Does It Cost Money to Donate a Kidney?

It is a fair question to ask early, and asking it does not make you less generous. Whether it costs money to donate a kidney depends on which costs you mean, so this page separates them.

What is covered for you

Your donation-related medical care — evaluation, surgery, hospital stay and standard follow-up — is generally billed to the recipient's insurance rather than to you. You should not be paying for the operation itself.

What is usually not covered

• Travel to and from the transplant center, sometimes repeatedly during evaluation
• Lodging if the center is far from home, plus meals
• Lost wages for the weeks you cannot work
• Childcare or elder care while you are in the hospital and recovering

For a donor without paid leave, lost wages are usually the largest single cost. Recovery typically runs four to six weeks, longer for physical work.

The Federal Reimbursement Program

The National Living Donor Assistance Center (NLDAC) is funded by the federal Health Resources and Services Administration. It reimburses eligible living donors for travel, lodging, meals, lost wages and dependent-care costs connected with evaluation, surgery and follow-up, subject to current program eligibility requirements and reimbursement limits.

Eligibility depends on the financial circumstances of both donor and recipient, and applications go through the transplant center. Ask your center's living-donor coordinator about NLDAC at your first appointment — not after surgery, because expenses have to be documented as you go.

Time off work

Ask your employer early. Some employers offer paid organ-donation leave; some federal and state employees have specific entitlements; the Family and Medical Leave Act may protect your job even where leave is unpaid. Get it in writing before you schedule surgery.

Insurance questions worth asking first

• Will donating affect my own health, life, or disability coverage? Check before donating.
• Who pays if I develop a complication months or years later? Ask the center to answer this in writing.
• Does my employer offer donation leave, paid or unpaid?

A realistic budget checklist

Work these out before you commit, not afterward. Most donors who run into financial trouble did not encounter an unexpected cost — they encountered an expected cost they had never added up.

• Evaluation trips. How many visits, how far, and can they be grouped into fewer journeys?
• Time off for testing, which is separate from time off for surgery and often overlooked.
• Surgery and recovery leave — four to six weeks, longer for physical work.
• A partner's time off, if someone needs to travel with you or care for you at home.
• Childcare or elder care during the hospital stay and early recovery.
• Parking and meals at the hospital, which are trivial individually and material over weeks.

Take that list to your transplant center's living-donor coordinator and ask which items NLDAC would reimburse in your circumstances. Doing it in that order — list first, then ask — produces a far more useful answer than asking in the abstract.

None of this should be a surprise on the day. Your transplant center's financial coordinator can help explain these potential costs and available assistance.