What is a pancreas transplant and how to help cover the costs with critical illness insurance?

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A pancreas transplant can be a life-altering procedure done on people who have type 1 diabetes.

Most pancreas transplants are considered for patients with type 1 diabetes whose diabetes has spiraled out of control. This type of transplant can be expensive, but critical illness insurance may help you cover medical and non-medical expenses associated with this procedure. 

Treating diabetes with a pancreas transplant 

Although a pancreas transplant is used for type 1 diabetes, it doesn’t automatically mean one would get the procedure just because they have diabetes. This type of procedure is usually seen as a last resort treatment and is done when everything else has been unsuccessful for patients with type 1 diabetes.

Health systems select people in need of a transplant based on their disease manageability. If your diabetes has gotten so out of control that your medication no longer works, you may be considered a good candidate. The patients added to the list for a pancreas transplant generally have additional medical problems such as: 

  • Kidney damage

  • Eye problems

  • Nerve damage 

  • And other afflictions because of type 1 diabetes 

These medical problems all stem from diabetes that is no longer manageable, and to prevent further complications, they give patients the go-ahead for a pancreas transplant. In addition, however, much less commonly, the pancreas transplant is sometimes performed on people with type 2 diabetes who require insulin therapy.

How does a pancreas transplant help? 

The goal of a pancreas transplant is to restore normal blood glucose levels to the body. A newly transplanted pancreas should begin to produce insulin that, in turn, manages blood glucose levels. After a pancreas transplant, you may not have to take insulin anymore. 

The newly transplanted pancreas typically comes from a deceased organ donor, whose pancreas must match your body immunologically. In some instances, the donor will be alive, but they'll only transplant a portion of the pancreas into the patient. 

Determining who gets a pancreas transplant

Before a pancreas transplant, there are a series of medical tests a person must go through, which can include: 

  • Blood tests 

  • Neuropsychological exams 

  • Kidney function tests

  • A chest X-ray 

These tests help determine whether the candidate is healthy enough for the pancreas transplant, as well as the rigorous drug regimen that comes afterward. After they complete all the exams, the patient is added to the transplant waiting list. 

The procedure

The pancreas transplant itself takes two to four hours. A patient can expect to be under anesthesia and, as a result, will be unconscious throughout the procedure.  After the transplant, the patient stays in the intensive care unit (ICU) for 10 to 14 days under strict monitoring to ensure no complications stem from the procedure. Some of the risks or complications of the procedure that they'll likely monitor patients for include: 

  • Blood clots 

  • Excess sugar in the blood or other metabolic problems

  • Urinary failure 

  • After the transplant, there are also several medications a patient is required to take to make sure the body does not reject the pancreas. 

As with all operations, there are a few risks, and pancreas transplants are no exclusion. For patients and medical professionals, some of the risks or complications of the procedure patients may be monitored for include: 

  • Blood clots 

  • Excess sugar in the blood or other metabolic problems

  • Urinary complications (like leaking or UTIs)

  • Failure of the donated pancreas

  • Rejection of the donated pancreas

Fortunately, the outlook for a pancreas transplant is generally positive. Since a pancreas transplant is highly sought after, patients usually must wait about a year or two to get one.¹ There are over 2,500 recipients on the pancreas transplant waitlist in the United States to date.²

Pancreas transplant cost

Once a candidate is notified of the available procedure, they can be billed $347,000.³ The cost of a pancreas transplant can differ significantly. In addition, some health insurance policies might not offer complete procedure coverage. For instance, some plans may pay for the transplant, but not the cost to find a donor. You should also know that some insurance plans still require copays for medications and clinic visits after the transplant, but that's not all. 

Your health insurance may cover a portion, but it may not cover the entire transplant and the care that comes after. 

Some of the costs that go into the grand total for a pancreas transplant include the following⁴: 

  • The cost of the evaluation for the transplant

  • Any procedure medical professionals must do to obtain the donated pancreas from the deceased

  • Hospital charges

  • Physician fees

  • The 10 to 14 day stay after the transplant is complete

  • Follow-up care 

  • The medication regimen for after the transplant, also known as the immunosuppressants

What is critical illness insurance?

Critical illness insurance is a type of supplemental health insurance. It can help you cover out-of-pocket medical expenses that your primary health insurance plan doesn’t cover. 

Critical illness insurance pays a cash benefit if you or a family member experience a covered serious illness, including major organ failure requiring a transplant, such as the pancreas, lungs, or liver. Once your diagnosis is verified, your insurance company will pay out a lump sum cash benefit depending on the type of illness. No need to wait until you receive treatment to submit a claim – critical illness benefits are only dependent on diagnosis. 

Plans vary from provider to provider, but all Guardian Direct critical insurance policies don’t involve any deductibles, co-pays, maximums, healthcare provider restrictions, or waiting periods. That means you can start benefiting from comprehensive critical illness insurance coverage right away for just the cost of your monthly premium. 

What conditions are covered?

Critical illness insurance covers a variety of life-changing illnesses. Exact coverage amounts and policies vary depending on your provider and your plan. Guardian Direct critical illness insurance covers over 30 major illnesses in the following four categories: 

  • Heart and vascular conditions – Heart attack, stroke, heart failure requiring a transplant, and arteriosclerosis requiring intervention

  • Cancer – Invasive cancer, cancer in situ, and benign brain tumors

  • Kidney failure – Kidney failure requiring dialysis or a transplant

  • Other major organ failure – Other major organ failure requiring a transplant, including the pancreas, lungs, liver, and bone marrow

  • Chronic illnesses like diabetes and asthma are not covered

Benefits paid will depend on the type of illness you are diagnosed with. You may even receive benefits for both the first and second diagnosis, in case you happen to be diagnosed with more than one covered critical illness. 

Get the care you need with critical illness insurance

With a pancreas transplant, there's a lot of costs to consider before and after the transplant. If you have health insurance, critical illness insurance can help fill in the gaps that medical insurance doesn’t cover so you can focus on recovery not medical bills. 

Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment, or medical advice. This is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.

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  1. https://www.mayoclinic.org/tests-procedures/pancreas-transplant/about/pac-20384783

  2. https://unos.org/data/transplant-trends/#waitlists\_by\_organ

  3. https://fortune.com/2017/09/14/organ-transplant-cost, 2017

  4. https://health.costhelper.com/pancreas-transplant-cost.html

Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.(exp.08/22)