A transplant is one of the few areas where Medicare's coverage is unusually broad — it pays for the surgery, the hospital stay, the donor's care, and the anti-rejection drugs that keep the organ working. It is also an area with one of Medicare's sharpest cliffs: people who qualified for Medicare only because of kidney failure lose their coverage 36 months after a successful transplant, at exactly the point when the medications become a lifelong requirement. Congress created a separate benefit to address that cliff. Here is how transplant coverage works in 2026, and what happens after the 36-month mark.
Which Transplants Medicare Covers
Medicare covers transplants that are performed at a Medicare-approved facility and are medically reasonable and necessary. Covered organ and tissue transplants generally include:
- Kidney
- Heart
- Lung and heart-lung
- Liver
- Pancreas, when performed with or after a kidney transplant in certain circumstances
- Intestinal and multivisceral
- Bone marrow and stem cell transplants for covered conditions
- Cornea
Facility approval matters. Medicare certifies transplant programs individually, and a hospital approved for one organ is not automatically approved for another. Before scheduling, confirm that the specific program is Medicare-approved for the organ involved.
What Part A and Part B Each Pay
Part A covers the inpatient side: the transplant surgery, your hospital room and nursing care, and drugs administered during the inpatient stay — including the induction immunosuppressants given at the time of surgery. In 2026, an inpatient stay carries a $1,736 deductible per benefit period, with $434 per day coinsurance for days 61 through 90.
Part B covers the outpatient side: pre-transplant evaluation and testing, physician services during and after the transplant, follow-up care, lab work, and immunosuppressive drugs after a Medicare-covered transplant. Part B cost sharing in 2026 is the $283 annual deductible plus 20% coinsurance.
Donor costs are generally covered. For a living donor, Medicare typically pays for the donor's evaluation, the donation surgery, and care for complications related to the donation — billed under the recipient's Medicare rather than the donor's own coverage. For deceased donors, organ acquisition costs are handled through the transplant hospital.
The Immunosuppressive Drug Rule
Part B pays for transplant drug therapy — the immunosuppressants that prevent rejection — but only when two conditions are met:
- You had Part A at the time of the covered transplant, and
- You have Part B at the time you get the drugs
If Medicare did not pay for your transplant — for example, you were transplanted before becoming eligible, or under other insurance — the drugs generally fall under Part D instead. Our guide to Part B vs. Part D drugs explains why that distinction matters: Part D out-of-pocket costs are capped at $2,100 in 2026, while Part B drug costs have no annual cap under Original Medicare.
The 36-Month Cliff for Kidney Patients
People who qualify for Medicare only because of End-Stage Renal Disease (ESRD) are in a different position than those who qualify by age or disability. Their Medicare — all of it — ends 36 months after a successful kidney transplant. Coverage for the immunosuppressants ends with it. Our guide to dialysis and ESRD coverage covers the full ESRD eligibility timeline.
If you qualify for Medicare because you are 65 or older, or because of a disability, this rule does not apply to you. Your coverage continues normally.
The Part B Immunosuppressive Drug Benefit (Part B-ID)
Since January 1, 2023, people whose ESRD-based Medicare ended at the 36-month mark may elect a limited benefit that covers immunosuppressive drugs only. It is not full Part B: it does not pay for office visits, lab work, hospital care, or any other service.
2026 costs:
| Item | 2026 amount | |---|---| | Monthly Part B-ID premium | $121.60 | | Annual deductible | $283 | | Coinsurance after deductible | 20% |
Higher-income enrollees pay an income-related adjustment on top of the premium, calculated the same way as the surcharge described in our IRMAA guide.
Who may qualify: you generally must have had ESRD-based Medicare that ended 36 months after a successful kidney transplant, and you must not have other coverage that would disqualify you — including a group or individual health plan, a Marketplace plan, Medicaid or CHIP coverage that includes immunosuppressive drugs, or VA coverage for those drugs.
How to enroll: contact the Social Security Administration at 1-877-465-0355 (TTY 1-800-325-0778). There is no fixed enrollment window — you may enroll or disenroll at any time, and there is no late enrollment penalty. Applying before your full Medicare ends helps avoid a gap where you pay the full drug cost yourself.
Help with the premium: if you have limited income and resources, a Medicare Savings Program may pay the Part B-ID premium, and Extra Help may assist with drug costs under Part D.
Planning for the Costs
A few points worth thinking through before and after a transplant:
- The 20% coinsurance on Part B drugs is uncapped under Original Medicare. A Medigap policy may cover it, and in a Medicare Advantage plan those costs count toward the plan's out-of-pocket maximum — no more than $9,250 in-network in 2026.
- Travel and lodging for transplant care are generally not covered by Original Medicare. Transplant centers often have social workers who know which foundations and programs help.
- Network rules apply in Medicare Advantage. If you are in an Advantage plan, confirm the transplant center is in-network and that any required prior authorization is approved before surgery is scheduled.
- Part B-ID covers drugs only. If it is your only coverage, routine post-transplant labs and monitoring are your responsibility — a reason many people compare it against other coverage they may be eligible for.
How to Get Help and Learn More
- Medicare.gov — See the official page on transplant coverage at medicare.gov/coverage/organ-transplants.
- 1-800-MEDICARE (1-800-633-4227) — For coverage and billing questions. TTY users can call 1-877-486-2048.
- Social Security (1-877-465-0355) — The dedicated line for Part B-ID enrollment questions.
- State Health Insurance Assistance Program (SHIP) — Free, unbiased counseling on transplant coverage and the 36-month transition, at shiphelp.org.
Summary and Next Steps
- Medicare covers transplants performed at Medicare-approved facilities, including donor costs, with Part A paying inpatient care and Part B paying evaluation, follow-up, and immunosuppressive drugs
- Part B pays for anti-rejection drugs only if you had Part A at the time of a Medicare-covered transplant and have Part B when you get the drugs
- People with ESRD-only Medicare lose all Medicare 36 months after a successful kidney transplant
- The Part B-ID benefit continues drug-only coverage for $121.60 per month in 2026, plus the $283 deductible and 20% coinsurance
- Part B-ID requires that you not have other disqualifying coverage, and is available through Social Security at 1-877-465-0355
If you or a family member is approaching the 36-month mark after a kidney transplant, it is worth starting the Part B-ID conversation several months early. A SHIP counselor can review the options alongside any employer, Marketplace, or Medicaid coverage you may also qualify for.
