Does Medicare Cover Blood Transfusions?

Learn how much it will cost to have a blood transfusion

by Ray Wilson+ on Jul 23, 2015 | 5 Comments

Needing a blood transfusion can happen to anyone if you have a car accident or other injury, surgery, bleeding, and disease. With so many emergency and non-emergency reasons for a blood transfusion, most people don’t think about what they would cost and is it covered at all by Medicare. We have the answers for you.

Does Medicare cover Blood Transfusions?

Yes and no. I know that seems confusing, but the first 3 pints of blood of a blood transfusion are not covered AT ALL by Medicare (unless they are donated). So if non-donated blood it is administered in a hospital you would have to pay for your 1st three pints AND if administered outside of a hospital setting you would pay for the 1st 3 pints PLUS your Part B deductible, copays, and coinsurance for fees for handling and processing the blood

Does Medigap Cover Blood Transfusions?

All Medigap plans cover the costs of the first three pints of blood, which can add up with an average cost of $300 per pint, and all plans cover all or part of your copays and coinsurance, but only Medigap C and F will cover your Part B deductible.

Learn More about Medigap Get a Medigap Quote

Does Medicare Advantage Cover Blood Transfusions?

While Medicare Advantage must cover everything that Medicare covers, it can vary in how it covers it. Many plans, like Original Medicare, require you to pay for the first three pints of blood, however, there maybe a plan that will cover it.

Learn More about Medicare AdvantageGet a MA Quote

For further questions call a Senior65 agent at 800-930-7956.

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Reader Comments and Questions

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By Sandra on May 02, 2017

Please confirm my understanding. Blood Transfusions, MC does not pay for the 1st three pints and would cost the PT approx $300.00 per. But if someone is under a MC Part "A" stay @ a SNF would this cost be passed on to the facility along with the Tech Component? Then following transfusion would be covered @ 80% by MC and if the PT has a TPL they would pick up the bal? Thank you for your help, Sandra

Sandra,
You most likely will have to pay for it unless you have a Medigap plan. To confirm, you will need to contact Medicare for specific coverage.
-Amy from https://www.senior65.com/


By Shelia Samuels on October 12, 2016

My mother has cancer and her body is not making blood. She needs at least two pints, but the doctor will only give her one at a time. What Medicare provision limits the number of pints anyone can be given at a time?

Shelia,
You will want to contact Medicare directly to find out why they are limiting her blood transfusions. Best of luck!
-Michelle from https://www.senior65.com/


By Dub Ivy on January 21, 2016

My father is 95 years old and has just been diagnosed with an aggressive leukemia. He can survive with a blood transfusion every 30 days. We have been told Medicare will not pay for it because of his age?

Dub,
There should be no limit on the amount of blood transfusions that Medicare will pay 80% of (first 3 pints you pay at 100%). If he is in Hospice, that would be the only reason I could imagine they are denying a blood transfusion. You should contact Medicare directly and find out why they have denied your father's claim.
-Amy from https://www.senior65.com/


By Kendra on August 19, 2015

Without Medigap, I could have to pay out of pocket for my blood? That seems ridiculous. Am I misreading this??!!!

Kendra,
We understand your frustration. And, unfortunately, no, you are not missing something. Just remember, that Medicare does not cover most services completely, it still has limitations and usually you have out of pocket costs. Medigap is meant to fill in those gaps by covering copays, coinsurance, deductibles, and adding extras like your first 3 pints of blood. Hope this helps.
-Amy from https://www.senior65.com/


By Lana Trent on August 05, 2015

I had a car accident and needed a blood transfusion and I didn't have to pay for the blood because it was donated (lucky me), but I did have to pay for the other costs. Now I'm turning 65, if I don't get donated blood and have to pay for the costs, do you think it's best I go with Medigap? And which Medigap plan do you suggest. Thanks so much!

Lana,
Medigap is a great option for help covering blood transfusions. We suggest looking into Medigap C or F because they will cover your Part B deductible, and with those you shouldn't have out of pocket costs.
-Jacima from https://www.senior65.com/



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