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This includes pre- and post-transplant medical care, hospital charges, organ procurement, doctor fees, and medications. This information comes from the January 2020 Milliman Research Report. Medicare covers heart transplants, but a person must pay coinsurance and deductibles. Private insurance coverage of the surgery varies among providers and plans. Candidates for the surgery may include people with end stage heart failure who have found the best medical treatments to be ineffective. However, doctors may exclude individuals with certain conditions, such as cancer, from consideration. Read on to learn more about heart transplants, including the cost, who may need one, and what to expect before, during, and after the surgery. What is a heart transplant Share on PinterestCoolpicture/Getty ImagesA heart transplant is a type of organ transplant surgery that replaces an affected heart with a donor’s heart. The surgery involves:cutting most of the major veins and arteries that attach to the affected heartremoving the diseased heart but leaving behind part of the left atrium, the chamber that receives oxygen-rich blood from the lungsconnecting the donor heart by sewing together the left atria of the two hearts and joining the donor heart to the necessary major arteries and veins Learn more about the anatomy of the heart. In 2020, about 3,499 people underwent this procedure. Candidacy for a heart transplant The stage of heart disease determines whether a person is a candidate for a heart transplant. The 1-year death rate from a heart transplant is in the range of 10–15%. Due to this, a person’s risk of death from their heart condition should be at least this high. Healthcare professionals consider individuals as possible candidates if they have advanced end stage heart failure. This means that optimal treatments have failed to reduce the symptoms or stop the progression of this condition. Primarily, this includes people with nonischemic cardiomyopathy and ischemic cardiomyopathy. Nonischemic cardiomyopathy refers to heart damage from heart attacks due to heart artery disease. Ischemic cardiomyopathy is heart damage that stems from factors other than heart artery disease. Surgeons also perform heart transplants for individuals with valvular heart disease and those who need a retransplant, but this occurs less frequently. Criteria that rule out a possible candidacy If a person does meet the above criteria for heart transplantation, it is still possible that a healthcare professional will refuse the surgery. People will not be a candidate if they have:cancercirrhosisan active infectionadvanced kidney diseasesevere lung diseasesevere psychiatric conditionssevere pulmonary embolisma pulmonary embolism that required treatment within the past 3–6 monthsa recent stroke or symptomatic and untreated peripheral vascular diseaseuncontrolled diabetes with end-organ damagea history of finding it difficult to adhere to a treatment plan or follow other medical guidanceactive smoking or drug use with an unwillingness to quit this use Cost and insurance In 2020, a heart transplant cost an average of $1,664,800. This includes expenses from:pre- and post-transplant medical careorgan procurementhospital chargesdoctor feesmedications Medicare covers heart transplants. However, a person with original Medicare, which refers to Part A and Part B, must pay the following:20% of Medicare-approved charges for doctor’s services after meeting the Part B deductible20% of Medicare-approved charges for medications after meeting the Part B deductiblevarious transplant facility costs Private insurance coverage of heart transplants varies widely. A person should contact their health insurance provider to ask which costs their policy covers. People are responsible for all costs that an insurer does not cover. What to expect Below is what to expect before, during, and after the transplant. Before the transplant Before the transplant, a person will undergo a complete physical examination and a mental health evaluation. If healthcare professionals decide that an individual is a good candidate for a transplant, the next step involves waiting for a donor heart that comes from someone who weighs a similar amount and has a compatible blood type. During the waiting period, people will need to make regular visits to their healthcare team, who will monitor their condition. During the transplant Once a compatible donor’s heart becomes available, staff will notify the heart recipient to come to the hospital. There, the person will receive medication to prevent their body from rejecting the new heart. The healthcare team will give the person anesthesia and begin the operation. During the operation, surgeons will prepare the person’s chest cavity to receive the new heart. They will remove the old heart and replace it before sewing up the incisions. After the transplant Following surgery, recovery occurs in the intensive care unit, which will involve a stay of up to 3 weeks. Cardiac rehabilitation, which is an exercise and education program, may start during this time. While in the hospital, people will learn how to monitor their overall health and weight, as well as their temperature, pulse, and blood pressure. Healthcare teams will also teach people how to look out for signs of an infection and detect early warnings that the body is rejecting the new heart. Throughout the first 3 months after hospital discharge, the person’s healthcare team will ask them to make frequent visits. These visits will test for rejections and infections, check heart function, and assess recovery. Life after a heart transplant The American Heart Association (AHA) reports that people who undergo a heart transplant do not have any particular activity restrictions. However, an individual should discuss their activity plans with a doctor to ensure that it is safe for them to exercise. A transplant can help a person have a more active, fulfilling life, but additional heart surgeries or a pacemaker may be necessary in the future. Individuals can take steps to protect their health. These include:exercising regularlyreaching or maintaining a moderate weighttaking medications properlykeeping all doctor appointmentseating a nutritious, balanced diet If a heart transplant fails, a second heart transplantation may not be possible. It is important to look after the new heart as well as possible. Summary Heart transplantation is expensive, costing $1,664,4800 in 2020. Medicare covers part of the cost of this procedure, but private insurance coverage may vary. Healthcare professionals will look at a range of factors to ensure that a person is a candidate for surgery. After the procedure, people will recover in the hospital for up to 3 weeks. Healthcare professionals will closely monitor them for 3 more months. Last medically reviewed on August 30, 2022Heart DiseaseSurgeryCardiovascular / Cardiology 9 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Ahmed, T., et al. (2022). Heart transplantation. https://www.ncbi.nlm.nih.gov/books/NBK557571/Alraies, M. C., et al. (2014). Adult heart transplant: Indications and outcomes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133547/Bentley, T. S., et al. (2020). 2020 U.S. organ and tissue transplants: Cost and estimates, discussions, and emerging issues. https://www.milliman.com/-/media/milliman/pdfs/articles/2020-us-organ-tissue-transplants.ashxCovering transplant costs. (n.d.). https://transplantliving.org/financing-a-transplant/covering-costs/de Jonge, N., et al. (2008). Guidelines for heart transplantation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2266869/Getting a new heart: Facts about heart transplants. (2012). https://www.myast.org/sites/default/files/pdfs/getting_new_heart.pdfHeart transplant. (n.d.). https://www.heart.org/en/health-topics/congenital-heart-defects/care-and-treatment-for-congenital-heart-defects/heart-transplantHeart treatments. (2022). https://www.nhlbi.nih.gov/health/heart-treatments-proceduresOrgan transplants. (n.d.).https://www.medicare.gov/coverage/organ-transplantsFEEDBACK:Medically reviewed by Darragh O'Carroll, MD — By Mary West on August 30, 2022 Latest newsWhat sets 'SuperAgers' apart? 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