BMT centers commonly require that patients or their families guarantee or show proof of how they will meet the charges for the transplant before they will be accepted into the program. Therefore, families whose child is covered by health insurance need to find out how much their child’s transplant benefit is and the specific details of what is and is not covered by it.
It is increasingly common for insurance plans to offer transplant coverage that is less than the total cost of a BMT (or organ transplant) and/or for there to be significant deductibles co-payments, and a resulting high dollar amount of patient responsibility for expensive procedures. Therefore, it is very important to learn exactly what your child’s coverage is and to get an estimate of expenses from the transplant center. Many centers will also require that the family make an advance deposit of the co-payment or of a percent of the estimated total cost. According to informing we have received from patient families and social workers nationwide that it is not uncommon that the deposit required be in the range of tens to hundreds of thousands of dollars. (For example, if a plan has a transplant benefit of $250,000 and covers each event or procedure at 80%, the patient share will be $50,000 plus any charges above the maximum allowed.)