Heart transplant costs and insurance information
Mayo Clinic has dedicated transplant financial services representatives and social workers who can assist you with insurance and financial questions regarding your transplant.
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.
In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. Many insurance companies require you to get preapproval authorization prior to transplant services.
Before your transplant, it's important that you work closely with your insurance company to understand your benefit plan. You'll be responsible for any of your transplant and medical care costs not covered by your insurance company.
You may want to ask your insurance company several questions regarding your transplant expenses, such as:
- What is the specific coverage of my plan? What are my deductibles, coinsurance, copayments, lifetime maximum amount and annual maximum amounts for both medical care and transplant services?
- Does my plan have a pre-existing or waiting period clause? If so, what is the time frame? Can this be waived?
- Does my plan include pharmacy coverage? If so, will my plan cover my current medications and immunosuppressant medications?
- Does my plan require any special approvals for evaluation or transplant? How long does the approval process take once submitted to insurance?
- Does my plan cover my transportation and lodging expenses during my transplant care?
- Does my current insurance require enrollment in Medicare when I become eligible?
- Does my insurance follow Medicare Coordination of Benefits guidelines?
- How will my current coverage change after I enroll in Medicare? Will my plan become a supplemental or secondary plan?
If your plan is a Medicare supplement, ask questions such as:
- Does my plan follow Medicare guidelines?
- Does my plan cover Medicare Part A and B deductible and coinsurance?
- Does my plan have a pre-existing or waiting period? If so, what is the time frame?
- Does my plan offer an option for Medicare Part D coverage?
Please plan for other expenses that may occur related to your transplant, which may include follow-up medical appointments, long-term medications, caregiver expenses, travel, parking, lodging and other expenses.
For international patients
Mayo Clinic has dedicated international patient account representatives who can assist you with questions regarding your costs and insurance. Read more about international financial services.
Mayo Clinic financial staff will work closely with your case managers from your insurance company. Your case manager, who is assigned to you, is available to answer questions and calls related to your insurance costs.
Feb. 14, 2017
- Scientific Registry of Transplant Recipients. http://www.srtr.org/default.aspx. Accessed May 13, 2016.
- U.S. News & World Report. U.S. News Best Hospitals 2015-16. http://health.usnews.com/best-hospitals/rankings. Accessed Feb. 22, 2016.
- Cook AJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. May 2, 2014.
- Heart transplant program to resume in fall of 1986. Mayovox. 1986:37;1.
- Mancini D. Indications and contraindications for cardiac transplantation. http://www.uptodate.com/home. Accessed April 22, 2016.
- Barbara Woodward Lips Patient Education Center. Heart transplant. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Yip DS (expert opinion). Mayo Clinic, Jacksonville, Fla. June 20, 2016.
- Barbara Woodward Lips Patient Education Center. Your child's heart transplant. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Johnson JN (expert opinion). Mayo Clinic, Rochester, Minn. June 20, 2016.
- Vucicevic D, et al. Sirolimus based immunosuppression results in lower incidence of post-transplantation lymphoproliferative disorders in heart transplant recipients. Journal of Heart and Lung Transplantation. 2015;34:s86.
- Kalya A, et al. Role of total artificial heart in the management of heart transplant rejection and retransplantation: Case report and review. Clinical Transplantation. 2013;27:e348.
- Shankar N, et al. LVAD implant as a bridge to heart transplantation is associated with allosensitization as measured by single antigen bead assay. Transplantation. 2013;96:324.
- Barbara DW, et al. The perioperative management of patients undergoing combined heart-liver transplantation. Transplantation. 2015;99:139.
- Burkhart HM, et al. Regenerative therapy for hypoplastic left heart syndrome: First report of intraoperative intramyocardial injection of autologous umbilical-cord blood-derived cells. Journal of Thoracic and Cardiovascular Surgery. 2015;149:e35. http://www.sciencedirect.com/science/article/pii/S002252231401602X. Accessed May 5, 2016.
- Pundi KN, et al. 40-year follow-up after the Fontan operation: Long-term outcomes of 1,052 patients. Journal of the American College of Cardiology. 2015;66:1700.
- Rosenbaum AN, et al. Current indications, strategies and outcomes with cardiac transplantation for cardiac amyloidosis and sarcoidosis. Current Opinion in Organ Transplantation. 2015;20:584.
- Grupper A, et al. Increased risk of antibody mediated rejection and subsequent allograft vasculopathy in women post cardiac transplantation. Journal of Women's Health. 2015;24:A-16.
- Rosenbaum AN, et al. Association between early cardiac rehabilitation and long-term survival in cardiac transplant recipients. Mayo Clinic Proceedings. 2016;91:149.
- Medical practice report: Heart transplant. Press Ganey. http://www.pressganey.com/. Accessed May 24, 2016.
- Khandhar SJ, et al. Optical coherence tomography for characterization of cardiac allograft vasculopathy after heart transplantation. Journal of Heart and Lung Transplantation. 2013;32:596.
- Mayo Clinic Children's Center becomes first accredited pediatric heart failure institute in Minnesota and fourth in the nation (news release). http://www.evaluategroup.com/Universal/View.aspx?type=Story&id=458981. Accessed June 27, 2016.
- Doctors name America's top residency programs (news release). U.S. News & World Report. http://health.usnews.com/health-news/top-doctors/articles/2014/02/20/doctors-name-americas-top-residency-programs. Accessed June 27, 2016.
- Centers of excellence. Extracorporeal Life Support Organization. https://www.elso.org/Excellence/CentersofExcellence.aspx. Accessed June 27, 2016.
- Heilman RL (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. June 24, 2016.