Yes, Medicare covers kidney transplants. It pays for the surgery itself, hospital stays, lab work, donor evaluations, and post-transplant medications. Uniquely, Medicare extends coverage to people with permanent kidney failure (end-stage renal disease, or ESRD) regardless of age, meaning you don’t have to be 65 or older to qualify.
Who Qualifies for Medicare Through ESRD
Most people get Medicare at 65, but kidney failure opens a separate path at any age. You’re eligible if your kidneys no longer work and you need regular dialysis or have had a kidney transplant, plus at least one of these applies: you’ve worked long enough to qualify for Social Security benefits, you’re already receiving Social Security or Railroad Retirement benefits, or you’re the spouse or dependent child of someone who meets either requirement.
This means a 35-year-old on dialysis can get Medicare if they or a qualifying family member has enough work credits. The coverage isn’t automatic, though. You need to apply through Social Security, and there’s typically a waiting period of about three months after dialysis begins (or sooner if you complete a home dialysis training program).
What Part A and Part B Each Cover
Medicare splits transplant coverage between its two main parts, and both play a role.
Part A (hospital insurance) covers inpatient services at a Medicare-certified hospital, laboratory tests to evaluate your medical condition and potential donors, the search for a matching kidney when no living donor is available, blood products and processing, and any additional inpatient care your donor needs if complications arise from surgery. Part A also covers the full cost of care for your kidney donor: the evaluation before surgery, the operation itself, and recovery afterward.
Part B (medical insurance) covers doctors’ fees for the transplant surgery, including care before, during, and after the procedure. It also covers physician services for your donor during their hospital stay. Where Part A handles the hospital facility costs, Part B handles the professional fees from surgeons, anesthesiologists, and other physicians involved.
You’ll still owe your standard Part A deductible for the hospital stay and the Part B coinsurance (typically 20% of the Medicare-approved amount) for physician services. If you have a Medigap supplemental plan or Medicaid, those may cover some or all of that remaining balance.
Coverage for Living Donors
If a friend or family member donates a kidney to you, Medicare covers their medical expenses related to the donation. This includes the pre-admission evaluation and workup, operating room and inpatient costs, and postoperative recovery. The donor gets unlimited days of inpatient care connected to the kidney removal, and follow-up services from the operating surgeon are included in the global surgical payment for 90 days after the procedure.
Complications that arise from the donation are also covered, as long as they’re directly attributable to the organ removal. Once the donor no longer has symptoms related to the donation, routine follow-up coverage ends. The donor doesn’t need their own Medicare enrollment for this. Their care is billed through the transplant recipient’s Medicare benefit.
Anti-Rejection Medications After Transplant
Kidney transplant recipients need immunosuppressive drugs for the rest of their lives to prevent the body from rejecting the new organ. Medicare covers these medications, but the rules around how long that coverage lasts deserve careful attention.
If you qualified for Medicare specifically because of ESRD (not because you turned 65 or have a disability), your Medicare coverage ends 36 months after a successful transplant. For many people, this created a dangerous gap: they still needed expensive anti-rejection drugs but lost the insurance paying for them.
Starting January 1, 2023, a new benefit called Part B-ID fills that gap. Once your ESRD-based Medicare ends at the 36-month mark, you can enroll in Part B-ID to continue receiving coverage for immunosuppressive drugs only. It doesn’t cover doctor visits, hospital stays, or any other services. It covers the transplant medications and nothing else.
Part B-ID Eligibility Rules
To qualify for Part B-ID, you must have been entitled to Medicare based on ESRD, and your coverage must have ended at the 36-month post-transplant cutoff. You also need to confirm that you don’t have other health coverage that includes immunosuppressive drugs. If you’re covered by an employer plan, a Marketplace plan, TRICARE, VA benefits that include these drugs, or Medicaid/CHIP with immunosuppressive drug coverage, you’re not eligible for Part B-ID.
You can enroll at any time by calling Social Security at 1-877-465-0355 or by filling out form CMS-10798. There’s no limited enrollment window, and if you drop coverage, you can re-enroll later. This flexibility matters because your insurance situation may change over time.
If you qualified for Medicare through age (65 or older) or disability rather than ESRD alone, this 36-month cutoff doesn’t apply to you. Your Medicare continues as normal, and your immunosuppressive drugs are covered under Part B or Part D depending on your plan.
What You’ll Pay Out of Pocket
Medicare doesn’t cover 100% of transplant costs for the recipient. Under Part A, you’re responsible for the inpatient hospital deductible, which in 2024 is $1,632 per benefit period. Under Part B, you pay 20% of the Medicare-approved amount for physician services after meeting the annual Part B deductible ($240 in 2024).
For anti-rejection medications covered under Part B, you typically pay 20% of the drug cost. Under Part B-ID, the same 20% coinsurance applies, plus a monthly premium. These costs can add up over years of continuous medication, so many people pair Medicare with supplemental coverage. Medigap policies, Medicaid (for those who qualify by income), or state pharmaceutical assistance programs can help reduce that ongoing expense.
If you’re enrolled in a Medicare Advantage plan (Part C) instead of Original Medicare, your transplant is still covered, but cost-sharing amounts vary by plan. Check with your specific plan for copay and coinsurance details before scheduling the procedure, since some Advantage plans require you to use specific transplant centers in their network.