Finances and Insurance
A blood stem cell transplant is an expensive medical procedure. Depending on the transplant center, the length of your hospital stay, and any complications, the treatment can cost hundreds of thousands of dollars.
Although insurance may cover most of the medical costs, a transplant also involves many out-of-pocket expenses such as parking, meals, temporary lodging, childcare, and others that can start to add up. It’s easy to be overwhelmed by the costs of a transplant.
Before your transplant, you should consider developing a financial plan. A good place to start is by reading the self-help financial guide available from the National Marrow Donor Program Mapping the Maze: A Personal Insurance and Financial Guide to Marrow and Cord Blood Transplant. You can order it online or call the National Marrow Donor Program Office of Patient Advocacy at 888-999-6743 or 612-627-8140 for a free copy.
Financial Aid & Fundraising
Even if insurance covers most of the cost of your transplant, you will probably have to pay part of the medical expenses out-of-pocket. Insurance co-payments, deductibles and uncovered expenses can quickly add up. In addition, your daily living expenses may be higher, particularly if your transplant is out of town. If you or a family member needs to stop working temporarily, your income will be less and can add to the financial strain.You can use the National Marrow Donor Program's online financial calculator to estimate what your out of pocket expenses will be and whether you have sufficient funds available to cover them.
Be sure to check with the transplant center social worker about financial assistance. Some transplant programs have special arrangemens with local hotels that offer free or low cost lodging; offer help with parking; provide food vouchers for cafeteria food; or know of local funds that can help patients with expenses.
The National Marrow Donor Program's Donor Search Assistance, and Transplant Support Assistance funds help with donor search costs and expenses such as food, ground transportation and prescription co-pays for the first six months after transplant. These funds are available only to patients being transplanted with cells from an unrelated donor. Call the National Marrow Donor Program at 888-999-6743 for more details.
Groups that help patients with a particular disease such as the Leukemia & Lymphoma Society or the Lymphoma Research Foundation also provide financial help. Others, such as the National Foundation for Transplant or the National Transplant Assistance Fund do not make grants, but will help families with fundraising events. See the list of Related Links on the right for groups that provide financial help to transplant patients.
Understanding your benefits and rights from insurance is often confusing and overwhelming. Our webcast, Navigating the Insurance Maze, explains the different type of insurance plans, and your rights and responsibilities as a insurance consumer.
A second webcast, Managing Your Medical Insurance, discusses how to safeguard and maximize your medical benefits.
Working with your insurance company early in the process is critical. Transplant centers usually require that insurance companies pre-approve the procedure before they begin your transplant.
Your transplant center will contact your insurance provider and send the necessary information about your diagnosis and type of transplant proposed. Depending on your insurance, the plan may cover all or only part of the treatment. Be sure to check if a spouse’s separate insurance plan, offered through their place of employment, has better coverage. If it does, consider moving under that coverage during an open enrollment period.
If You are Denied Coverage
If your insurance plan denies coverage of all or part of your treatment, you have a right to appeal that decision. Common reasons given for denying coverage are that the insurance company considers the procedure experimental or not medically necessary. Often, additional information from the transplant center will resolve the issue.
The specific steps you must take when filing your appeal are outlined in your insurance contract and must be followed carefully. Your transplant center may help you file the appeal. If you are unsure about how to file your appeal, organizations such as the Cancer Legal Resource Center, the Patient Advocate Foundation or Your Benefits Advocate can help. If you need a referral to an attorney with experience in these matters, please contact BMT InfoNet at 888-597-7674 or submit your request for help online.
Employment and Disability
While you or a family member is hospitalized, you may be entitled to employment protections and disability benefits. If you are the patient and continue working after your transplant, you may be entitled to accomodations at your work place to enable you to perform your duties. Our webcast, Employment Rights and Disability Insurance, discusses these protections and benefits in detail.