Recipient: Financial Planning
The GRHealth Kidney and Pancreas Transplant Program encourages a financial plan for those who are considering a transplant. The high cost of post-transplant medications and other associated transplant fees make it difficult for many to manage. Financial Coordinators, along with a Fundraising Coordinator and Social Worker, work together with transplant candidates to help develop a financial plan to cover post-transplant expenses.
Financial Planning for Transplant
A financial plan is necessary prior to being considered for a transplant evaluation. Determining a need for a financial plan is dependent upon your insurance coverage. During the transplantation process you will be required to attend Transplant Orientation Class. At the class, copies will be made of your insurance information and of your identification card. You will also be asked to sign a release of medical information form so we may obtain pertinent information for your transplant evaluation.
The financial coordinators will contact your insurance company and determine coverage for transplant surgery and post transplant medications. You will be notified by phone or mail about your coverage for transplant. Depending on the coverage, you may need to be placed on a financial plan or proof of savings plan to cover the post-transplant out-of-pocket expenses. We encourage you to call your insurance company and verify coverage amounts for transplant.
Commercial insurance companies usually require copies of your evaluation medical records to determine necessity. It is important to check with your insurance company to determine if they will pay for a transplant at GRHealth. Most plans have prescription coverage with the plan. The financial coordinator will call your insurance company to find out what your copayment will be for medications and whether they need to be pre-authorized.
How do insurance companies cover transplant expenses?
Medicare part A covers 100% for transplant surgery and Medicare part B covers 80% toward clinic visits, doctor fees, and immunosuppressant (anti-rejection) medication for three years after transplant (unless you have Medicare for another disability or for age). A financial plan is usually needed for those who only have Medicare A, B, and D.
Medicare part D covers prescription medications, however the plan has a gap in coverage. After the total drug costs reach $2,510, you will meet this gap in coverage and the next $4,050 must be paid by you before Medicare will pay for any medications.
If you only have Georgia Medicaid, it covers 100% of transplant expenses; however, Georgia Medicaid requires medical records to determine eligibility for payment which we will assist you with submitting.
If you only have South Carolina Medicaid and are not eligible for Medicare benefits, your insurance will not cover a transplant at GRHealth. As long as you are eligible for Medicare benefits you are covered for transplant.
If the financial coordinator determines that you need to be placed on a financial plan, we will contact you and explain how your insurance coverage pays for transplant expenses and what your out-of-pocket expenses will be post-transplant. We will then have the fundraising coordinator contact you. The fundraising coordinator will work with you and your family to develop a financial plan to cover post-transplant medications and other expenses. A financial goal or proof of savings amount will be determined. The fundraising coordinator will assist you and your family by providing ideas in which your goal can be achieved; for many this is done through fundraising. The goal may be satisfied using an existing savings account, an existing retirement account, or through other financial means.
The GRHealth Transplant Coordinators work with other programs to help you obtain your goals. Programs such as The Georgia Transplant Foundation, The National Transplant Assistance Fund, Donate Life, and The National Foundation for Transplant offer services for transplant candidates, their families, and living donors.
The Access to Care program, available through The Georgia Transplant Foundation (GTF), is only available to Georgia residents. This program will match your savings dollar per dollar up to $10,000. The fundraising coordinator can help you understand the program and enroll. The Transplant Savings Account, also available through GTF, is available to residents of South Carolina. The Transplant Savings Account cannot match your fundraising deposits, but it does offer many benefits associated with the Access to Care program.
Fundraising is a great way to help offset the high costs of post-transplant medications and associated medical expenses. The fundraising coordinator has many ideas to help you determine which fundraiser will best fit your lifestyle. Below are tips for a successful fundraiser:
Open a savings account designated as a transplant fund for you. Have two people you trust open the account for you, it is best you do not have direct access to the account. Family members, the pastor at your church, or close friends would be good choices.
Attend a fundraising seminar.
Make it known that you are trying to raise money for transplant expenses. Talk to your family and friends about your savings goal. Ask for volunteers to help you raise the money.
Talk to your church or civic group about helping. Most churches are willing to help their members in time of need especially for a life saving event.
Meet with your team of volunteers. Educate them on your needs. Choose a team leader other then yourself to coordinate the event. Decide on a fundraiser. Set a date and time for the event. Larger events take at least 3 months to coordinate.
Advertise your fundraiser. Talk to the media. Call around to the local paper and radio stations to see if they will advertise it for free. Try to have as much donated as possible.
Send letters to friends, family, businesses, churches and civic groups asking for donations.
Have a donation jar available for monetary donations.
Imagine yourself coming to the event. What would you be looking for?
Do not spend more on the event then you expect to make. You should make at least 50% profit on your event.
Make sure you follow all state and federal laws when planning an event.
Plan an event that is fun and profitable!
There are many types of fundraisers to choose from. Some are easier then others, such as bake sales, car washes, raffles, and garage sales. Others take more planning, such as benefit concerts, auctions, school fundraisers, barbeques and fish-fries. Finally, there are those that take a lot of time to coordinate, such as golf tournaments, benefit dinner and dance, and large musical productions. Whichever event you choose is great, just make sure you and your fundraising team within your means.