Costs and insurance

Lung 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 before receiving transplant services.

Insurance information

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 about 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 insurance require enrollment in Medicare when I become eligible?
  • Does my insurance follow Medicare Coordination of Benefits Guidelines?
  • How will my 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 Part B deductible and coinsurance?
  • Does my plan have a pre-existing or waiting period clause? If so, what is the time frame?
  • Does my plan offer an option for Medicare Part D coverage?

Other expenses

Please plan for other expenses that may occur related to your transplant. These may include, for example, follow-up medical appointments, long-term medications, caregiver expenses, travel, parking and lodging.

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.

Case managers

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.

Oct. 13, 2016
References
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