What are the rules about Medicare drug coverage for post-organ transplant, under 65 Medicare beneficiaries?

Medicare covers prescription drugs used in immunosuppressive therapy under Part B when an individual receives a Medicare-covered organ transplant. The time limit for the coverage of immunosuppressant drugs has been removed for those drugs given after December 21, 2000. If the transplant was not covered by Medicare, drug coverage is provided by Part D.

However, Medicare coverage will end 36 months after the month of the transplant for those who are under 65 and have Medicare solely on the basis of End Stage Renal Disease (ESRD). Once Medicare coverage ends, the individual will have to find general insurance for his/her continued healthcare including coverage for the drugs s/he is taking as Medicare Part B and D will not be available.

(Back to Medicare Drug Coverage: Formulary)