Medicare Benefit Policy - Post-transplant Services Provided to Live Donor

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Before donating, please be sure to get details on the insurer that is covering your donation.
Here is Medicare's current policy:

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Medicare Benefit Policy Manual Chapter 11 - End Stage Renal Disease (ESRD)  140.9 - Post-transplant Services Provided to Live Donor (Rev. 1, 10-01-03) A3-3178.9

The donor is covered for an unlimited number of days of care in connection with the kidney removal operation. Days of inpatient hospital care used by the donor should not be charged against either party's utilization record. However, the program's assumption of liability is limited to those donor expenses that are incurred directly in connection with the kidney donation. Expenses incurred for complications that arise with respect to the donor are covered only if they are directly attributable to the surgery.

Coverage of kidney donor services includes postoperative recovery services directly related to the kidney donation. The period of postoperative recovery ceases when the donor no longer exhibits symptoms related to the kidney donation. Claims for services rendered more than three months after donation surgery will be reviewed carefully.

However, follow-up examinations may be covered up to six months after the donation to monitor for possible complications. The requirement that additional payment cannot be made for services included in the donor nephrectomy charge still applies.

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