Organ Transplants And Health Insurance

by Casey Trillbar

Medical issues can be terrifying, and when it comes to learning that you need an organ transplant, the fear can be all-consuming. Add to this the sheer cost of any surgery (some outpatient surgeries can easily cost over $25,000), and you have a recipe for disaster.
Regardless of whether someone that needs a transplant is poor or rich, with or without health insurance, hospitals will require the patient or a legal representative to discuss payment arrangements for a transplant. Even individuals with excellent insurance may still have to pay thousands of dollars for an organ transplant. With recovery time usually rather extensive, and anti-rejection and immunotherapy medication prices through the rough, even individuals with a reasonable income may simply find the procedure unaffordable.
Some hospitals are more willing to work with patients than others. Most, if not all, have financial assistance programs specifically for those who need a procedure done but lack the money to pay easily.
While most hospitals offer loan repayment options, it is better to request an application for any programs that either reduce or even eliminate the bill(s). These programs require extensive paperwork to apply, often amounting to a heavy stack of documents. Expect to be required to provide evidence of all monthly bills, outstanding debts, all sources of income for at least the past three months, and tax statements.
Also plan to write a hardship letter describing the current financial situation, expected financial circumstances due to the surgery, and medical need for the surgery. Individuals without insurance should make an effort to show that attempts have been made to obtain health insurance, but it has been denied, offered with ridiculous riders, or is utterly unaffordable. Provide a detailed monthly budget as well, with a list of all debts. While all of the paperwork can take considerable amounts of time to complete, this attempt has the potential to obtain complete payment of the surgery from the program.
Another factor to consider when it comes to organ transplants and health insurance is that different organ transplant centers have differing conditions as to the order of receipt of replacement organs. All centers are part of the United Network for Organ Sharing, an organization that maintains a nationwide patient list. Organs are sent to either the sickest patients or those that have been on the waiting list the longest.
However, there is a huge problem when it comes to this system. Each of the 256 organ transplant centers in the United States is permitted to independently determine who gets on the list. Since there is no regulation as to this process, these centers are allowed to reject patients that lack health insurance or a ready ability to pay for out-of-pocket costs.
With this in mind, it is best for anyone to contact a number of different centers and request information about their policies, and apply at the one that gives you the best chance for quickly getting on the organ transplant list.
Always keep in mind during all phases of your health care that you are always your best advocate, and don't be afraid to question anything.

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