What happens when there is a need for an organ and insurance will not cover it?

Most organ transplants are covered by third party reimbursement insurance and Medicaid or Medicare. In some instances, there may be an insurance cap whereby the member is only eligible for a certain amount of funding for surgical procedures. In those cases, every transplant program has social workers who will investigate those cases and support the patient in terms of writing special requests and/or petitioning the cap, so that the patient can receive the transplant. In Indiana, we have seldom heard of patients needing life-saving organs that have been turned down because of insurance limits.