Frequently Asked Questions About Transplants
- What is the Cigna LifeSOURCE Transplant Network®?
The Cigna LifeSOURCE Transplant Network® is a transplant network that is made up of more than 170 designated transplant facilities that have met quality and cost criteria and have contracted with Cigna LifeSOURCE to offer transplant services to Cigna-covered individuals, and to others accessing the network.
- What else makes up the Cigna LifeSOURCE program?
The program includes a team of nurse transplant case managers that serve as your one point of contact within Cigna. These case managers help each individual get the most from their coverage dollars. Transplant-specific benefit analysts, claims specialists and a leadership team all work to help you access quality transplant care.
- What is a Cigna LifeSOURCE Designated Program?
A Cigna LifeSOURCE Designated Program is a transplant services program with an in-network facility and the program meets Cigna LifeSOURCE's quality and cost criteria. In order to be considered a Designated program in the Cigna LifeSOURCE Transplant Network®, the facility must be a designated program for the specific type of transplant requested.
- What is a Supplemental Program?
A Supplemental program is a transplant services program with an in-network facility and the program does not meet the quality and/or the cost criteria to qualify as a Designated Program. Your benefits may or may not cover a transplant at a Supplemental Program. Your case manager can tell you if you have coverage for a Supplemental Program.
- Why should I get my transplant at a Designated Cigna LifeSOURCE Transplant Program?
- Cigna LifeSOURCE Designated Programs have transplant programs that have satisfied our quality and cost criteria. We have arranged special rates with these in-network facilities that can save you significant out-of-pocket costs, depending on your coverage.
- How do I know if a transplant center is in the Cigna LifeSOURCE Transplant Network?
Your transplant case manager can tell you which transplant facilities are in-network for your type of transplant. For a list of in-network facilities and the transplant programs for which they are contracted, please view our network.
- How does a facility get in the Cigna LifeSOURCE network as a Designated Program?
Transplant facilities must meet established patient and graft (transplanted organ or tissue) survival requirements, offer support services to transplant patients, and have a quality team of transplant medical professionals. They must also be willing to agree with Cigna LifeSOURCE on reasonable rates. These rates benefit Cigna-covered individuals through lower out-of-pocket costs.
- How do you know each facility maintains its quality?
Each Cigna LifeSOURCE Designated Program is recredentialed annually. The number of transplants performed and the results of these operations, as well as medical team stability, are reviewed to help ensure quality transplant services.
- If a hospital is in-network, does that mean I can get any type of transplant at that center?
No. Cigna LifeSOURCE considers each type of transplant program individually. Each must meet certain requirements. For example, a hospital may be considered an in-network Designated Program, but only for specific transplant types. For example, they can be Designated for kidney but not for heart.
- Why is there a special network for transplants?
Because transplants are such complex procedures, and follow-up care is crucial to the success of transplants, Cigna Healthcare has formed a special network that only contracts with facilities that have established quality transplant programs.
- Why am I not able to go to the hospital I usually use for regular care for a transplant?
Not all hospitals do all types of transplants. Cigna LifeSOURCE only contracts with programs that meet established quality requirements as well as agree to reasonable rates. To see if your regular hospital is in-network for your type of transplant, please call your case manager or view our network.
- What if I would still rather be treated at a facility that is not a part of the network?
If you have out-of-network coverage, you may be treated at the facility of your choice, but at a lower coverage level. Your case manager can tell you if you have out-of-network coverage.
- What is a transplant case manager?
A transplant case manager is a registered nurse (licensed in at least one state) who is specially trained to help you with the management of the medical condition for which you need a transplant, and who can help manage your transplant coverage. They will help you navigate the health plan coverage aspects of transplantation, as well as help you get the most from your plan dollars.
- What will my case manager do for me?
Your case manager is there to guide you before, during and after your transplant. They will answer questions, outline your responsibilities and keep you informed and aware of your covered services. Your case manager will not ask you confusing medical questions only a doctor can answer. They will talk to you in layman terms. Your transplant case manager cannot offer medical treatment or advice, but will help you get the treatment and services you need.
- How do I reach a transplant case manager?
When you become a potential transplant recipient, you will receive an introductory letter and other information from your transplant case manager. If you are not sure who your case manager is, please call 800.668.9682.
- When should I call my transplant case manager?
You should call your transplant case manager for things such as:
- Questions or concerns about your health coverage
- Changes with your medical condition
- You are hospitalized
- You need home care
- Any other questions or concerns about your transplant
- How often will my case manager call me?
Your case manager will usually be in contact with you at least once a month, more often around the time you have your transplant. You can call your case manager any time you would like. They are usually in the office from 8:00 a.m. to 6:00 p.m. EST.
- What if an organ becomes available in the middle of the night?
All you need to do is follow the instructions given by your doctor. Your transplant facility will call Cigna LifeSOURCE the next business day to verify your eligibility. Your authorization will already be in place.
- What if I have to travel far away to a transplant facility?
The transplant travel benefit may be available to help pay for eligible transportation and lodging expenses for you and one companion or caregiver (up to two caregivers for a dependent minor). The travel program is available only when Cigna has authorized coverage for a transplant at a Cigna LifeSOURCE Transplant Network Designated Program that is contracted for the specific transplant being requested, and when the facility is located more than 60 miles (one way) from your home. You may be eligible for up to $10,000 in travel benefits. Please ask your transplant case manager if you are eligible for this coverage and if it is applicable to your circumstances.
- What kinds of things are covered under the travel benefit?
Air, rail or bus travel, car rental, taxi, shuttle services, public transportation, cost of gasoline for use of a rental or personal car, parking, ferry charges, and housing associated with visits or admissions to the transplant clinic or transplant facility. Please ask your transplant case manager if you are eligible for this coverage and if it is applicable to your circumstances.
- What kinds of things are not covered under the travel benefit?
Lost wages due to time off from work required for the transplant (for recipient, companion or donor), books, magazines, entertainment, loss of money or loss or damage to luggage or clothing, travel or other personal trip insurance, telephone calls, laundry, dry-cleaning, toiletries, fines or traffic tickets, alcohol or tobacco products, barber, beautician, massage services, air travel costs over coach rates, air travel by air ambulance, companion for a covered donor, deposits for housing or utilities and expenses for potential donors. For more information on what is and is not covered, please contact your transplant case manager.
- Can I bring someone with me to support me during my transplant?
Yes. The travel benefit includes coverage for qualified expenses for the transplant recipient and one caregiver if the recipient is an adult, or two caregivers if the recipient is a child.
- Will my travel benefit pay for the travel expenses of my donor?
Yes. Qualified expenses for an approved donor are covered. Please ask your transplant case manager if you are eligible for this benefit and if it is applicable to your circumstances.
- How do I know if I am eligible for Medicare benefits?
Please call the Social Security Administration at 800.772.1213. For the hearing or speech impaired, please call 800.325.0778. You may also visit www.ssa.gov.
- If I have Medicare, am I still eligible for Cigna LifeSOURCE coverage?
Usually, yes. At the time Medicare becomes the primary insurance provider, you are usually still eligible for Cigna LifeSOURCE coverage if you use a Cigna LifeSOURCE Designated Program (in-network facility). You will continue to work with a Cigna LifeSOURCE transplant case manager.
- Who do I call if I have a question about claims or payment?
Your case manager can help you with questions about claims. Case managers work with transplant benefit analysts to help you understand your coverage.
- How does Cigna LifeSOURCE know I may be a candidate for transplant?
There are many ways Cigna LifeSOURCE can become aware that you may be facing a transplant. Your regular doctor or transplant center may call us or make an online referral. A claim code for a diagnosis or for a procedure you have had can also trigger our systems to alert the Cigna LifeSOURCE program. You may call us at 800.668.9682 to let us know that you may be a candidate for transplantation.
- How do I decide which Designated Program to use?
Your transplant case manager can help you make this decision. There is also a lot of information on the Internet at sites such as www.unos.org (United Network of Organ Sharing), www.bethematch.org (National Marrow Donor Program), www.SRTR.org (Scientific Registry for Transplant Recipients that gives statistics for solid organ transplant programs), www.kidney.org (National Kidney Foundation), optn.transplant.hrsa.gov (Organ Procurement and Transplantation Network which gives statistics for solid organ transplant programs) and other sites.
- Who pays for expenses incurred by my donor?
This depends on your specific coverage, but Cigna LifeSOURCE usually covers donor-related expenses involved in evaluating a donor, the donation surgery and immediate follow-up care. Long-term medical treatment would fall to the health coverage of the donor. For coverage specifics, please call your transplant case manager. If you have more questions about Cigna LifeSOURCE Transplant Network, please contact your case manager or call 800.668.9682.
