Financial Issues

• Most medical costs for living donation are paid by the recipient's insurance.
• This includes the medical costs related to the donor's:
  • Pre-surgery medical tests
  • Transplant surgery
  • Hospital stay
  • Care after surgery
  • Donation-related care up to 2 years post-donation
  
  
  Click here to learn about who pays if the donor is an undocumented immigrant.

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• Yes. You do not need to have health insurance to pay for the medical costs of donation.
• The recipient's insurance pays the medical costs of living donation.
  
  Click here to learn whether undocumented immigrants can still donate.

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• National Living Donor Assistance Center (NLDAC) gives financial aid to people who want to donate a kidney. Click here to learn more about NLDAC.
• Other groups award financial aid to cover travel and lodging costs. Click here for resource guide.
• Family members can give personal time and financial support to help cover the costs not covered by the recipient's insurance.

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• Some states offer tax deduction or credits to living donors to help cover costs
• Illinois does not offer tax deductions or credits to living donors, but offers paid leave of absence to living donors who are state employees
• California does not offer tax deductions or credits to living donors, but allows living donors who are state employees to take up to 30 days of paid leave of absence
• Call your congressman or congresswoman for more information or click here to learn more about federal and state legislation about donor leave laws and tax deductions and credits at Transplant Living

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• The Transplant Social Worker
• The Transplant Financial Coordinator
• An Independent Donor Advocate
• Your Family

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• If you work for the federal government, you get 30 days paid time off for living donation through the Donor Leave Law.
• Not every state offers this benefit to employees. Please ask your employer.
• Private Sector Employees: Some are allowed a leave of absence, but it differs by state, individual case and company.

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• Some donors could get time off using sick leave, disability and the Family and Medical Leave Act (FMLA)
• If your job offers disability insurance, then you may be able to get disability pay
• You should talk to your employer for more information

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• If you were to get complications after donating, then you may not be able to do the work you were doing before donating. You might have to find other work suited to your health needs. If you have health complications from donating, it may be hard to find future employment.
• If you need more time to recover than your employer allows, your employer may not be able to wait. It is possible that your job could be lost.
• If your employer does not approve your time off to donate, but you decide to donate anyway, then you might lose your job.
• It is important to talk to your employer before you donate to find out how much time your employer will allow you to take off.

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• You may have a hard time getting health, disability, or life insurance in the future.
• You may have a harder time switching health insurance plans after donating because of higher premiums or a pre-existing waiting period.
• Your insurance carrier may not cover future health problems that arise due to the donation.
• Talk with the transplant center social worker or financial coordinator about how donating might affect your insurance policy.
• Check your insurance contracts for any information on how living donation could affect your policy.
• The Affordable Care Act may improve your ability to switch insurance plans without any penalty.

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• There have been cases where living donors have had problems renewing or obtaining life insurance policies after donating.
• Donation may affect your maximum lifetime benefits.
• Check to see if donation affects your current life insurance policy.

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• No. It is illegal to buy or sell human organs. Click here for more information on the National Organ Transplant Act (NOTA) of 1984.
• However, the National Organ Transplant Act allows some payments to be made to living donors for costs relating to: travel, housing, and lost wages due to the donation of an organ.

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• If you do not have any health insurance and do not qualify for any coverage, you can still get a transplant, but you will need to pay for the costs out of your own pocket.
• If you are a U.S. citizen or documented immigrant with end-stage kidney disease (ESKD), you may be able to get Medicare coverage for your transplant.
  
  Click here to learn about how undocumented immigrants can get transplants.

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• As the recipient, your health insurance should cover most costs related to transplant surgery and transplant medications.
• Insurance companies may be:
  • Private, e.g., Blue Cross/Blue Shield
  • Medicare (if eligible)
  • Medicaid (if eligible)
  
  
  Click here to learn about how a transplant is paid for if the recipient is undocumented.

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• $150,000 - $250,000 on average
• Required medications, tests, and doctor visits cost about $20,000 per year for the life of the transplanted kidney.
• Costs vary by transplant hospital, so you should ask your hospital about costs in advance.

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• U.S. citizens and documented immigrants diagnosed with (ESKD) End-Stage Kidney Disease by a health care provider.
• ESKD patients getting Social Security or Railroad Retirement benefits.
• ESKD patients who meet the needed work credits under Social Security (40 quarters or 10 years work), Railroad Retirement or as a government employee.
• The spouse or dependent child of a person who has met the work credits or who is getting Social Security or Railroad Retirement benefits.
• Undocumented immigrants are not eligible for Medicare or Medicaid.
• For more information on Medicare eligibility, please visit www.cms.gov.

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• Medicare covers 80% of the cost of transplant surgery.
• Medicare Part B covers 80% of the cost of anti-rejection medicines for up to 36 months (3 years) post-transplant.
• The remaining 20% of costs may be covered by a secondary health insurance policy or covered by the recipient's own out-of-pocket payment.
• Medicare coverage ends after 3 years after the transplant for younger, able-bodied patients.
• Some patients may keep Medicare after 36 months post-transplant if they are eligible based on age or disability status.

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• After 2014, the federal Affordable Care Act will not allow insurance companies to deny coverage to individuals with a pre-existing condition.  Insurance coverage, however, may be more expensive for you after the kidney transplant. Also, it may be harder to get life insurance after the transplant.

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• Fundraising. Recipients and donors can raise funds to cover transplant costs.
• There are groups that help patients organize their own fundraising campaigns.
  • Resources Guide
• People can legally give others a tax deductible gift of $10,000.
• Friends and co-workers may be able to donate vacation time to another person.

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