Transplant Insurance Carveout Product

Optum offers an organ transplant “carveout” insurance product to employer associations, unions, Taft Hartley groups and self-funded employers. Recent market demand indicates a growing interest in this type of coverage.

The Managed Transplant Program (MTP) is underwritten by UnitedHealthcare Insurance Company (UHIC). UHIC is an AM Best “A” rated insurer. MTP includes 365 days of coverage and does not have pre-existing exclusions. Once coverage is bound, all transplant-related costs are covered. It's a great way to provide value to your customers and earn additional income for your business. Learn more about the benefits of offering MTP to you, your customers and their employees, below. 

Transplant Centers of Excellence Network

Pediatric Transplant Centers of Excellence Network

MTP benefits employers by:

• Helping advance the strategy for controlling costly and volatile transplant expenses to provide predictable budgeting
• Providing access to the nation's leading transplant Centers of Excellence (COE) network for employees and dependents
• Reducing the cost of stop loss insurance premiums
• Reducing the need for lasering of transplant patients at stop loss insurance renewal
• Protecting against the risk of having to satisfy 2 annual stop loss insurance deductibles for a single patient whose transplant care crosses treaty years
• Removing transplants from stop loss renewal experience

Patient benefits

Through MTP, members and their dependents gain access to the Optum Transplant COE network — the premier transplant network in the country — with over 180 transplant centers. Data shows that patients treated at COE network programs have shorter lengths of stay and reduced complications/re-admissions than the overall population hence enhancing clinical outcomes and reducing costs. Through MTP, your clients can stabilize their health care budget and provide their employees with access to extraordinary care.

Transplant Reinsurance Carveout Product

Optum offers an organ transplant “carveout” reinsurance product to Managed Care Organizations (MCOs). As costs and incidence of transplantation increase, the exposure to transplant risk becomes greater for an MCO. Offering this unique first-dollar product to your reinsurance customers provides them unparalleled protection while adding another source of revenue for your business. 

The Managed Transplant Program (MTP) is underwritten by United Health Insurance Company (UHIC) paper. UHIC is an AM Best “A” rated insurer. MTP includes 365 days of coverage, including the cost of anti-rejection drugs.

MTP benefits MCOs by:

• Providing a predictable premium expense in place of unpredictable transplant claims exposure
• Freeing up cash reserves, normally held in anticipation of expected transplant claims
• Allowing your clients to focus on other high-dollar service categories
• Enabling an outsource solution of dedicated transplant case managers to support the needs of the MCO clinical organization and patient
• Reducing the cost of medical reinsurance coverage
• Providing additional risk protection where standard reinsurance has gaps

Member benefits

Through the Managed Transplant Program, members gain access to the Optum Transplant Centers of Excellence (COE) network — the premier transplant network in the country — with over 180 transplant centers. Data shows that patients treated at COE network programs have shorter lengths of stay and reduced complications/re-admissions than the overall population hence enhancing clinical outcomes and reducing costs. Through MTP, your clients can stabilize their health care budget and provide their employees with access to extraordinary care.