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Managed Transplant Program for employers

The Managed Transplant Program (MTP) manages the clinical and financial aspects of your employees’ transplant cases.

Value of our Managed Transplant Program

MTP is a first-dollar, fully insured transplant carve-out product designed to manage risk, control costs and improve patient outcomes.

Transplant likelihood

For a 400-life group, there is a 55% chance of having a transplant episode within 5 years.

Transplants can be unpredictable

1 in 5,600 members will experience a transplant.

Transplants are costly

The average billed charge per episode is $743K.

Experience and Scale

We have over 30 years of experience managing transplants.

Fully insured coverage for transplants

MTP protects self-funded groups from the risk of unpredictable, high-cost transplant procedures and costs associated with stop loss, including deductibles and lasering.

Superior cost controls, clinical care and risk management

MTP complements stop loss coverage and provides more complete protection from the high costs associated with a transplant. Employers can better manage their overall risk exposure by combining our expertise in the stop loss market and our experience in managing transplants.

Designed to address coverage gaps while reducing costs

  • No deductibles, coinsurance or copays
  • Includes all solid organ and blood and marrow transplants
  • Covers transplant-related expenses from evaluation through 365 days post- transplant, including immunosuppressant drugs

  • Protection for the full population begins as soon as coverage is bound
  • Unlimited lifetime benefit for transplant services preserves annual max benefit of underlying major medical coverage
  • Stop loss premium credits typically result once coverage is in place

  • Minimizes future stop loss premium increases by carving out transplant experience
  • Drives increased stop loss persistency
  • Eliminates lasers at stop loss insurance renewal on potential transplants

To learn more: Call 1-866-427-6845

Statistics source: Analysis of Bentley TS, Phillips S. 2020 U.S. organ and tissue transplant cost estimates and discussion. Milliman, Inc.  Published February 18, 2020. Accessed March 1, 2020. Milliman estimated U.S. average billed charges related to 30 days prior to and 180 days after transplant for the population under age 65.