What is the cost of a liver transplant (with and without insurance)?

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Liver transplant is a surgical procedure that involves the replacement of a diseased liver with a healthy one. A healthy liver can be obtained from donors who have died recently and have not had liver injuries. These donors are known as cadaver donors or deceased donors.

Alternatively, new livers can be obtained from healthy living persons (usually referred to as living donors). Living donors donate only a portion of their liver since the human liver can regrow and return to its normal size.

However, the number of persons waiting for a liver transplant is greater than the number of available donors – both cadaver and living donors, creating a high demand for new livers.

Currently, more than 14,000 patients are on the waiting list to receive a liver transplant in the US. The list keeps growing long since getting a healthy liver requires someone to die, and the deceased person must have decided in advance to be a liver donor, or their family must give permission. And if you opt for a living donor, getting an appropriate match can take longer.

On average, an adult patient can wait up to 145 days, and a child can wait for 72 days, making the entire liver transplant procedure time-consuming as well as a costly affair.

How Much Does a Liver Transplant Cost?

According to consumerhealthratings.com  liver transplants costs without insurance can go up to $800,000.

 This figure covers the entire bill, from 30 days before the transplant surgery to six months after the transplant. The charges include: 

  • Consultation fees
  • Tests costs: These are the costs of lab tests, x-rays, heart tests and general health exams. Each of these tests can range from $500 to $1500. 
  • Follow-up care costs such as: 
    • Medications after the procedure: These are mainly anti-rejection drugs and cost around $3000 per month.  (the drugs are may be needed for six months or longer)
    • Living donor expenses: these refer to any expenses a living donor may incur such as medical evaluation costs and transport costs. These are usually covered by the recipient. 

The above costs can vary on a case-to-case basis and can also be negotiated. Most times, hospitals offer at least a 30% discount to cash-paying or uninsured patients. Before you visit any hospital or transplant center, consult with their financial counselor to assist you in finding avenues to pay for the liver transplant procedure.

How Much Does Insurance Cover for a Liver Transplant?

For patients covered by health insurance, a huge percentage (usually 80%) of the transplant costs are paid by the insurance company.  The percentage varies depending on the insurance company. 

Often, you’d still have to pay for a donor search, clinic visits, lab tests, prescribed medication, and 10% to 20% of your surgery.  All these can cost approximately $100,400.

If you are a candidate for a liver transplant, it’s important that you work closely with your health insurance provider to understand your policy and which benefits you qualify for.  Some of the questions to ask are: 

  • Does my insurance cover 100% of the medical expenses? 
  • What is the amount I must pay each year before insurance pays 100 percent?
  • Are doctor visits, hospitalizations and prescribed medications covered? 
  • Will the insurance company pay for the transplant if it’s done at any hospital?
  • If I have a pre-existing condition, will my insurance provider still pay for the liver transplant?  

Why Does a Liver Transplant Cost So Much? 

A liver transplant is expensive because it is a resource-intensive procedure. The surgery needs a lot of resources such as time, money, and good logistic support. For example, the availability of liver donors is not automatic. You have to wait for weeks and months to get the right donor, increasing the demand for new liver hence high transplant costs. 

Team of specialists is needed

Additionally, the surgery needs a team of doctors, nurses, and other specialists, not just the transplant surgeon. The team must comprise a hepatologist, hematologist, anesthesiologist, physiotherapist, dietician, and pediatrician if the patient is a child- note that all of them are highly paid. There are also a few doctors across the world who can do liver transplant surgery successfully, making the procedure even more expensive.

Pre-transplant Costs

The costs associated with the transplant, from the pre-transplant evaluation costs to the surgery and the post-surgery costs, are pretty high. Pre-transplant evaluation costs are a month-long procedure, hospital transplant admission, consultation costs, and evaluation costs.

Post-transplant Care

After the surgery procedure, you are likely to remain in an intensive care unit for several days. The transplant team will be monitoring your situation to detect any signs of complications. That is to ensure the new liver is working before being discharged.

While at home, you will be undergoing blood tests several times in the first week. Beyond that, you will be taking medications for the rest of your life. Such drugs will help you in reducing the risk that comes from transplant complications. Moreover, these drugs keep your immune system against attacking the new liver.

Other expenses after the liver transplant come in the form of long-term medications and follow-up medical appointments. Still, you will incur the caregiver costs, travel, lodging, and parking expenses.

How Can You Get a Liver Transplant More Affordably? 

Even for patients with insurance cover and adequate income, liver transplant costs can cause financial stress. You may end up exhausting your personal savings or liquidating some of your assets to pay the medical expenses.

There are various financing options you can explore to help you get liver replacement more affordably. They include:

Payment plans

Various hospitals offer payment plans to help patients cover expensive medical costs. The plan usually does not have strict requirements so you may qualify. So, you can approach the hospital’s finance counselor to negotiate for a payment plan to help pay off the medical bills.

Medical Loans

Medical loans are a great option if you need funds urgently for an expensive  medical procedure such as liver transplant.  Medical loans are a type of personal loan, so you  do not require collateral and can be used to pay for the medication, high deductibles or your follow up care costs. However, remember to look for the best interest rates depending on your financial situation 

Medicare

You can use Medicare, government-funded insurance that covers organ transplants. However, not everyone qualifies for the cover. Only individuals above 65 years, individuals below 65 years with certain disabilities, and those diagnosed with end-stage liver failure qualify for the Medicare cover. Additionally, patients may qualify if they or their spouse contributes to the Medicare system.

Medicaid

Medicaid can also help meet a portion of the medical expenses. Most Medicaid programs differ from one State to the other, and each State determines if you qualify for the cover and the benefits you enjoy. And some will only cover transplants performed in their State unless there are no liver transplant centers in their State.

Fund Raising

Holding fundraising events, such as walkathons or appealing to family members and friends can help raise the money needed for the transplant. Before launching a fundraising campaign, it is recommended to liaise with a legal advisor to enlighten you on the legal and financial laws regarding fundraising.

Several organizations such as American Transplant Foundation, Help Hope Live, National Foundation for Transplants and many more help patients access life-saving surgery.

Going Overseas

You can also have a liver transplant done abroad. But this move calls for intensive research and patience before you get the right hospital/country that offers affordable services. India, Thailand, Turkey, Brazil are some countries involved in medical tourism. You can get medical surgery costs at significantly lower prices than hospitals in the US due to lower infrastructure costs.

In India, the cost of a liver transplant can be as low as $28,000, and you still enjoy world-class treatment. In Thailand, the total cost of a liver transplant is $45,000.

Is it Worth Getting a Liver Transplant?

Indeed yes. According to the American Journal of Transplantation, patients who have undergone liver transplant have an 89% chance of living one year after surgery. About 75% of the patients will live for at least five years, and 53% live a normal life 20 years after the liver transplant surgery.

However, the life expectancy after liver transplant surgery depends on a number of factors, including

  • health status of the patient at the time of transplant,
  • age of the patient
  • Body Mass Index
  • Cause of the liver failure

Transplant recipients also directly contribute to how long they can live after the surgery. They have to follow the prescribed immunosuppression medication, pay attention to medication schedules and lifestyle changes. Learn how to avoid infections, never miss clinic visits, and closely follow their doctor’s advice. This way, they will enjoy an enhanced quality of life for longer.

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