Transplant donor coverage in CA

[Cali-Mel]

We have a California member who is in need of a bone marrow transplant. Per his major medical carrier, they do not cover the donor's medical costs nor the transportation of the transplanted ‘organ’, if transportation is needed. The carrier only covers the recipient as ‘medically necessary’ with pre-authorization, etc.

Is this standard in the industry? It seems like it would incentivize NOT being a donor...I'm hoping we were told things incorrectly. What are you seeing across the country?

Thanks!

 

[Lee Vena]

Employee health plans almost never cover any donor costs. Reach out to National Marrow Donor Program for info on the donor, or the facility/provider involved. Generally speaking, donors do not get charged. Good luck.

 

[Cali-Mel]

Thanks Lee. I haven't worked on a transplant issue in 20 years. I appreciate the information.