If you and your doctor are considering a bone marrow or cord blood transplant (also called a BMT), then you may have a number of questions. You are probably learning more about the BMT process. You might also be wondering what expenses are involved in getting a BMT and whether or not your insurance will cover such costs.
If you have no health insurance, call your county human services department to see if you qualify for state medical assistance or other help. For information about other programs that may be available to help, go to the Patient Advocate Foundation Web site at www.patientadvocate.org/resources.php.
Evaluating your health care plan
Every insurance company pays for the transplant process in different ways — some pay for all of it, some pay for part of it and some do not pay for it at all. It is very important to find out early what transplant expenses are covered. Here are some steps you can take to learn about your insurance coverage. It may be a good idea to ask a trusted family member or friend to help you so that you can focus on your health.
- Read any written information that has been given to you explaining your plan.
- If you have insurance through your workplace, ask to speak with the person or department in charge of benefits. He or she may be able to help you with insurance coverage questions.
- Ask for a financial representative at your doctor's office, hospital or transplant center. He or she will be able to assist you with questions and can also tell you about any costs you will be responsible for paying.
Services that may not be covered
You may want to ask if the following items are covered by your specific health insurance plan:
- Testing to find a matched unrelated or related donor or cord blood unit
- Donor costs
- Transplants for a rare diagnosis
- Travel and lodging expenses to and from the transplant center for patient and/or caregiver
- Food costs while staying near transplant center
- Parking costs
- Prescriptions for post-transplant discharge or outpatient medications
- Office visits coverage
- Home health care
- Psychiatric coverage
- IV Neupogen injections
- Procurement of cells from the donor
- Harvest/storage fees prior to transplant
- Backup collection of cells
- Clinical trials
- Sperm/egg storage
- Insurance premiums when patient is not employed
- Fees for post-transplant home preparation (carpet and drapery cleaning, replacing filters on heaters, air conditioning cleaning)
- Change in cost of living after transplant (different food needs, for example)
- Child-care costs
If your insurance does not cover all of your costs related to transplant, you may be eligible for Financial Assistance for Transplant Patients.
A marrow or cord blood transplant for United States citizens or residents is usually paid for through private or government insurance programs. If you are not a United States citizen or resident, check with your government or healthcare provider about transplant coverage outside of your country. If you will be going to a transplant center outside of your country, you may need to make a large financial deposit or pay for the transplant in full before being considered.
Contact your insurance company
- Contact your insurance company. Ask for your case manager. If you do not have a case manager, ask for one to be assigned to you. He or she may help you understand your coverage and/or what steps you need to make sure the costs are covered when the bills come in.
- Keep good notes of any conversations you have with your insurance company.
- Record the dates of your conversations and names of persons you speak to.
- Ask for all information in writing.
To ensure that you get the maximum insurance coverage possible, Be The Match® Patient Services has a team dedicated to supporting you before, during and after a bone marrow or blood cell transplant. We offer you free, confidential on-on-one support and financial guidance. Our goal is to help you get what you need, when you need it.