Published online by Cambridge University Press: 10 March 2009
The economic, political, ethical, and medical issues surrounding organ transplantation are complex, and coverage policies for it vary considerably among insurers. Some insurers cover virtually all transplants, while others cover few or none (Wyoming Medicaid does not cover any transplants) (3;4;5;6;7). In the past, insurers have followed Medicare's lead regarding coverage of new technologies. This has not been the case with organ transplantation. Although Medicare does not cover heart transplants, almost all Blue Cross/Blue Shield plans and commercial health insurers, as well as one-half of the state Medicaid plans and one-third of the Health Maintenance Organizations (HMOs), do cover heart transplants. (See note, p. 570.) In addition, although Medicare does not cover heart–lung transplants, a substantial proportion of Blue Cross/Blue Shield plans, commercial health insurers, state Medicaid plans, and HMOs cover it. At present, Medicare covers kidney and cornea transplants, selected pediatric liver transplants, and selected bone marrow transplants.