Improving the transplant services process
Manage risk, control costs and improve patient outcomes with our Managed Transplant Program (MTP). This program is a first-dollar, fully-insured transplant carve-out.
Designed to address coverage gaps while reducing costs
No deductibles, coinsurance or copays
Managed Transplant Program solutions include coverage on all solid organ and blood and marrow transplants, as well as transplant-related expenses from evaluation through 365 days post-transplant, including immunosuppressant drugs.
No pre-existing clause or lasering
Get protection for the full population as soon as your employee coverage is bound. This includes unlimited lifetime benefits for transplant services to preserve the annual maximum benefit of your underlying major medical coverage.
Coverage eliminates lasers at stop loss renewal.
Minimize future stop loss premium increases
MTP delivers this through carving out the transplant experience and driving increased stop loss persistency. Stop loss carriers may provide premium credits for having transplant carve out coverage in place.
Key benefits
Manage the risks associated with your employee’s transplant needs.
Transplant readiness
For a 400-life group, there is a 58% chance of having a transplant episode within 5 years.1
Reduced exposure
One in 5,300 members will experience a transplant.
Experience and scale
We have over 35 years experience managing transplants.
Cost management
The average billed charges for a transplant episode can quickly rise to $1 million or more.2
Fact sheet
Significant cost controls, clinical care and risk management
MTP complements stop-loss coverage and provides more complete protection from the high costs associated with a transplant.
Employers can better manage their overall risk exposure by combining our expertise in the stop loss market and our experience in managing transplants.
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Complementary solutions
Transplant Resource Services
Transplant Solutions
- Ortner N, Holzer H. 2025 U.S. organ and tissue transplant cost estimates and discussion. Milliman, Inc. Published Feb. 13, 2025. Accessed Mar. 11, 2025. Milliman estimated U.S. average billed charges related to 30 days prior to and 180 days after transplant for the population under age 65.
- Repriced claims data from transplant cases managed by Optum. August 2024.