How Much Does a Heart Transplant Cost?
We all know the vital role the heart plays to the human body. It transports blood and, with it, the oxygen and nutrition our bodies need to breathe and function. But if your heart does not function properly, doctors might recommend a heart transplant. We’ll examine in this article the cost of a heart transplant, how it’s paid for, and the care required throughout. First up, the heart transplant itself.
What is heart transplant surgery?
A heart transplant is a cardiac medical procedure performed on patients whose heart functions are failing (end-stage heart failure) and they need a healthy, new heart. The new heart is from a deceased donor heart. Due to its severity, a heart transplant is a last resort after treatment options such as medications and other surgical procedures. About 3,700 heart transplants are conducted each year in the U.S., Yale Medicine reports.
A heart transplant may be needed for many reasons, including:
- Cardiomyopathy (when the heart muscle becomes weakened)
- Coronary artery or coronary heart disease
- Ventricular arrhythmias (irregular heartbeats)
- Congenital heart defects (heart problems you’re born with)
- Heart valve disease
- Other severe heart conditions
While many successful heart transplants happen every year in the United States, many patients remain on a transplant program waiting list. During these waiting periods, they are assessed to determine if they meet eligibility criteria. These may include overall health assessments, heart function, lung transplant evaluations, blood pressure checks, and psychological well-being tests.
Appropriate donor organs are hard to come by because many factors (such as blood type, tissue match, and body size) need to be considered. These are the factors that decrease the possibility of rejection and ultimately give way to success. Receiving a new heart is a traumatic and challenging experience, but patients and their families also need to be ready for the financial toll.
Understanding the costs of a heart transplant
The cost of a heart transplant is a lot more than just the surgery. The total average cost of a heart transplant (including pre- and post-surgery care) was $1,664,800 in 2020, according to a report by Milliman.
Here’s a breakdown of potential costs:
- Pre-transplant care: Testing, consultations, evaluations, and prescriptions can run as high as $49,800.
- Organ procurement: The procedure of acquiring and transporting a heart is calculated to cost $131,500.
- Surgical procedure and hospital stay: Between surgery and a lengthy hospitalization stay, costs can run over $1 million. This extends to inpatient treatment, monitoring, and support services.
- Physician and surgeon fees: Typically in excess of $111,000.
- Post-transplant care: It often can take months of intense medical follow-up at a cost that may reach $270,000.
- Follow-up care: After a transplant, frequent checkups, lab tests, and evaluations can help monitor your transplant’s success.
- Lifelong medications: Immunosuppressant medications are required for the rest of a heart transplant patient’s life and cost on average about $39,500.
- Hidden costs: Travel, housing near the medical center, and home accommodations are considerations as well.
- Insurance coverage: Your specific insurance provider and plan can have a large impact on how much you owe in out-of-pocket costs. Because most people really don’t buy their own insurance, they generally get it from their employer, it might even be useful to learn about deductibles, co-pays, and network restrictions.
The total cost of a heart transplant can be staggering, but there are resources that can help.
Crowdfunding for heart transplants
Insurance or not, the U.S. healthcare system can leave families with substantial out-of-pocket expenses. Crowdfunding can be a literal lifesaving way to help offset some of those costs. GoFundMe isn’t just for when you yourself need a heart transplant; you can also use it to raise money for one if your spouse or a friend needs a heart transplant. It only takes a few minutes to create a fundraising page and spread the word to your network.loved one, or a friend in just a few minutes by starting a fundraiser.
Insurance coverage for heart transplant surgery
Insurance can help reduce heart transplant costs, but coverage varies.
Private health care coverage
The cost is often largely covered by employer-provided plans or private insurance policies. Compare the transplant treatment options for your plan and find out which providers and centers are in-network. Check with your insurer for coverage of heart transplants and other care. This type of health insurance is also available from the insurance provider or through the Health Care Marketplace.
Government health insurance plans
Costs associated with transplants may be covered by public health insurance programs like Medicaid and Medicare.
For people who are 65 and older, or who have disabilities or some illnesses (like heart failure or a history of heart attack), Medicare covers many of their costs. The procedures have to be performed at facilities approved by Medicare.
Medicaid, which pays for care for low-income patients who are eligible, has its own rules, which differ by state.
Understanding the specifics of your plan may help you prepare for surgery.
Heart surgery financial assistance options
If you need help paying for your heart transplant, some nonprofit groups may be able to assist:
- HealthWell Foundation: Helps with premiums, co-pays, and other expenses.
- Patient Action Network (PAN) Foundation: Offers financial help to underinsured patients.
- The Assistance Fund: Provides assistance with treatment and medication costs for chronic illnesses, including heart failure.
- American Heart Association: Provides resources, advocacy, and support for people who have heart disease.
Managing heart transplant costs
For many, a heart transplant is a prospect that gives hope for a better quality of life. But the expenses can be crushing. Here’s how to prepare:
- Understand the full financial picture. Be aware of your deductibles, co-pays, and co-insurance. Check credentials with providers and obtain any pre-authorizations.
- Make time to reach out early to nonprofit organizations and patient advocacy groups. The United Network for Organ Sharing, a private, nonprofit organization that oversees organ donation through the government, published a guide with a series of questions to ask before transplantation.
- Explore payment plan options with your medical center.
- Consider internships or volunteer work with healthcare organizations to build connections and gain insights into the transplant process.
- Research other assistance options, like vouchers or prescription programs.
- Contact a transplant center and other organizations, like Habitat for Humanity, for help with housing during medical care.
- Depend upon loved ones, friends, and caregivers for physical and emotional support to aid you on the road to recovery.
Many heart transplant patients also have complex lifetime medication needs. The immunosuppressive medications are very important in order to prevent rejection, and they should be taken as directed.
If you are waiting for a kidney transplant or another organ transplant, well, your costs may be different, and it never hurts to shop around and do some homework.
It may take some effort, but you might be able to maneuver around the costs and receive the care you need.
Get started today
The cost of a heart transplant may feel insurmountable, but you’re not in this alone. If you or someone you care about is going through a transplant, there are resources and support systems that can assist. GoFundMe, one of the biggest crowdfunding platforms, sees thousands of people beginning their own online fundraising journeys on any given day. Our platform is an excellent way to reach a broader audience and get help.
Remember, organ donation is a critical gift that saves lives. Start a GoFundMe today and take the first step toward funding the care you need for your heart transplant. help you need for your heart transplant, get started with GoFundMe.