Most BMTs are covered by insurance. Upon referral, a patient financial representative is assigned to each patient. The patient financial case manager identifies sources of payment for the BMT. However, they may be additional expenses related to travel, lodging, meals, parking and telephone calls. In many cases, there may be changes to the household income when family members take time off work to be caregivers.
What does a BMT cost?
The cost of a blood or marrow transplant varies depending on the disease being treated and the type of transplant. You can't assume your insurance company will cover any or all costs of a BMT. There are a variety of resources available to help you. Work with your hospital social worker to identify these resources.
Will insurance cover all transplant expenses?
Sometimes insurance will provide reimbursement for non-medical expenses related to traveling away from home for medical treatment. Often, insurers assign a transplant case manager, who can help you identify what will be covered by insurance and what your financial responsibilities will be. It's important to understand your deductible and copay responsibilities in your insurance policy. You will also need to check your insurance coverage for home healthcare, outpatient medications and durable medical equipment, which are required after transplant for many patients.
What about missing work?
Employers vary on coverage they must provide to an employee taking leave due to the care of an immediate family member (spouse, child, or parent) with a serious health condition. To determine your employer's specific coverage, contact the Human Resources department at your work place.
What if my insurance company refuses to cover a BMT?
Enlist the help of your physician and BMT Center to work with your insurance company. It is possible to persuade an insurance company to cover a BMT. Don't hesitate to involve an attorney. In many cases, your situation can be successfully resolved by an attorney without going to court.
What if we don't have private medical insurance?
Whether or not you have private medical coverage, it may be to your benefit to apply for assistance through Supplemental Security Income (SSI), Medicare or Medicaid, and Social Security Disability Insurance (SSDI). If you have private insurance, these programs may provide supplemental benefits to assist you with medical expenses that are not covered by your primary insurance.
The programs that most commonly provide benefits to pediatric BMT patients are SSI and Medicaid.
- Supplemental Security Income (SSI) provides financial benefits to blind or disabled adults and children who have limited incomes or resources. It is important to apply for SSI as soon as possible because if you are eligible, benefits go into effect on the first of the month following the month of application (or benefits may be retroactive from the date of approval. Children under eighteen quality for these benefits if they meet social security's definition of disability and if their parents' assets and incomes fall within certain guidelines. Once a child turns eighteen, his or her parents' assets and income are no longer considered.
- Medicaid is a healthcare program for children and adults with low incomes and limited assets. Federal and state governments jointly finance Medicaid. In most states, those who quality for SSI also qualify for Medicaid. If you are eligible for Medicaid, assistance may be retroactive for up to three months from the date of application, so it is important to apply as soon as possible. Contact your BMT financial case manager to determine if your state Medicaid is accepted here.
When should we apply for insurance coverage?
It is important to complete applications insurance as soon as possible, even if you're not sure you will be eligible for benefits. If you are determined to be eligible for insurance coverage, programs will often use the date of application as the date on which benefits begin. Your social worker can help you obtain necessary forms and information.
It is useful to keep a record of all telephone calls, letters related to assistance programs, medical bills, and receipts. If you receive medical bills while your application for medical assistance is pending, inform the billing party that an application has been made.
Are there any grants or ways to raise funds for a transplant?
Families, friends and co-workers often want to help. You may consider asking family, friends and your community to help with fundraising, so you can focus on getting ready for the transplant and recovery. Here are some resources to consider.
Basics of Fundraising
General information on fundraising ideas and techniques on planning a fundraiser for an individual.
(Formerly NTAF) provides support around raising funds in your community to help pay for the medical expenses related to care not covered by insurance (formerly National Transplant Assistance Fund)
BMT Infonet: Fundraising and Financial Aid
A national resource directory of foundations and organizations that can provide financial advice and support.
National Foundation for Transplants
Provides fundraising consultation and resources to those needing transplants.
Children’s Organ Transplant Association
Offers fundraising assistance and family support to children and young adults who need a life-saving transplant.
How long will I have to stay at the BMT center? Do the BMT centers provide temporary housing?
The length of stay varies based on the type of transplant. Allogeneic BMTs are longer (60 to 100 days) than autologous BMTs (30 to 60 days). Most centers have some arrangements for temporary housing. Contact the social workers at the centers for the best information. Check with your insurance company to see if they will pay for housing.
Who can help if you have questions?
The University of Minnesota Masonic Children’s Hospital employs a staff of highly trained financial counselors who understand coverage issues for BMT. Patient Financial Services representatives will work with you, your insurance company, and your physician to arrange for payment for transplant-related services. Representatives are also available to discuss payment options and can help you identify other financial resources that might be useful.
Contact a BMT Financial Case Manager
Last Names A through G Alison Thao (612) 273-4906 1(800) 688-5252 ext. 34906 firstname.lastname@example.org
Last Names H through O Cecile Lee (612) 273-6048 1(800) 688-5252 ext. 36048 email@example.com
Last Names P through Z Heather Land (612) 273-7725 1(800) 688-5252 ext. 37725 firstname.lastname@example.org