Organ transplants and anti-rejection drugs under Medicare

Which transplants are covered

Medicare covers heart, lung, kidney, pancreas, intestine and liver transplants under certain conditions, but only in Medicare-certified facilities. It also covers bone marrow and cornea transplants under certain conditions. The surgery itself may be covered as an inpatient hospital stay under Part A.

Kidney donors: Medicare pays the full cost of care for your kidney donor. Neither of you pays a deductible, coinsurance or other costs for the donor's hospital stay.

Anti-rejection drugs

• Part B covers immunosuppressive drugs if Medicare paid for the organ transplant.
• You must have had Part A at the time of the transplant, and must have Part B when you get the drugs.
• You pay 20% of the Medicare-approved amount after the Part B deductible.
• If Part B doesn't cover them, your Part D drug plan does.

After a kidney transplant: the drug-only benefit

If you have Medicare only because of kidney failure (ESRD), it ends 36 months after a successful kidney transplant. Medicare offers a separate benefit that keeps paying for your immunosuppressive drugs after that, if you don't have certain other coverage, like a group health plan, TRICARE or Medicaid that covers them.

• It covers only immunosuppressive drugs (including certain compounded ones), nothing else. It isn't full health coverage.
• In 2026 it costs $121.60 a month (more with higher income) with a $283 deductible, then 20% of the Medicare-approved amount.
• You can sign up any time after your Part A ends, if you had Medicare because of ESRD when you had the transplant. Call Social Security at 1-877-465-0355 (TTY 1-800-325-0778).
• If your income and savings are limited, a Medicare Savings Program (QMB, SLMB or QI) may help pay for it.

Medicare Advantage and transplants

If you're on a transplant waiting list or think you'll need one, check before joining a Medicare Advantage plan that your doctors and transplant hospital are in its network, which drugs it covers and their costs, its prior authorization rules, and how it covers living donors.

More on kidney failure coverage: Medicare for ESRD.