Be Financially Prepared for a Transplant

I received the following article from The Transplant Experience, a newsletter sent out by Astellas Pharmaceuticals:

"Make Sure You Are Financially Prepared For The Transplant Jouney Ahead"

While you're waiting for your transplant, it's a good idea to find out exactly what benefits your healthcare plan will provide to help pay the costs of your transplant surgery, follow-up care, and medications. There are many types of healthcare plans that offer different levels of coverage. Staying informed can help you maximize the benefits you receive and also prevent unexpected surprises when you visit the doctor's office, hospital, or pharmacy.

Start by talking to your transplant financial coordinator or social worker—they can guide you on how to get the most from your plan. Some pharmaceutical companies, including Astellas, can also offer assistance on understanding benefits available under your plan. If you are pre-transplant, your doctor may intend for you to take Prograf® (tacrolimus capsules) once you receive your new organ. In this case, you may take advantage of Astellas Reimbursement ServicesSM (ARS), which delivers high-quality support services at no cost to you. ARS can research your coverage and tell you what your out-of-pocket costs should be—before you go to the pharmacy for the first time.

To get help understanding your future coverage, call ARS at 1-800-477-6472, Monday through Friday, between the hours of 9 am and 8 pm EST.


Steps to ARS benefit verification

1. Contact ARS to request assistance with a benefit verification or to complete a Benefit Verification Request Form, which you can download here. If you have any questions while completing the form, please contact ARS at 1-800-477-6472 or complete the form with your healthcare provider or case manager. Once the form is completed, fax it and a copy of the front and back of your insurance card(s) to ARS at 1-866-317-6235.

2. Within one day, your insurance provider will be contacted by ARS to verify your benefit coverage and any claims submission requirements.

3. Once this information has been verified, you or your healthcare provider will receive a Summary of Benefits by mail or fax.

4. ARS is available to answer any questions you or your healthcare provider may have.
*Based on analysis of patients covered by commercial plans who receive Prograf prescriptions.


To better prepare for the cost of transplant surgery, here are some important questions you should ask your financial coordinator:

•Does my plan cover expenses such as travel, food, and lodging while I am at the transplant center? Will it cover these expenses for my family?

•If my plan covers travel, food, and lodging costs, how much will it pay? Will it cover the cost of a person to come with me?

•Do the costs vary if I have a living donor?

•What financial coverage does the hospital accept (Medicare, Medicaid, private insurance, etc)?

**For additional questions, visit the financial support section of www.TransplantExperience.com.

##I am NOT endorsing any particular products, companies or services, etc. My intent is to merely provide information for others as is sent to my email. If you have any questions about any company you read about in these newsletter copies, please contact that company directly as I am in no way affiliated with them, aside from receiving information regarding kidney transplant and its anticipated experiences and needs. Additionally, I do NOT receive any compensation for passing this information to my readers. Thank You.
ScottW