What should a transplant recipient know about health insurance?

Insurance has become the ugly word of medicine. With that said, it is important that you know as much as you can about your insurance coverage if you are going for an organ transplant surgery. How much are your office and prescription co-pays? Do you require preauthorization for appointments with specialists or for tests? Do you know when your Consolidated Omnibus Budget Reconciliation Act (COBRA) is going to run out?

Do you know what your coverage limitations are? If you are enrolled in a new plan as of the first of the year, do you know how your new insurance differs from your old? Do you know if your providers are still in-network? Do you have a coverage cap on your insurance?

As you can see, there are a million questions that can come up in relation to your insurance. The questions above are just the beginning. It is important to make friends with your insurance case manager as there is usually a person assigned to your case when you have been approved for a transplant. They can be an invaluable resource to you should questions arise. Do not leave your insurance correspondence unopened in a pile on the kitchen table. Many patients have done this and been lost when their coverage unexpectedly lapsed or expired because a payment was not sent or a form not completed. Please speak to your social worker or financial coordinator BEFORE you are in a situation where you are out of coverage with no medications.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.