The Transplant Program at Stony Brook Medicine accepts the following insurance:

  • Medicare Part A and B - with a Medicare Supplemental
  • Medicare HMOs: Empire/Anthem Mediblue Advantage (PREFIX Y8E, Y7N, VOF, VOG, JWX), Agewell, Emblem VIP Medicare HMO, UnitedHealthcare Nursing Home Plan 1(PPO I-SNP), UnitedHealthcare Assisted Living Plan (PPO I-SNP)
  • Straight Medicaid
  • Medicaid HMOs: Health First, Fidelis, Emblem HIP/Health Care Partners (HCP), United Community Plan
  • Empire BlueCross BlueShield PPO (NO Marketplace plans or Blue Distinction)
  • Excellus Health Plans
  • Local 1199 National Benefit Fund
  • Emblem HIP/HCP/GHI/Essential Plan (NO Emblem GHI Medicare)
  • Oxford (Freedom or Liberty)
  • United Healthcare PPO
  • Magnacare
  • Aetna Commercial Plans (Center of Excellence)
  • OPTUM Center of Excellence/Transplant Access Program
  • UMR
  • Only Essential Plan; Emblem Health, Empire NY Essential, HealthFirst
  • Only Marketplace Plan; United Healthcare Compass, Emblem Health
  • Only Managed Medicare; Empire Mediblue, Anthem Advantage, Agewell, and Emblem HIP VIP Medicare
  • Managed Medicare PPO Plans; With out-of-network benefits
  • VA Community Care Network

The following insurances require benefit investigation: NOTE: Your insurance may not cover kidney transplant, even if Stony Brook Hospital takes your insurance plan.

  • Cigna
  • Affinity Health Plans/Molina managed Medicaid
  • Managed Medicare's
  • MetroPlus managed Medicaid
  • Oxford Metro

The insurances listed above are accepted by Stony Brook Medicine's Transplant Program with out-of-network benefits only. If you do not see your insurance listed above, please contact our Financial Coordinator at (631) 444-7406

In the event that you receive a bill for your pre-transplant evaluation visit, please contact our Financial Coordinator at the number above.

If you have Medicare, you must have a supplemental plan! See below for more details:

  • Medicare covers only 80% of transplantation costs
  • Medicare Part B covers only 80% of the immunosuppressant medications. You will be responsible to pay 20% of all costs
  • We are not able to transplant you with Medicare coverage alone. You must have a secondary insurance or a supplemental plan in order to be transplanted. Transplant costs can be very expensive without the proper coverage.

Medicaid Coverage
If you have Medicaid coverage that is paid by your dialysis center, or your health insurance premium is covered by the Health Insurance Premium Program (HIPP), once you receive a kidney transplant, the payments will become your responsibility. The transplant center cannot cover the premiums. If this is the case, please contact one of our Social Workers. If you are unsure if this applies to you, please contact your dialysis center Social Worker.

 

Last Updated
09/23/2022