Members

Transplant Program

When you need an organ or bone marrow/stem cell transplant, our transplant program can help you get the care you need in the most effective setting, with the best possible outcome. We’ll provide the information you need to make informed decisions about your care and help you understand your diagnosis and care plan. We can also help you find a Centers of Excellence transplant facility.

For more information, you or your provider can call us toll-free at 1-888-906-0958 (TTY: 711), 8 a.m. – 5 p.m., Monday – Friday.

Before You Receive Care

Your health care providers must receive prior authorization from Medica before providing transplant-related care (including pre-transplant evaluations). Without prior authorization, these services may not be covered and Medica may not pay your claim.

Prior-authorization is needed for the following transplant types:

Bone marrow or stem cell (peripheral or umbilical cord blood)
Heart (adult or pediatric)
Heart-lung
Intestinal
Kidney
Liver
Lung (single or double)
Simultaneous pancreas and kidney (SPK)
Pancreas after kidney (PAK)
Pancreas (pancreas alone)

Requesting Prior Authorization

To request prior authorization, ask your provider to complete the Transplant Prior Authorization form and fax it to 952-992-3556.

Need More Support?

You or your provider can request the help of a case manager. Case managers work on your behalf to manage prior authorization requirements. They will also help you find network facilities for pre- and post-transplant services, such as home health care, home therapy and social service support. To request these services, call 1-888-906-0958.

Questions?

Call us at toll-free at 1-888-906-0958 (TTY: 711), 8 a.m. – 5 p.m., Monday – Friday, or email us at [email protected].

Medica Utilization Management and Clinical Appeals Department
PO Box 9310 CP440
Minneapolis, MN 55440