Perspective               

Medicare Pays for Intestinal Transplants

As you may already know, Medicare covers most of the costs associated with heart, kidney, lung, and liver transplants. Medicare now covers intestinal transplants for seniors and people with disabilities who have intestine failure and also experience complications with total parenteral nutrition, a method of feeding patients whose digestive systems are unable to absorb nutrients. Prior to this decision, people with Medicare typically paid over $400,000 out-of-pocket for an intestinal transplant operation.

Medicare will only pay for an intestinal transplant if it is performed at a hospital that has demonstrated past success in the procedure. Only facilities that perform at least 10 intestinal transplants a year and have a 65 percent one-year patient survival rate will be eligible for Medicare reimbursement.

The coverage decision offers new hope to those whose only chance for survival is an intestinal transplant. According to a spokeswoman at the University of Pittsburgh Medicare Center, there are about 40,000 patients in America who are undergoing total parenteral nutrition. About 13,000 of these patients will develop life-threatening complications, including liver failure, blood clots, and severe infections, that can only be treated with an intestinal transplant.

If you have intestine failure and are receiving total parenteral nutrition, talk to your doctor about getting an intestinal transplant. While Medicare will pay the cost of the procedure, keep in mind that Medicare may not cover all of the costs of the immune suppressive drugs following the procedure. To learn more about Medicare coverage of intestinal transplants, call your State Health Insurance Assistance Program, or SHIP. The number is listed in Medicare & You.

_________________________________