Financial Assistance for Liver Failure

Living with liver failure is life altering, not just physically and emotionally, but financially as well. The costs of ongoing medical treatments, prescription medications, and, in some cases, a liver transplant can quickly add up, leaving many patients and their families struggling to manage mounting expenses. For those navigating the complexities of chronic liver disease or liver failure, understanding the available options for financial assistance can provide much-needed relief.

The good news is that there are resources to help. From health insurance coverage and patient assistance programs to nonprofit organizations and solutions like viatical settlements, patients living with liver failure have access to a variety of tools to manage the cost of care.

The Financial Challenges of Liver Failure

Managing liver disease or liver failure places a tremendous financial strain on patients and their families. The costs of hospital stays, ongoing medical treatments, and critical prescription medications quickly add up, often leaving patients feeling overwhelmed. For those who require a liver transplant, expenses can soar to hundreds of thousands of dollars, including the costs of pre- and post-surgery care. As of 2020, the average billed cost for a liver transplant in the United States was approximately $878,400.

For many, the challenges of health insurance coverage and rising out-of-pocket costs add even more stress. Even with health insurance, patients may face high health insurance premiums, deductibles, and gaps in prescription drug coverage. These financial stresses are often compounded by an inability to work, further reducing household income and straining a family’s ability to manage medical care costs.

For patients with limited income, finding financial assistance becomes essential. Programs like Medicare Part B, nonprofit organizations such as the HealthWell Foundation, and patient assistance programs can provide some relief. However, understanding and accessing these resources can be complicated and often requires the guidance of a social worker or advocate.

Despite these options, many patients continue to face significant financial gaps, struggling to afford medications or pay for necessary care. This is where solutions like viatical settlements can make a meaningful difference, offering eligible patients immediate financial relief to cover expenses and reduce financial stress.

Viatical Settlements

For liver failure patients facing mounting medical bills and reduced income, traditional forms of financial assistance may not always be enough. This is where viatical settlements offer an impactful solution. A viatical settlement allows you to sell your life insurance policy to a private company in exchange for a lump sum of cash. This immediate access to funds can provide significant relief, especially for those struggling to cover costs like dialysis services, prescription drug coverage, or the expenses of a potential liver transplant.

How Do Viatical Settlements Work?

If you qualify for a viatical settlement, you can sell your life insurance policy for a percentage of its face value. Unlike traditional insurance payouts, which are only available after the policyholder passes away, viatical settlements let you access this money while you’re alive, offering financial flexibility when you need it most.

Example Calculation:

• Face Value of Policy: $200,000
• Upper Percentage Payout: 80%

Lump Sum Cash Payment:

• Calculation: $200,000 × 80% = $160,000

Key Considerations:

• The percentage payout depends on factors such as:
  • The insured’s life expectancy (shorter life expectancy typically leads to a higher percentage payout).
  • The policy terms (type of policy, premiums, and coverage details).
  • Current market conditions for viatical settlements.

This lump-sum payment can provide immediate financial relief to cover medical bills, transportation, medications, or other essential expenses without restrictions on usage. By opting for a viatical settlement, patients avoid the need to apply for multiple assistance programs, streamlining your access to funds.

Why Consider a Viatical Settlement?

• Immediate Cash: Funds can be used for any purpose, paying off health care costs, handling daily expenses, or simply easing financial stress.
• No Restrictions: Unlike other forms of financial aid, viatical settlements are not limited to specific uses.
• Empowerment in a Difficult Time: For patients who feel stressed by rising health care expenses, this option offers a sense of relief and security.

Government-Sponsored Financial Assistance Options

The U.S. government offers several programs to help patients with liver disease and liver failure manage the high costs of medical treatments, liver transplants, and other necessary health care expenses.

Inpatient Services (Medicare Part A):

• Hospital Stays: Medicare Part A covers inpatient hospital stays necessary for liver cancer treatments, including surgeries and liver transplants, when performed in Medicare-approved facilities (Medicare).
  • Deductible: In 2024, the deductible for each benefit period is $1,632.
  • Coinsurance:
    • Days 1–60: No coinsurance.
    • Days 61–90: A daily coinsurance amount applies.
    • Beyond 90 days: Patients may use up to 60 lifetime reserve days, each with a higher daily coinsurance.

Outpatient Services (Medicare Part B):

• Doctor Visits and Treatments: Covers outpatient services such as chemotherapy, radiation therapy, and consultations.
  • Annual Deductible: Typically $226 in 2024.
  • Coinsurance: After meeting the deductible, Medicare covers 80% of approved costs, leaving patients responsible for the remaining 20%.
    • Example: If an outpatient chemotherapy session costs $500, Medicare would pay $400, and the patient would owe $100 per session.

Liver Transplant Coverage:

• Eligibility: Medicare covers liver transplants for patients with end-stage liver disease or certain conditions like hepatocellular carcinoma, provided specific criteria are met (CMS).
• Associated Costs:
  • Part A: Covers hospital inpatient services, including the transplant surgery.
  • Part B: Covers doctor services and outpatient care related to the transplant.
  • Immunosuppressive Drugs: Medicare covers immunosuppressive (anti-rejection) drugs under Part B if the transplant was covered by Medicare.

Additional Considerations:

• Medicare Advantage Plans (Part C): These plans are required to provide the same benefits as Original Medicare but may offer additional coverage, including prescription drug coverage and an annual out-of-pocket maximum. It’s important to check with your plan directly to understand exact costs and coverage details.
• Supplemental Insurance (Medigap): To help cover out-of-pocket costs like deductibles and coinsurance, patients may consider enrolling in a Medigap policy. These policies can provide additional financial protection during treatment.

Support from Charitable Organizations

For many patients living with liver disease or liver failure, charitable organizations provide an important safety net when health care costs become overwhelming. These groups offer financial assistance, educational resources, and emotional support to help with managing a chronic illness.

American Transplant Foundation

Offers grants ranging from $500 to $1,000 to transplant recipients to assist with anti-rejection medications and other essential expenses. Here is a great resource for seeking out further programs to help in these trying times.

HealthWell Foundation

The HealthWell Foundation provides financial aid to eligible patients to cover health insurance premiums, copay assistance, and costs related to prescription medications. For instance, their Metabolic Dysfunction-Associated Steatohepatitis (MASH) fund offers up to $8,000 in assistance for medication copayments or insurance premiums to patients with annual household incomes up to 500% of the federal poverty level. 

This support also extends to doctor visits, disease-related laboratory testing, diagnostic testing, and transportation costs for treatment and monitoring.

Local Charities and Nonprofits

In addition to national organizations, many local charities partner with transplant centers, hospitals, and health care providers to offer grants, free services, or transportation assistance. A social worker or patient advocate can be a valuable resource in connecting patients to these programs.

Regional Assistance Programs: Many local organizations provide grants typically ranging from $200 to $2,000, depending on the patient’s needs and available funding. It’s advisable to consult with a social worker or patient advocate to identify these resources.

Additional Ways to Reduce Health Care Costs

In addition to insurance and charitable programs, patients living with liver disease or liver failure can adopt practical strategies to manage their health care costs more effectively.

Work with Health Care Providers

• Many health care providers and transplant centers offer payment plans or sliding-scale fees based on income.
• Transplant coordinators may assist in reducing costs for services related to liver transplants or follow-up care.

Seek Financial Aid from Drug Manufacturers

• Pharmaceutical companies often provide prescription assistance programs to reduce the cost of medications for eligible cancer patients.
• Ask your doctor or pharmacist about available options, or visit drug manufacturers’ websites for details on financial assistance.

Explore Local and State Programs

• Beyond national programs, many states offer assistance programs for transportation, home care, and treatment support. These resources often work in partnership with Medicare or private insurance.
• Contact your local health department or a social worker to explore what’s available in your area.

Here are some examples of state-specific programs that offer such assistance:

California’s Medically Tailored Meal Program
Provides home-delivered, medically tailored meals to individuals with chronic illnesses, including liver disease, to support their nutritional needs during treatment.

New York State Medicaid Transportation
Offers non-emergency medical transportation for Medicaid recipients to access necessary medical services, ensuring patients can attend appointments without financial burden.

Texas’ Community Care for Aged and Disabled (CCAD) Program
Provides in-home care services to eligible individuals with chronic conditions, assisting with daily activities to help maintain independence and improve quality of life.

Florida’s Medically Needy Program
Offers assistance to individuals who do not qualify for standard Medicaid but have significant medical expenses, helping cover costs related to treatment and care.

Illinois’ Department on Aging Community Care Program
Provides in-home and community-based services to seniors with chronic health conditions, including liver disease, to support their care needs and reduce hospitalization.

As you can see, each state has their own programs and funding based on the needs of their residents. It’s worth investigating and reaching out to the specific state funded programs to see what kind of assistance can be offered.

Leverage Secondary Coverage

• If you have multiple forms of insurance, coordinate them to maximize your health insurance coverage. For example, Medicare may act as a secondary payer, covering costs your primary insurance doesn’t.

Finding Financial Relief for Liver Failure

Living with liver failure or advanced liver disease brings emotional and financial challenges. While programs like Medicare, patient assistance programs, and support from organizations such as the American Liver Foundation provide invaluable relief, the process of identifying, applying to, and managing multiple sources of assistance can be time-consuming and overwhelming—especially during such trying times.

In contrast, a viatical settlement offers the convenience of a single, immediate, lump-sum cash payment. By accessing the value of your life insurance policy, you can sidestep the taxing process of navigating various programs and instead focus your energy on your health, well-being, and loved ones. This flexible financial solution can help bridge the gap in coverage and provide the peace of mind you need to face the challenges ahead with greater confidence.

If you’re ready to explore how a viatical settlement can provide financial relief, the team at American Life Fund is here to help. Call us today at 877-261-0632, or email us at info@americanlifefund.com to learn more. Together, we’ll help you find the financial peace of mind you deserve.