant.
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Top 5 Questions About Living Kidney Donation
Each year, more than 5,500 living donors successfully give an organ to someone waiting on the transplant list. If you are thinking about donating an organ to a relative, friend or even to a stranger, its important to understand the process and the risks involved. To help you with this important decision, we made a list of the top 5 questions about living donation.
1. How can I be a living kidney donor to someone I know?
First, the person who needs a kidney has to be evaluated by a transplant center and accepted onto the transplant waiting list. Next, youll need to speak with the transplant coordinator at that center. If you live far away from the transplant center where your loved one is being evaluated, you may be able to have some of the testing done near you. However, you should speak with your loved ones transplant center first so they can start the process.
2. What tests are used to determine if someone can be a kidney donor?
There are a number of tests that will be done to determine if you are able to be a living donor and if youre a good match for the recipient. In general, you should be in overall excellent health with no medical problems, and have two kidneys and normal kidney function. You may need physical examinations, psychological testing and donor/recipient compatibility testing, including blood and tissue typing.
3. Whats involved in the surgery and whats the recovery period?
4. What are the long-term risks of kidney donation?
Can I Sign Up As An Organ Donor
Anyone over age 18 can sign up. In many states, people younger than 18 can sign up as well. There are several ways to sign up.
Let your family know about your decision. If the time comes, they wont feel surprised and can help carry out your wishes. The transplant team may ask them for information.
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Medicare Immunosuppressive Drug Coverage For Kidney Transplant Recipients
End-stage renal disease is substantial and permanent loss in kidney function. Persons with ESRD require either a regular course of dialysis treatment or a kidney transplant to survive. The Medicare program provides coverage for health care services for the vast majority of individuals diagnosed with ESRD, regardless of age.
In 2010, roughly 489,000 Medicare beneficiaries received ESRD-related servicesâless than 1% of the total Medicare population. According to the United States Renal Data System , in 2010, Medicare expenditures for the ESRD-related services totaled $32.9 billion, or roughly 6.3% of total Medicare expenditures.
Individuals who have received a kidney transplant usually require immunosuppressive drugs for the rest of their life to minimize the risk of their immune system rejecting the donor kidney. In 2010, Part B expenditures for immunosuppressive drugs totaled $345 million. Under Part B, Medicare provides payment for immunosuppressive drugs based on manufacturersâ reported average sales price , for each drug, plus a 6% handling and storage payment. Since 2009, the ASP for commonly used immunosuppressive drugs has decreased by over 50%âmost likely due to the use of generics.
Selena Gomez Publicly Thanks Francia
The actress even celebrated this year’s World Kidney Day by thanking Francia, saying she’s “forever grateful” for her selfless donation in 2017. Francia also released a statement of her own. She took the opportunity to share her experience with fans to spread awareness.
Francia tweeted that she’s seen the impact of kidney disease firsthand, so she shared links and resources with fans on “how can we work to ensure those living with kidney disease are living well.” Shortly after Francia shared this series of tweets, Selena took to Twitter to reshare her friend’s post, writing, “Thank you for blessing me. I am forever grateful to you.”
Although there have been some questions about where Selena and Francia’s friendship stands over the past few years, the singer made it very clear that she will forever be thankful to Francia. While Selena has also been fairly private about her kidney transplant experience, like Francia, she too has opened up more in recent months.
Fans are glad Selena and Francia are doing so well all these years after the transplant surgery.
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What Organs Can A Living Donor Donate
The kidney is the most commonly transplanted organ from a living donor. One entire kidney is removed and transplanted. Living liver donation, where a segment of the donors liver is transplanted, occurs less often, and the donor is usually related to the recipient. A few living donor uterus transplants have been performed as part of clinical trails. Also, in rare cases, a segment of organs such as lung, intestine or pancreas can be transplanted from a living donor.
What If I Have My Tests And Follow
We urge you to have all of your tests at the University of Minnesota Medical Center. But we know this is not always practical if you live far away.
You may be able to have some donor tests and follow-up visits at your clinic. But certain tests must be done here at the transplant center. Talk to your transplant coordinator.
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What Are The Signs Of Unhealthy Kidneys
Although the kidneys are tiny organs in our body, they are essential in regulating our bodies and keeping us healthy. The majority of kidney diseases go undiagnosed until the symptoms become worse. Swollen feet increased urination at night, and swelling around the eyes in the morning are early signs of kidney problems. Vomiting, fluid retention, and vertigo are severe symptoms that can lead to kidney failure.
How Much You Can Claim
The maximum payment is equal to 342 hours of leave at the minimum wage.
For a full-time worker working 38 hours per week, earning minimum wage, that equates to 9 weeks of leave. A part-time or casual person can spread that time over a longer period, depending on how many hours you would normally work per week and how many hours you are paid for your leave.
If you earn more than the minimum wage, you will not get an hour-for-hour reimbursement of leave credits.
For example, the 201920 national minimum wage is $19.49 per hour, or $740.80 per 38-hour week, the maximum payment your employer can claim is $6,667.20 .
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A Kidney For $10000 Paying Donors Actually Pays Off New Study Finds
Paying living kidney donors $10,000 to give up their organs would save money over the current system based solely on altruism even if it only boosts donations by a conservative 5 percent.
Thats according to a new analysis by Canadian researchers that rekindles the ongoing debate about whether its practical and ethical to offer financial incentives for human body parts.
We have a problem. We dont have enough organ donors coming forward, said Dr. Braden Manns, an associate professor and clinical professor in nephrology at the University of Calgary. He led the new study published Thursday in the Clinical Journal of the American Society of Nephrology.
We need to figure out a way to solve that problem. We shouldnt throw out, out of hand, solutions that could increase donations.
But other kidney experts say that even if its cost-effective to pay people for organs, the moral issues the practice generates might backfire.
Sometimes these things have unintended consequences, said Dr. Stephen Pastan, a board member for the National Kidney Foundation and a transplant surgeon at Emory University in Atlanta. If we paid $10,000, a lot of altruistic donors would say that its just a cash transaction. Donations could go down.
Right now the question is theoretical. In the U.S., Canada and other countries except Iran paying people to donate organs is illegal.
The obvious question, the elephant in the room is, Why dont more people donate? Manns said.