Original Medicare (Part A and Part B) does cover heart transplants and certain other organ transplants if considered medically necessary by a doctor.
Medicare Advantage (Part C) plans also cover heart transplants, and they also include an annual out-of-pocket spending limit. This can potentially save you money in Medicare costs for your heat transplant.
Original Medicare does not include an out-of-pocket spending cap.
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Hospital costs related to your heart transplant are typically covered by Medicare Part A.
Doctor services related to your transplant are typically covered by Medicare Part B.
Even if Medicare covers your heart transplant, you are generally responsible for a portion of the costs. Some of these costs include:
Lifetime reserve days are 60 additional days of coverage that can be used over the course of your life. For each lifetime reserve day, Medicare pays all covered costs except for the daily coinsurance. Once you use these 60 days, they cannot be renewed.
If you have a Medicare Advantage plan, your coinsurance and deductible costs could vary. All Medicare Advantage plans include an annual out-of-pocket spending limit.
Depending on the type of Medicare Advantage plan you have, you may be required to get your heart transplant from a doctor or hospital in your plan network.
For specific pricing information regarding your heart transplant, we recommend speaking with your doctor directly.
Medicare covers immunosuppressive transplant drugs if Medicare also helped pay for your heart transplant.
Medicare Advantage (Medicare Part C) plans are sold by private insurers as an alternative to Original Medicare.
Every Medicare Advantage plan must provide the same hospital and medical benefits as Medicare Part A and Part B, which means if your heart transplant is covered by Original Medicare, it should also be covered by Medicare Advantage.
Medicare Advantage plans may also offer benefits that aren’t offered by Original Medicare.
To learn more about Medicare Advantage, or to find Medicare Advantage plans in your area, speak with a licensed insurance agent.
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Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
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