Horizon Transplant Program
Organ and tissue donation gives transplant patients the possibility of having a normal, healthy life. The Horizon Transplant Program is available to help donors, recipients and their families, when dealing with a condition that needs a transplant. We can help you find quality specialty care from health care professionals designated as Blue Distinction® Centers for Transplants and provide additional support for you and your transplant donor through Horizon's Case Management Program.
What are Blue Distinction Centers for Transplants?
In 2019, local Blue Plans invited hospitals across the country to be considered for the Blue Distinction Centers for Transplants Program¹. These hospitals' transplant programs were evaluated on objective, transparent Selection Criteria with Quality, Business and Cost of Care components. Designation as a BDC for Transplants differentiates hospitals locally, as well as nationally, and includes two levels of designation:
- Blue Distinction Centers (BDC): Hospitals recognized for their expertise in delivering specialty care.
- Blue Distinction Centers+ (BDC+): Hospitals recognized for their expertise and cost-efficiency in delivering specialty care.
To date, 166 hospitals have been designated as Blue Distinction Centers for Transplants, representing more than 623 organ-specific transplant programs across the country.
Blue Distinction Centers for Transplants offer quality designations for nine transplant types:
- Adult Heart
- Adult Lung (deceased and living donor)
- Adult Liver (deceased and living donor)
- Adult Kidney (deceased and living donor)
- Adult Bone Marrow/Stem Cell (autologous and allogeneic)
- Pediatric Heart
- Pediatric Liver
- Pediatric Kidney
- Pediatric Bone Marrow/Stem Cell (autologous and allogeneic)
Case Management²
If you're an organ and/or tissue donor or are a Horizon member interested in receiving a transplant, you are eligible for our Case Management Program. A Case Manager can help you understand the process and get the care and services you need throughout the transplant process. Most participants enrolled in the program are referred by their doctor or health care professional, but you may also contact Horizon yourself to ask for case management services. This voluntary program is available to Horizon members at no additional cost. Please call 1-888-621-5894, option 2, for information about participating transplant facilities, to request educational materials or to get help from a case manager.
Medications
Horizon's Case Managers can also help you and your donor understand transplant-related medicines better.
Your doctor may prescribe new medicines before and after your transplant surgery. Horizon can help you understand the medicine that your doctor prescribes to you and any instructions they provide before and after a transplant. Medicine schedules and dosing can be confusing. Your doctor may need to change medicines or dosages to find a combination that provides the most benefit with minimal side effects.
It's also important to select a pharmacy you're comfortable with and a knowledgeable pharmacist to help you understand the medicines and manage your medicine schedule. A good pharmacist can help explain side effects and recommend tools to organize and track medicines.
Donors may also need a medicine schedule and should choose a pharmacy they are comfortable with.
Additional Medicare/Medicaid Coverage Requirement
The Centers for Medicare and Medicaid Services (CMS) requires that Medicare and Medicare Advantage members must receive all transplant-related services only at Medicare-approved transplant facilities.
