Pancreas transplants
Medicare Coverage Information
Overview
Medicare provides coverage for pancreas transplants when they are medically necessary and meet specific clinical criteria. These complex procedures are typically covered under Medicare Part A for eligible patients with specific medical conditions.
- Pancreas transplants are covered when deemed medically necessary
- Must be performed at Medicare-approved transplant centers
- Typically covered for patients with severe diabetes or pancreatic failure
- Requires pre-authorization and comprehensive medical documentation
- Coverage includes the surgical procedure, hospital stay, and related medical services
- Medicare Part A beneficiaries
- Patients with end-stage pancreatic disease
- Individuals with severe type 1 diabetes
- Patients recommended for transplant by qualified physicians
- Covered under Medicare Part A hospital insurance
- Beneficiary may be responsible for 20% of Medicare-approved costs
- Part B may cover additional immunosuppressive medications
- Actual out-of-pocket costs depend on specific Medicare plan
- Must be performed at Medicare-certified transplant facilities
- Requires documented medical necessity
- Limited to patients meeting specific clinical criteria
- Pre-transplant evaluations and testing must be approved
- Consult with your healthcare provider about transplant necessity
- Contact Medicare at 1-800-MEDICARE for specific coverage details
- Get a comprehensive evaluation at a Medicare-approved transplant center
- Verify your specific Medicare plan's transplant coverage
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicarepancreas transplantorgan transplant coverageMedicare transplant benefitspancreatic surgery
Related Coverage Topics
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