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The cost of a transplant, including preliminary testing, organ procurement, the surgery itself and post-operative recovery varies across the country and depends on the organ type and hospital. These costs, ranging from $250,000 to more than $1.5 million, begin to accumulate even before the transplant.

QBE's Solution for Organ Transplant Risk

We provide self-funded employers with a stand-alone fully-insured solution to protect against these potentially catastrophic medical expenses. This coverage is economically priced; and premiums can be efficiently offset through corresponding rate discounts provided by stop loss carriers.

Why add organ transplant coverage to a self-funded health plan?

Client:

  • The number of transplants and related expense in the U.S. continues to increase year over year
  • Transplants are most often isolated for higher specific deductibles (lasered) by stop loss carriers
  • Removing transplant risk may eliminate associated lasers and reduce stop loss premiums
  • PEPM rates contribute to predictable healthcare budgeting

Broker:

  • Potential to enhance stop loss profitability
  • Contributes to increased account persistency
  • Discounts to stop loss premium
  • Competitive differentiator
  • High organ transplant policy persistency

While using a transplant network will help mitigate the severity of a transplant claim, a transplant insurance policy will mitigate both severity and frequency.

How QBE makes it possible

  • First dollar 100% in-network coverage
  • Benefit maximum options: $1 million, $2 million and unlimited
  • Evaluation up to 365 days post-transplant benefit period
  • Nationwide access to recognized transplant Centers of Excellence
  • URAC accredited transplant nurse case managers and transplant pharmacy service to assist patients throughout their benefit period
  • Travel and lodging expenses for patient and companion included

Coverage for all major organ and tissue transplants

  • Heart
  • Kidney
  • Lung
  • Pancreas
  • Intestinal
  • Liver
  • Multi-Organ
  • Allogeneic bone marrow or peripheral stem cell
  • Autologous bone marrow or peripheral stem cell

QBE provides first-dollar coverage for all transplant-specific physician, hospital and drug charges for single or multi-organ transplants that result from a covered specified disease.There is no deductible or coinsurance for in-network providers.

The need for an organ transplant can indiscriminately strike at any time. Although medical advances continue to deliver successful outcomes for patients, the cost of quality care is high and continues to rise by significant rates. QBE’s organ transplant coverage is one of the most comprehensive products currently available in the market and provides a stabilizing solution for these unpredictable occurrences. Delivery of excellence sits at the heart of what QBE does. Our expertise in managing risk gives self-funded employers
the security they need to invest, grow and make their visions possible.

Downloads

Organ Transplant Fact Sheet (pdf)

United Network for Organ Sharing

National Marrow Donor Program 

For more information about The Solution for Organ Transplant and how we can help your business, please contact:

John Richert
VP, Lead Underwriter, Organ Transplant
978.619.1573
John.Richert@us.qbe.com

 

 

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