2008 Annual Meeting Abstracts
Medical and Life Insurance Difficulties for Living Organ Donors
Jennifer E. Verbesey, M.D., Mary Ann Simpson, PhD, Elizabeth A. Pomfret, MD, PhD.
Lahey Clinic, Burlington, MA, USA.
Objectives: To determine if living donors (LD) encounter difficulty obtaining health or life insurance.
Design: Telephone survey (15 questions).
Setting: Transplant centers performing living donor transplantation.
Participants: Program representatives of 101 centers with living donor programs.
Main Outcome Measures: Incidence of insurance denial to living donors and transplant center’s response to event.
Results: Of 101 LD transplant centers initially surveyed (52 kidney, 49 liver), 18 were excluded for low volume (<3 LD transplants/year), leaving 83 (51 kidney, 32 liver) centers for analysis. 44 programs (53.0%) discussed insurance issues with potential donors. Of those, 9 include potential insurance problems in their written consent; 35 include verbal information. Liver programs (20/32, 62.5%) address insurance issues more often than kidney programs (24/51, 47.0%). Several (6/83, 7.2%) responded, “We never realized this could even be a problem.” Potential donors withdrew solely due to insurance concerns in 13 programs (9 KTx, 4 LTx); 16 programs (11 KTx, 5 LTx) reported 24 donors with actual difficulty obtaining insurance after donation. All had uncomplicated surgeries and were considered completely well by the transplant team. 12 obtained insurance after multiple letters and 1 required intervention from the state insurance commissioner. One patient received a high quote. Ten patients solicited help from their transplant team and have appeals pending.
Conclusions: 1) Live donors face real risks in obtaining insurance. 2) Approximately 50% of programs don’t address insurance issues preoperatively. 3) Live donor centers should address potential for insurance problems early in the evaluation process, and advocate for donors if necessary. 4) Transplant professionals should work to prevent insurance companies from penalizing healthy organ donors.