Can’t find whether the plan I got gets transplants

Hi, I got my brother who needs a transplant a health plan through healthcare.gov a special sign up option and he needs a transplant. I don’t see it as a requirement but was told by Georgetown to make sure and really need my brother to get a transplant and I’m lost.

4 Likes

You should check your plan’s contract or contact your carrier to ask about it.

4 Likes

When I call Cigna it says it requires the policy holder to call. I have power of attorney would I be able to inquire? You think?

4 Likes

I’m not sure if that would work if your brother never listed you as an authorized user on his account or if his insurance carrier allows it. Is your brother unavailable for a call?

Can you log into the insurance portal? You should just need his Social Security number and policy number to set it up if you haven’t done that yet.

Regardless, a transplant will require prior authorization, and a doctor can verify the benefits that way—assuming it’s something covered."

4 Likes

The healthcare policy doesn’t take effect until the first. They are running several tests to confirm he’s healthy enough. He is high on the transplant list, and I’m worried that if I wait until the first, it might be too late.

4 Likes

The policy documents might be in the healthcare.gov portal, but if he’s not a member yet, most customer service representatives can’t help because they need the member number and profile.

You may need to press 0 or ask to speak to an operator. Try to ask a general question about the policy instead of a member-specific question

4 Likes

I’m a va resident but they have their own health care portal but thank you that is very helpful I appreciate it.

3 Likes

Check Your Policy Documents: Review the benefits summary or policy documents you received when you enrolled. Look for sections on coverage for surgeries or transplants.

2 Likes

If you’re still having trouble Consult Your State’s Insurance Department, your state’s insurance department may be able to help clarify coverage details for you.

1 Like

Call the customer service number on your insurance card. Ask them directly if transplants are covered under your plan.