While liver transplant surgery is expensive, insurance can cover a significant portion of the costs for those eligible for the procedure. There are also organizations that a person can contact for financial support.
A liver transplant is a surgical procedure for people in the end stages of liver failure. A person may require a liver transplant when other treatment options are not able to restore liver function or reverse liver damage.
This article provides an overview of the cost of liver transplants. It also covers the other financial options available.
The cost of a liver transplant can vary depending on a person’s location, medical charges, healthcare facility, insurance coverage, and other factors.
Evidence from 2020 indicates that a liver transplant costs $878,400.
The cost of a liver transplant covers the entire bill of the procedure from 30 days before the transplant to 6 months after the surgery.
|What it means||Estimated cost|
|Procurement||Procurement covers all services to recover the liver tissue from a donor. |
This includes the costs of retrieval, preservation, and transportation of the liver.
|30-days pretransplantation||These are medical costs that a patient incurs 30 days before the hospital admission for a liver transplant. |
It can cover the costs of comprehensive physical, psychological, and laboratory testing.
This can include crossmatching for donor compatibility, blood screening, and X-rays.
|Hospital transplant admission||This fee covers admission and facility charges, including room and board, inpatient care, and other facility-based expenses.||$490,600|
|Physician services||These are charges for a doctor’s professional services during a liver transplant admission. |
It covers every surgical procedure per the Healthcare Common Procedure Coding System (HCPCS) guidelines.
|Post-transplant discharge||This includes all hospital readmissions, lab testings, outpatient visits, and postsurgical complications 180 days after a liver transplant. |
It can consist of both transplant-related and nontransplant-related expenses.
|Outpatient medications||It covers the cost of all prescription medications, including immunosuppressants, from discharge to 180 days after.|
A person’s insurance plan will determine the coverage they can get. However, most insurance plans have a cap on the amount they can pay.
People who are in the end-stage of liver disease and require a liver transplant may be eligible for Medicare.
The liver transplant must be in a Medicare-approved facility to qualify for Medicare benefits. Medicare Parts A and B will cover transplants and other medically-important health services.
Medicare part A will cover the following costs for a person receiving a liver transplant and their living donor.
- any necessary laboratory tests and physical exams
- services required for a liver transplant
- procurement of the liver
- followup care
- immunosuppressive, or transplant, drugs
Medicare part B will cover:
- doctor’s or liver specialist’s visits
- transplant drug therapy
- certain immunosuppressive medications, if related to Medicare-covered liver transplant
A person receiving a liver transplant can purchase private health insurance plans that combine original Medicare Parts A and B in a single policy.
Medicare Advantage, or Medicare Part C, can help with the following out-of-pocket costs, which include:
- emergency ambulance transportation
- emergency room care
- mental health counseling
- physical, occupational, and speech therapy
Part C plans can also include a drug coverage known as Part D, which covers prescription drugs only.
A liver transplant patient may be eligible for a Part C if they:
- already have Medicare Parts A and B
- need more coverage for prescription drugs
After a person’s insurance has covered a good part of their liver transplant cost, they will still have to pay for other expenses, including:
- transplant facility charges
- lab tests not on the Medicare plan
- 20% of the Medicare-approved costs for doctor’s service
If they have secondary insurance, it can help cover the remaining medical expenses.
Medigap is a private insurance plan that can help cover costs left over by Original Medicare. These costs can include deductibles, copayments, and coinsurance following a liver transplant.
Medigap only pays after a person and Medicare have completed their medical services payments.
A person with secondary insurance may not need a Medigap plan since their second policy will pay for any additional expenses not covered by Medicare.
If a person is eligible for a liver transplant and needs free or low cost care based on certain income and family size requirements, they may be eligible for Medicaid.
Most Medicaid programs only cover liver transplants in their state unless there are no available transplant centers.
Medicaid can cover liver transplant costs that include:
- hospital care
- physician services
- laboratory and X-ray tests
- prescription drugs
- personal care services
- home-health services
The following financial aid programs assist people with their liver transplant costs:
A person does not need to pay to donate part of their liver. The recipient’s insurance covers all medical expenses during the transplant evaluation and surgery. However, a person may be responsible for paying for their medical maintenance test to ensure they are healthy to donate their liver.
They may be responsible for some out-of-pocket travel expenses which the recipient’s insurance will not cover, such as:
- travel expenses such as gas and airfare
- food and lodging during the donor evaluation
- lost wages during recovery
Health insurance can cover vital liver transplant costs, including hospital services, medical services, immunosuppressants, and post-transplant care.
Many insurance beneficiaries will still incur additional expenses. However, some financial options can help them cover it.
A person who requires a liver transplant should discuss any financial or insurance concerns with a financial coordinator at the transplant center. The financial coordinator will help them determine which insurance plan they are most eligible for and how to manage the cost of care.