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Status of Insurance Coverage for Organ Transplants in the United States: A Review of Recent Surveys

Published online by Cambridge University Press:  10 March 2009

Fred J. Hellinger
Fred J. Hellinger
Affiliation:
National Center for Health Services Research and Health Care Technology Assessment
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Extract

The economic, political, ethical, and medical issues surrounding organ transplantation are complex, and coverage policies for it vary considerably among insurers. Some insurers cover virtually all transplants, while others cover few or none (Wyoming Medicaid does not cover any transplants) (3;4;5;6;7). In the past, insurers have followed Medicare's lead regarding coverage of new technologies. This has not been the case with organ transplantation. Although Medicare does not cover heart transplants, almost all Blue Cross/Blue Shield plans and commercial health insurers, as well as one-half of the state Medicaid plans and one-third of the Health Maintenance Organizations (HMOs), do cover heart transplants. (See note, p. 570.) In addition, although Medicare does not cover heart–lung transplants, a substantial proportion of Blue Cross/Blue Shield plans, commercial health insurers, state Medicaid plans, and HMOs cover it. At present, Medicare covers kidney and cornea transplants, selected pediatric liver transplants, and selected bone marrow transplants.

Type
Statistics
Information
International Journal of Technology Assessment in Health Care , Volume 2 , Issue 3 , July 1986 , pp. 563 - 570
Copyright
Copyright © Cambridge University Press 1986

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References

REFERENCES

1.American Council on Transplantation of the American Red Cross. In Facing the organ crisis. Washington Post. 03 15, 1986, Health Section, p. 15.Google Scholar
2.Blue Cross and Blue Shield Association. Criteria for evaluating institutions for liver and heart transplants. Chicago, IL: Blue Cross and Blue Shield Association, 1985.Google Scholar
3.Blue Cross and Blue Shield Association. Current status of plan coverage: Transplant 1985 update. Chicago, IL: Blue Cross and Blue Shield Association, 1985.Google Scholar
4.Crowley, G. M., & Plotnick, E. M.Organ transplant survey. Washington, DC: Group Health Association of American, Inc., 1985.Google Scholar
5.Fuchs, M.Organ transplantation: Issues and challenges confronting HMO's. Washington, DC: Group Health Association of America, Inc., 1985.Google Scholar
6.Health Insurance Association of America. HIAA survey of coverages for organ and tissue transplant recipients under group comprehensive and major medical expense plans. HIAA Research and Statistical Bulletin No. 2–85, 1985.Google Scholar
7.The Intergovernmental Health Policy Project and the Health Care Financing Administration. Medicare coverage and payment policies for organ transplants: A fifty state review. Washington, DC: Health Care Financing Administration, 1985.Google Scholar
8.Tennenbaum, D., Blue Cross and Blue Shield Association Technology Management Department. Personal communication. April 17, 1986.Google Scholar
9.U.S. Department of Health and Human Services Task Force on Transplantation. Report to the Secretary and the Congress on immunosuppressive therapies. Washington, DC: U.S. Government Printing Office, 1985.Google Scholar