Frequently Asked Questions
Does my insurance cover blood and marrow transplants?
We recommend each patient go through the following steps with their insurance company. While we are available to assist, many insurers will only provide this information directly to their patients.
Step 1: Contact your insurance provider to determine if they cover stem cell transplants.
Typically the member service number is provided on the back of your insurance card. Once you are in contact with a customer service representative, verify that they are able to provide you information on your benefits and simply ask if your plan provide coverage for stem cell transplants. You may be assigned a case manager to assist you in the pre-transplant process.
Step 2: Request a detailed summary of your benefits.
If you do not already have a summary of your covered benefits, request a full detailed version for your records. This will assist you in understanding what you are responsible for throughout the transplant process, from tests, imaging, and pharmaceutical products.
Step 3: Ask detailed questions on your plan.
The following questions are helpful in determining the details of your insurance plan:
- Am I covered for stem cell transplant for my diagnosis?
- Does my policy restrict where I can receive care? Is Jefferson in my provider network?
- Does my policy have a deductible and coinsurance amount? If so, for what and how much?
- Does my policy have co-payments? If so, for what and how much?
- Does my policy have co-payments for prescriptions? If so, for what and how much?
- Is there a yearly or lifetime maximum amount of out of pocket expenses that I would be responsible for? If yes, how much? What costs are included in this amount?
- Are there any coverage exclusions in my policy? If yes, how long is coverage excluded?
- Does my policy cover unrelated transplants for my diagnosis?
- Does my policy cover expenses for testing to find a matched donor?
- Are there any limits or exclusions for my donor coverage?
- Does my policy limit the number of transplants I can receive in a lifetime?
- Is pre-authorization required for pre-transplant testing?
- Is pre-authorization required for treatment? If so, to whom should the request be sent?
- Does my policy cover indirect expense for me, my family/caregiver, such as travel, food, and lodging costs while I receive care? If so, how much?
- If I have a complaint, or want to appeal my coverage, how do I do that?
Step 4: Contact Theresa McNeil, 215-955-9384, for an initial insurance discussion.
Theresa will be your insurance company's primary contact at Jefferson during the transplant process and will work to make sure your care is properly covered according to your benefits.