Newark Beth Israel Medical Center Heart Transplant Cost

A heart transplant is a major operation. Numerous factors play into heart transplant cost, and there are numerous ways to pay for a heart transplant.

“How much is a heart transplant?” is a common question that patients ask.

While the question can never be answered with one hundred percent certainty, having a general idea of the heart transplant cost upfront helps patients make financial plans. Additionally, knowing costs that are not so transparent helps patients avoid potential pitfalls.

Generally speaking, a heart transplant before insurance coverage can potentially cost well over 1 million dollars. Some but not all of what patients pay for includes:

  • Initial testing with or without hospitalization
  • The surgery and hospital stay afterward
  • Medications before, during, and after surgery
  • Visits before and after surgery

Nonmedical wages are also important to consider. These can potentially include:

  • Transportation/travel
  • Lodging
  • Childcare

Finally, lost wages should be considered, as patients will undoubtedly miss a substantial amount of time from work throughout the heart transplant process.

Different ways to pay for a heart transplant

Fortunately, patients do not have to shoulder all or even the majority of the financial burden.

  • Private insurance will often pay for the majority of the heart transplant cost. One caveat is most insurance plans have a maximum amount they cover, which unfortunately is usually not the full heart transplant cost.
  • Secondary insurance comes into play to pick up where primary insurance leaves off. It will typically pay some, the majority, or all of what primary insurance does not cover. Patients who do not have secondary insurance are strongly encouraged to obtain it through their employer, the government, or a private company.
  • Medicare will cover heart transplant cost; however, it is not available to everyone. Only patients who are 65 or older, younger patients with disabilities, and patients with end-stage renal disease qualify for Medicare.
  • Medicaid varies from state to state. Heart transplant patients who qualify for Medicaid are encouraged to talk to their heart transplant coordinator about heart transplant cost and what is covered.
  • Tricare is supplemental insurance that is available to active and retired military members. It will cover some of the heart transplant cost.

How to navigate insurance for a heart transplant

Patients must have a thorough conversation(s) with their insurance provider before their heart transplant. Knowing what insurance will and will not cover helps patients avoid being blindsided by unexpected costs. Some important questions to ask insurance companies include:

  • What specifically does my plan cover in regards to transplant services? What are my deductibles and copayments?
  • What is the maximum amount for transplant services?
  • Does my plan cover immunosuppressant medications?
  • Does my plan include medication coverage?
  • Will I need special approval for a heart transplant or evaluation for a heart transplant? If so, how long does the approval process take?
  • Will my plan cover nonmedical costs?
  • Is there a specific provider I need to use?

Tips that can help you navigate insurance include, always:

  • Keep copies of medical bills, insurance forms, and payments you have made
  • Follow the rules as stated by the insurance company
  • Keep a detailed log of conversations with anyone about insurance, bills, or payments
  • Talk to the Newark Beth Israel heart transplant team to let them know what insurance you have

Finally, patients are encouraged to speak to their Newark Beth Israel heart transplant coordinator about navigating insurance. Transplant coordinators have the knowledge and experience needed to help patients understand insurance and all of the financial aspects of a heart transplant. Do not let cost steer you away from a heart transplant, contact one of our heart transplant coordinators today to get the help you need.

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