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CostHelper > Health & Personal Care  > Medical Specialties & Departments > Lung Transplant

Lung Transplant Cost


How Much Does a Lung Transplant Cost?

 
average costWith Health Insurance: Copays + 10%-50% Coinsurancehigh costWithout Health Insurance: $500,000-$800,000
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A lung transplant[1] is a type of surgery in which one or both diseased or failing lungs are replaced with healthy lungs. A number of different diseases can damage the lungs, including chronic obstructive pulmonary disease, cystic fibrosis and pulmonary hypertension, but a transplant would typically be recommended after medication or other medical interventions have failed. According to the National Institutes of Health[2] , though living-donor lung transplants are possible, most organs are donated by someone under age 65 who is brain dead but still on life support.

Typical costs:

  • For patients covered by health insurance, out-of-pocket costs for a lung transplant typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can easily reach the yearly out-of-pocket maximum. A lung transplant typically is covered by health insurance, although insurers may require a patient to get the transplant at a specific center.
  • According to the United Network for Organ Sharing[3] , a nonprofit organization that maintains the national Organ Procurement and Transplantation Network[4] , the cost of a transplant includes preliminary testing, the surgery itself and post-operative recovery costs, and can vary depending on region and hospital.
  • The typical cost of transplant is $500,000-$800,000, depending on whether the procedure involves one or both lungs. A 2011 report on the cost of organ and tissue transplants in the United States by the actuarial and consulting firm Milliman[5] found the total cost of a single lung transplant to be $561,200, which includes $10,300 for a month's worth of care leading up to the transplant; $73,100 for the procurement of the organ; $302,900 for hospital transplant admission; $33,500 for the surgeon; and $23,700 for immunosuppressants and other prescription drugs. The report estimates the total cost for a double transplant to be $797,300.
What should be included:
  • According to the Mayo Clinic[6] it could take months or years before a suitable donor becomes available through the donor-recipient matching system administered by UNOS. Matches are based on specific criteria, including blood type, geographic distance between donor organ and transplant recipient, and severity of the recipient's lung disease.
  • A transplant surgery[7] typically takes 4-8 hours for a single lung transplant and 6-12 hours for a double transplant. It is done with the use of a heart-lung machine, which circulates blood while a patient's heart is stopped. Patients are put under general anesthesia for the surgery.
  • After surgery[8] , a lung transplant patient will spend several days in the intensive care unit, connected to ventilator for breathing assistance, and tubes that drain fluids from the lungs and heart. Recovery often involves a one- to three-week hospital stay, with another three months of frequent monitoring for complications. Complications[9] , associated with a lung transplant can sometimes be fatal. Rejection and infection are the two major risks.
Additional costs:
  • According to The Boomer Esiason Foundation[10] some personal expenses associated with lung transplants, such as food and lodging expenses incurred when a patient and their family moves to be closer to a transplant center, are not covered by insurance.
Discounts:
  • Many hospitals offer discounts of 30% of more to uninsured/cash-paying patients. At St. Joseph Hospital[11] in Orange, CA, for example, patients without health insurance may qualify for a 45% discount off billed charges.
  • The hospital also offers an additional 10% discount if payment is made within 10 days of the patient receiving the bill.
  • Under the federal government's Hill-Burton program[12] low-income patients may qualify for for free or low-cost services.
Shopping for a lung transplant:
  • UNOS offers a list[13] of common funding sources to help patients with the costs of transplants.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
 
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External Resources:
  1.  www.mayoclinic.com/health/lung-transplant/MY00106
  2.  www.nlm.nih.gov/medlineplus/ency/article/003010.htm
  3.  www.transplantliving.org/before-the-transplant/financing-a-transplant/the-costs/
  4.  optn.transplant.hrsa.gov/
  5.  publications.milliman.com/research/health-rr/pdfs/2011-us-organ-tissue.pdf
  6.  www.mayoclinic.com/health/lung-transplant/MY00106/DSECTION=how-you-prepare
  7.  www.nlm.nih.gov/medlineplus/ency/article/003010.htm
  8.  www.mayoclinic.com/health/lung-transplant/MY00106/DSECTION=what-you-can-expect
  9.  www.mayoclinic.com/health/lung-transplant/MY00106/DSECTION=risks
  10.  esiason.org/lung-transplantation.php
  11.  www.sjo.org/For-Patients/Your-Hospital-Bill/Self-Pay-Discount-Program.aspx
  12.  www.hrsa.gov/gethealthcare/affordable/hillburton/
  13.  www.transplantliving.org/before-the-transplant/financing-a-transplant/funding-sources/
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