Since 1973, Medicare has covered treatment for any American citizen with end-stage renal disease, and 80 percent the bill for costly immunosuppressive medications. However, CMS will only pay the bill for 36 months if the patient wouldn't otherwise qualify for Medicare, i.e. people under 65.
However, that limit has been under attack for a while. In March, for example, two Senators introduced a bill [1] that would require Medicare to cover the costly drugs needed to fight kidney rejection for the life of the transplant. Now, the reform bill passed by the House includes a similar provision.
The measure could cost the government a great deal of money, as the immunosuppressive drugs can costs anywhere from $1,000 to $3,000. In fact, the Congressional Budget Office estimates that unlimited coverage would add $100 million per year to the $23 billion Medicare pays for its kidney program. That's probably why previous attempts to lift the limit have never even made it to the voting stage. (On the other hand, is $100 million a year that big a deal against a $23 billion budget, given that lives are at stake?)
Given these costs, which under-65 patients know they'll have to bear eventually, right now some kidney transplant candidates aren't even putting themselves on the transplant lists, UPI reports.
To learn more about this issue:
- read this UPI piece [2]
Links:
[1] http://www.fiercehealthcare.com/story/bill-challenges-medicare-limit-meds-kidney-recipients/2009-03-13
[2] http://www.upi.com/Health_News/2009/09/14/Kidney-transplant-coverage-in-health-bill/UPI-78311252928110/