Does Medicare Cover Blood Transfusions and How Many Pints Are Covered?

Medicare Blood Coverage

Needing a blood transfusion can happen to anyone if you have a car accident or any other injury, surgery, bleeding, and disease. With so many emergency and non-emergency reasons for a blood transfusion, most people don’t think about what they would cost or if it is covered by Medicare at all. We do have the answers for you.

Does Medicare cover Blood Transfusions?

Yes and no. I know that seems confusing, but the first 3 pints of blood of a blood transfusion are not covered AT ALL by Medicare (unless they are donated). So if non-donated blood is administered in a hospital you would have to pay for your 1st three pints AND if administered outside of a hospital setting you would pay for the 1st 3 pints PLUS your Part B deductible, copays, and coinsurance for fees for handling and processing the blood

Does Medigap Cover Blood Transfusions?

All Medigap plans cover the costs of the first three pints of blood, which can add up with an average cost of $300 per pint, and all plans cover all or part of your copays and coinsurance, but only Medigap C and F will cover your Part B deductible.

Medicare Blood Coverage in a Nutshell

How often is it covered?

Medicare Part A (Hospital Insurance) covers blood you get as a hospital inpatient. Medicare Part B (Medical Insurance) covers blood you get as a hospital outpatient.

Who’s eligible?

All people with Medicare Part A and/or Part B are covered.

Your costs in Original Medicare

Part A:

In most cases, the hospital gets blood from a blood bank at no charge, and you won’t have to pay for it or replace it. If the hospital has to buy blood for you, you must do one of these:

  • Pay the hospital costs for the first 3 units of blood you get in a calendar year
  • Have the blood donated

Part B:

If the provider gets blood from a blood bank at no charge, you won’t have to pay for it or replace it. However, you’ll pay a copayment for the blood processing and handling services for every unit of blood you get, and the Part B deductible applies. If the provider has to buy blood for you, you must do one of these:

  • Pay the provider costs for the first 3 units of blood you get in a calendar year
  • Have the blood donated by you or someone else