Financial and Insurance Issues

Who pays for living donation?

Generally, the recipient's Medicare or private health insurance will pay for the following for the donor (if the donation is to a family member or friend). Donors should always coordinate their tests with the transplant coordinator at the hospital in case there are any exceptions:

  • Evaluation to determine if the person is a good candidate for living donation
  • Donation surgery
  • Post-operative care

However, the following expenses generally wouldn't be paid by either the recipient or the donor's insurance:

  • Lost wages during the donor's recovery. Time off from work is not covered by Medicare or private insurance. However, donors may be eligible for sick leave, state disability and the Family and Medical Leave Act (FMLA).
  • Travel expenses. If you are traveling to a transplant hospital away from home, you can incur expenses for travel, lodging expenses during evaluation and recovery, phone calls to home, childcare, etc. Some transplant hospitals offer free or low-cost hospitality houses for you and your family–be sure to ask about your options.
  • Expenses for treatment of unrelated conditions that are discovered during the evaluation process
  • Some follow-up expenses may also not be covered, so it's important to discuss these matters with the transplant center. The financial counselor and/or transplant social worker at the hospital can answer any questions you have about the cost of donation.

Click here for a Living Organ Donation Cost-Estimation Worksheet. Again, potential donors should talk to the transplant hospital about their unique situation.

Will my health or life insurance coverage be affected by donation?

Your health insurance should not be affected by donation. The Affordable Care Act has made it illegal for health insurance companies to refuse to cover you or charge you more because you have a pre-existing condition.

However, some living donors have reported either having difficulty getting life insurance or facing higher premiums for life insurance. In such cases, it may be necessary for transplant centers to inform the insurance carrier of existing data that report that the patient is not at increased risk of death because of donation.

If you already have insurance, check your insurance contracts carefully to see if living donation would affect your current policies. You might also want to consult with a lawyer who is knowledgeable about insurance law.

If you are considering donation, talk to the financial counselor and social worker at the transplant center to find out if donation will affect your health or life insurance coverage. It is important for potential donors to carefully consider these issues before proceeding with donation.

You may also be able to acquire life insurance through the Living Organ Donor Network, which offers an option to donors to purchase life, disability and medical insurance for complications which might arise from being a kidney donor. The insurance is optional for transplant centers that participate in the Living Organ Donor Network data registry program as well as for individuals that may wish to benefit from this protection. For information on how to participate or find kidney transplant programs that participate contact Arlene Skinner at AFDT by phone at 800-543-6399 or by email at

Is there any assistance available for lost wages, travel and lodging?

There is a chance that living donors might experience lost wages during their recovery period, which can be a big expense. Living donors are typically responsible for any time lost from work, unless their employer is able to provide paid leave or allow the donor to use short-term disability. Some donors use a combination of vacation time, sick leave and/or short term disability during their recovery period. The NKF suggests that you discuss these issues with:

  • Your transplant center (Financial Counselor and/or Transplant Social Worker)
  • Your employer's Human Resources department

For help with travel and lodging you may qualify for assistance through the National Living Donor Assistance Program. This program provides financial assistance to those who want to donate an organ but are not able to afford the travel and subsistence expenses associated with living organ donation.

For help with lost wages to help cover expenses such as: mortgage or rent, utilities, car payment or insurance you may qualify for assistance through the American Transplant Foundation. The maximum amount of a grant is $700.

If a living donor donates at an NKR (National Kidney Registry) Donor Shield Center, OR if they are involved in an NKR swap between transplant centers, they will automatically be eligible for Donor Shield Coverage. This includes:

  1. Lost Wage Reimbursement for up to 6 weeks
  2. Travel, Lodging, & Mileage Reimbursement up to $6,000 for donors and their caregiver
  3. Legal Support
  4. Coverage for Uncovered Donor Complication Costs (recipient’s insurance may also cover)
  5. Lost Wage & Travel Reimbursement for Donor Complications
  6. Priority for a living donor kidney transplant themselves if one is ever needed

Are there any laws related to taking time off to donate a kidney?

Employees of the Federal Government

Employees of the federal government receive 30 days paid leave for organ donation and 7 days for bone marrow donation. The leave is over and above the employee's sick and annual leave.

Employees of State Governments

Modeled after federal law (for federal employees), many states have begun to offer state employees up to 30 days leave (paid or unpaid) for serving as a living organ donor. This leave is considered separate from any annual or sick leave already accrued by an employee. Usually, the period of leave is 30 days for organ donors or 7 days for bone marrow donors. Click here for detailed state-by-state information.

Private Sector Employees

Eight states (Arkansas, Connecticut, Illinois, Louisiana, Maine, Minnesota, Nebraska and Oregon) allow a leave of absence for private sector employees but in many cases, it only applies to marrow (not organ) donors. Click here for detailed state-by-state information.

Are there tax deductions or credits available for living donors?

Many states have already enacted tax deductions or credits to living donors for unreimbursed expenses associated with donation. Click here for detailed state-by-state information.

There is pending federal legislation that would provide a federal tax credit of up to $5,000 for unreimbursed expenses, including lost wages, for living donors of kidney, liver, lung, pancreas, intestine or bone marrow.

Please help us get this legislation passed! Join the NKF's Take Action Network to advocate for legislation to help living donors, transplant recipients and kidney patients. Be sure to reply to ALL the featured alerts.

Where can I get more information?

Potential donors should talk with their transplant hospital about financial and insurance issues. The hospital will have a "Transplant Social Worker" and/or "Transplant Financial Counselor" who can advise potential donors about their options, along with what expenses will be incurred by the recipient's insurance, the donor or the hospital.

You can also request a free Q&A from the United Network for Organ Sharing entitled "What Every Patient Needs to Know." The booklet has an extensive section on financial issues for both donors and recipients, including social services, insurance coverage, Medicare and Medicaid coverage, fund raising campaigns and other possible sources of assistance. Contact UNOS (888-894-6361) to request a copy.

You can also click here to visit the Live Donor Financial toolkit online for more on Living Donation and Employment and Living Donation and Insurability after Donation.

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NKF Cares is a free, confidential hotline with trained professionals ready to answer your questions or concerns. Our peer-mentoring program, NKF PEERS, connects anyone affected by kidney disease with an informed and supportive mentor who has already been through the process.