Warning: This article may trigger feelings of fear and discomfort if you need a heart transplant, and like most of us also have financial concerns about paying for it. Please know that there are resources out there to help transplant recipients, ask your hospital social worker. I wrote this blog based on my individual experience with my heart transplant. I also wrote it because I was curious and I knew it would cost more money than I could possibly afford.
How Much Does a Heart Transplant Cost?
The Answer: $1.2 million dollars (US).
Prior to getting listed on the Heart Transplant Waitlist, I was required to meet with a hospital financial counselor to discuss my ability to pay for the transplant and the annual cost of my care.
Let’s talk money.
They don’t talk about insurance authorization or the cost of transplant during Grey’s Anatomy. What I am telling you is the reality.
You will need some financial resources (insurance and some cash on hand) to have a heart transplant in the US.
I did not pay $1.2 million dollars because I have health insurance. Though, it has been a financial struggle for me to maintain continuous insurance coverage in my lifetime (especially during times of under and un-employment), but as a childhood survivor of cancer I knew it might save my life (and it did).
Below, I’ve broken down the cost of the $1.2 million dollars. I’ve included both annual expectation and one-time cost of a heart transplant.
$5,700-$15,000 minimum in annual insurance premiums plus co-pays & Max out-of-pocket
If you don’t have insurance, then you might be able to get some charity funding or in some states you may qualify for state-funded high risk insurance, but you may need to do some sort of fundraising (think GoFundMe).
If you are private pay, you will be expected to pay in advance a portion of the total amount. The hospital may want to see your bank account (yep), prior to getting on the Waitlist.
The financial counselor at my Transplant hospital stated that they like to see at least $40,000 in your bank account, if you’re private pay (an outrageous thought!).
I had to laugh with stress when they gave us a handout on “How to do Fundraising for Your Heart Transplant,” as if I had the energy for such an undertaking.
$10,000 Travel & Lodging
For two years during the workup through post-op care, I lived 3 hours away from my home. My insurance company would not pay for a transplant in my hometown (talk about stressful), but it would reimburse me and my Caregiver for transplant-related travel and lodging FOR THE REST OF MY LIFE, up to $10,000.
I’ve met many recipients who rent apartments or live in extended stay hotels near their transplant hospitals. If you have to fly to the Mayo clinic, for example, for transplant check-ups for the rest of your life, insurance may reimburse you for your flights, rental car and hotels.
I have a transplant friend (she had a double lung transplant) that flies from Central Texas to Phoenix every 3 months. She and a caregiver drive the 26 hours during flu season to avoid infection.
$35,000 Annual Cost of Anti-rejection Medications
Anti-rejection medication costs about $35,000 annually and you must take them for the rest of your life. Did I mention this is the cost every year?
It’s important that you demonstrate the resources to access post-op care or it may be problematic to getting on a transplant wait list. The transplant team considers many factors beyond just medical necessity to determining if a patient is a good candidate for their transplant program.
Recipients need a support system, who is going to take care of you and drive you to appointments? You need reliable transportation to get to/from appointments, including airfare and hotel if you’re far from the hospital. And you need some sort of financial means to have stable housing, afford medications and ability to attend future appointments and procedures.
Typically a heart transplant is not the immediate emergency room situation that is portrayed on TV. The transplant team will evaluate your case at their weekly meeting to discuss your overall medical need, financial resources and social support system prior to getting on the Waitlist.
$50,000-$70,000 Work Up
The “work-up” can take days or weeks; it includes all the testing and meeting with countless specialists to determine if you are a good candidate medically to endure a heart transplant. You may also get a second work up opinion, which means these tests will likely be repeated and the cost will double ($140,000).
Tests include cardiac catheterizations, MRI/CT Scans and consultation with every medical specialty you can possibly imagine, including the dentist. You must have good teeth and not have gum disease to be eligible for a transplant. There is a correlation between gum disease and heart problems.
This is the cost of performing surgery on the donor to remove the organ and then transport it to the recipients’ hospital. Hearts are transported in a cooler (often red and white) on dry ice. The cooler is carried by a medical professional (a surgeon or nurse). The organ may be flown on a commercial or private airplane, if needed. Once the organ is received a transplant cardiologist must exam it for viability for transplant. All this must be done within 4-6 hours. It’s a time sensitive procedure.
The donor does not pay for any costs related to organ donation. Likewise a donor family may not be financially compensated in anyway for giving an organ. Buying and selling organs is illegal in the United States.
$70,000 Transplant Surgery
This is just to pay for the cardiac thoracic surgeon and team to perform the transplant surgery.
Anesthesia during the surgery is the single most expensive cost of a heart transplant.
$140,000 Post-Operative Care for 6 Months/Cardiac Rehab/Cardiac Biopsies/Surveillance
The first few weeks I was out of the hospital I saw my transplant team in clinic 3 times a week!
It was a physical challenge to walk, get in the car and then spend nearly a full day, getting blood work, echos and meeting with multiple disciplines. They call this “Surveillance,” and I would say I was watched closely.
About 2-3 months after I’d healed from the transplant surgery, I was strong enough for Cardiac Rehab. This is supervised exercise 3 times a week by nurses and exercise physiologists.
$640,000 Hospital Stay
I was in the hospital for 30 days and half the time I was in the ICU.
Patients are in the hospital for a heart transplant between 15 to 45 days with the average stay around 22 days; during this time the recipient will be in the ICU. I also spent 4 days on life support (aka ventilation), this is the highest level of care in a hospital and most expensive, because it’s one-on-one nursing care and requires technical support.
The above linked article suggests that the successful outcome of the patient is based on the experience of your hospital, so I encourage you to do some research on the heart transplant program you choose: it could be a matter of life or death.
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Here is my most viewed YouTube video on the cost of transplant: