Optum offers products for complex medical conditions such as:
Bariatric
Cancer
Chronic Kidney Disease
Congenital Heart Disease
Orthopedics
Transplantation
VAD
Women's Health Services
- Fertility
- Neonatology
- Pregnancy

 

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Managed Transplant Program for Self-Funded Groups

The Managed Transplant Program (MTP) provides first-dollar insurance coverage with no deductibles, average daily maximums (ADMs) or other per case charges. This coverage allows your organization to budget more effectively and provide maximum clinical value to your transplant patients.

Employee Benefits

The Managed Transplant Program provides access to the nation's leading Centers of Excellence (COE) transplant facilities. 

  • Only centers with the highest survival rates and transplant volumes are included in the COE network
  • Covers all transplants: Solid Organ, Blood and Marrow
  • First-dollar coverage means no deductibles or co-pays
  • Unlimited Lifetime Benefit
  • Preserves the lifetime maximum of underlying major medical costs
  • Covers immunosuppressants (anti-rejection drugs)
  • Covers transplant-related expenses from one day prior to the transplant through a maximum of 365 days following the transplant

Self-Funded Group Benefits

The Managed Transplant Program mitigates the risk for transplants, giving you predictability through a standard monthly premium. MTP pays virtually all your transplant claims.

MTP Risk Mitigation Advantages:

  • Reduced cost of specific stop-loss insurance premium
  • Eliminated lasers at stop-loss insurance renewal on potential transplants
  • Protection against multiple specific deductibles in consecutive years
  • Protection against potential costs of multiple transplants in one year
  • Reduced financial liabilities for specific stop-loss insurer
  • Access to Specialized Physician Review, an independent expert physician review service for decision support and second opinions on transplant cases
  • Access to Managed Transplant Program nurse consultants, who provide support and guidance to patients throughout the transplant experience

Network Maps

Transplant Centers of Excellence Network
Pediatric Transplant Centers of Excellence Network

 

Transplant Review Guidelines

Stem Cell Transplant Review Guidelines

Solid Organ Transplant Review Guidelines