Medicare Organ Transplant Coverage

Written by:

Megan Whitenton

Reviewed by:

Amy Albert

5 min read

Key Takeaways

Medicare will cover most medically necessary organ transplants.
Medicare will usually cover 80% of costs related to organ transplants.
Examples of organ transplant surgeries that Medicare covers include kidneys, lungs, liver and heart.
The transplant must occur at a Medicare-certified transplant center.
Medicare Part BMedicare Part B is medical insurance that covers Medicare-approved services — such as medically necessary treatment and preventive services — and certain other costs, like durable medical equipment. Medicare Part B is part of Original Medicare. will also typically cover immunosuppressive drugs to prevent transplant rejection.

Original Medicare (Part A and Part B) covers organ transplants for beneficiaries who meet certain criteria, including being diagnosed with end-stage organ disease or failure that necessitates a transplant and a high likelihood of successful organ transplantation. Medicare also considers a transplant candidate’s medical history and the severity of their condition.

Why Medicare-Covered Organ Transplant Benefits Matter

Organ transplants can be a last-resort treatment option for patients experiencing life-threatening, end-stage organ failure or disease. Once a patient is evaluated and deemed a viable candidate for an organ transplant, they must join the national organ transplant waiting list. While wait times vary, patients may wait between four months and five years for a match.

Seniors are especially vulnerable to advanced organ diseases that may require a transplant. According to OrganDonor.gov, more than 60% of organ donors in 2023 were over age 50, including 23% who were 65 or older. The number of organ transplant recipients aged 65 and older continued to increase from 2023 to 2024, according to the Organ Procurement and Transplant Network.

Medicare Parts A and B cover the costs of common organ transplants like those listed below.

Common Organ Transplants Covered By Medicare

Kidney transplant: You must be diagnosed with end stage renal disease (ESRD), which means permanent kidney failure that requires dialysis or transplant, to qualify for Medicare benefits for this procedure.
Lung transplant: Medicare covers lung transplant costs for patients diagnosed with end-stage lung disease or a terminal condition causing respiratory failure, such as cystic fibrosis, chronic obstructive pulmonary disease (COPD), or pulmonary hypertension.
Liver transplant: Candidates for a Medicare-covered liver transplant must be diagnosed with end-stage liver disease or acute liver failure due to a condition such as alcoholic liver disease, cirrhosis, or hepatitis C.
Heart transplant: You may need a heart transplant if you are experiencing long-standing heart failure despite undergoing previous treatments, such as installing a pacemaker. Conditions necessitating a heart transplant may include heart attacks, viral infection of the heart muscle, high blood pressure, or heart valve disease.
Cornea transplant: A cornea transplant may be necessary for patients experiencing a chronic condition that causes damage to the cornea or distorts vision permanently. Common examples include Fuch’s dystrophy, Keratoconus, trauma to the eye, or corneal infections.

Medicare coverage may include, but is not limited to, the above organ transplant conditions.

Have questions about your Medicare coverage?

Call Today

How Medicare Covers Organ Transplants

Medicare covers organ transplants provided beneficiaries meet two key criteria: they must require a transplant out of medical necessity and they must undergo the transplant in a Medicare-approved facility. Specifically, this means a physician must determine that the patient needs an organ transplant to treat their condition and otherwise meets the eligibility terms of Medicare’s transplant program.

Medicare Part A Organ Transplant Coverage

Generally, Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, and home health care and services. In the case of a medically necessary organ transplant, Medicare Part A covers the labs, tests, and exams necessary to diagnose the patient’s condition, the costs of locating and compensating the donor for your transplant surgery, the surgery itself, and the post-surgery hospital stay. Beneficiaries must pay the Part A deductible ($1,676 in 2025) to get coverage.

Medicare Part B Organ Transplant Coverage

Medicare Part B covers doctor services and outpatient care. For organ transplant recipients, this means the doctors’ services that are necessary before, during, and after the transplant surgery, the immunosuppressive drugs required post-surgery, and some medical supplies related to organ transplant surgery, are covered. Medicare Part B covers 80% of these organ transplant costs once a beneficiary meets their annual Part B deductible ($257 in 2025).

Medicare Coverage for Immunosuppressive Drugs

Most patients who have undergone a successful organ transplant require immunosuppressive drugs for the rest of their lives to prevent their body from rejecting the transplanted organ. Medicare typically covers immunosuppressive drugs for life through Part B benefits (Part B-ID). This coverage applies solely to immunosuppressive drugs. Medicare beneficiaries are ineligible if they have coverage through an employer, the Healthcare Marketplace, TRICARE, Medicaid, or the Department of Veterans Affairs.

How Medicare Advantage Covers Organ Transplants

Medicare Advantage plans offer healthcare beyond the scope of Original Medicare, such as dental, vision, and hearing services. Beneficiaries may purchase a Medicare Advantage plan from a private insurance provider but must still maintain Part B premiums to enjoy benefits. The individual costs and terms of Medicare Advantage plans tend to vary by region and carrier.

For organ transplant candidates, Medicare Advantage plans may also include different eligibility requirements and benefits than Original Medicare. Be sure to confirm that your preferred Medicare Advantage plan would cover this benefit and that your providers are in-network.

How Much Organ Transplants Costs With Medicare

Original Medicare covers organ transplants once you meet your Part A and Part B deductibles, though your costs may vary if you have coverage through a Medicare Advantage Plan. The following details the costs of the various types of Medicare coverage for organ transplants.

Medicare Part A

Premiums: Most beneficiaries qualify for free Part A premiums because they (or their spouse) paid into Medicare for at least 10 years; however, others may pay either $285 or $518 per month, depending on their work history.
Deductibles: The Part A deductible for inpatient hospital care is $1,676 in 2025.
Copays/Coinsurance: Once you pay your Part A deductible, Medicare pays 100% of the costs for your stay in the hospital of up to 60 days. After that, you owe partial costs for an extended stay in the hospital of up to 150 days, after which you’d pay 100% out of pocket.

Medicare Part B

Premiums: The Part B premium cost is $185 in 2025. You must pay the Part B premium each month to continue receiving services through Original Medicare or Medicare Advantage.
Deductibles: The annual Part B deductible costs $257 in 2025.
Copays/Coinsurance: Medicare typically covers 20% of approved organ transplant costs once you meet your annual deductible.

Medicare Advantage

Premiums: Premium costs for Medicare Advantage vary by plan; however, you must continue paying your Part B premium, along with Part A, if applicable, to receive Medicare Advantage benefits.
Deductibles: Deductibles may also vary from one Medicare Advantage provider to the next.
Copays/Coinsurance: While these costs also vary by plan, Medicare Advantage typically pays 100% of the costs of care once you meet your annual deductible. Your plan may also maintain an annual out-of-pocket limit for deductible, copay, and coinsurance costs.

Other Benefits to Consider

Non-organ transplants: Depending on your condition and diagnosis, you may require a non-organ transplant. Like organ transplants, Medicare covers procedures such as bone marrow and stem cell transplants once beneficiaries pay their Part B or Medicare Advantage deductibles and meet other requirements.
Skilled nursing facilities: You may need to visit a skilled nursing facility or rehability care center after receiving an organ transplant. Medicare Part A covers inpatient services including skilled nursing facility care for a limited number of days, provided the beneficiary meets their deductibles and other qualifying requirements.
Mental health: Medicare covers wide-ranging aftercare for organ transplant recipients, which may include mental health services. Benefits include inpatient psychiatric care and outpatient mental health services. Beneficiaries must also undergo a mental health assessment through the U.S. Centers for Medicare and Medicaid Services before being placed on a transplant waitlist.

Putting It All Together

Medicare covers the unique costs associated with organ transplants through Part A, Part B, and Medicare Advantage Plans. Beneficiaries must meet select requirements, including being diagnosed with end-stage organ failure or life-threatening condition requiring a transplant, demonstrating a high likelihood of a successful transplant, and seeking in-network services. Consider consulting a licensed insurance broker or agent for assistance in accessing organ transplant benefits through Original Medicare or choosing a Medicare Advantage plan.