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Understanding your health insurance can be confusing. Listen as patients and doctors talk about why it's important to understand and ask questions about your insurance coverage.

Learning about your health insurance coverage

Some insurance policies do not cover marrow or cord blood transplants. Some insurance policies will cover the transplant, but may not cover all the services that you need before or after the transplant. The financial coordinator at your transplant center will help you plan for expenses not covered by insurance and find other financial resources that may be available.

You may also find it helpful to learn about your insurance coverage and transplant costs on your own. You may want to:

  1. Ask your insurance company to provide you with a copy of your health insurance policy, and any information they can give you about your plan.
  2. You may want to ask a trusted family member or friend to help you so that you can focus on your health. Ask your insurance company what you need to do to have someone speak to them on your behalf. Most likely you will have to give your permission in writing for someone other than yourself to talk to your insurance company.
When talking with your insurance company, remember to:
  • Ask for a specific person from the insurance company to be assigned to you. Many insurance companies assign a case manager to help patients. 
  • Be sure the person you are talking to is authorized to quote coverage information. Ask for his or her name and contact details.
  • Record the date(s) of your conversations. 
  • Mapping the Maze: Transplant and health insurance can help you learn more about the types of health insurance and questions you should ask your insurance company.

Learning about the Affordable Care Act (ACA)

The Affordable Care Act (ACA) is a health care law that changed health insurance rules in the United States. Some of these changes help marrow and cord blood transplant patients.    

If you have questions on how the ACA affects you, talk to your transplant center social worker or financial coordinator. They will help you find the answers you need.   

Mapping the Maze: Transplant and Affordable Care Act can help you learn more about how the ACA affects transplant patients’ coverage, internal and external reviews, and clinical trial coverage.

Learning about transplant costs not covered by insurance

After you learn about your insurance coverage, you can begin to determine what transplant costs will not be covered by your insurance. These may include tests to find an unrelated donor or cord blood unit, some prescriptions or lodging and transportation. An example of an out of pocket cost would be temporary living arrangements for you and your family to be near the transplant center.

Transplant costs worksheet can help you determine the other out-of-pocket costs related to your transplant procedure. Download or print PDF.

While these costs may seem overwhelming, financial assistance for some transplant costs may also be available.

Elias and his family had to relocate to another state to get his transplant. His young parents’ income was reduced to nothing—but their expenses increased greatly as a result of the transplant. Even though Elias’ transplant was covered by insurance, many transplant-related costs were not. They worked closely with the social worker at the transplant center to learn if they were eligible for any assistance.

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