Major Organ Transplants

As a part of the CalAIM initiative, all major organ transplants, will be covered by the Alliance for all eligible adult Medi-Cal members.  This change is effective January 1, 2022.

Transplants for children under age 21

State law requires children who need transplants to be referred to the California Children’s Services (CCS) program to see if the child is eligible for CCS. If the child is eligible for CCS, CCS will cover the costs for the transplant and related services. If the child is not eligible for CCS, then the Alliance will refer the child to a qualified transplant center for evaluation. If the transplant center confirms the transplant would be needed and safe, the Alliance will cover the transplant and related services.

Transplants for adults age 21 and older

If your doctor decides you may need a major organ transplant, the Alliance will refer you to a qualified transplant center for an evaluation. If the transplant center confirms a transplant is needed and safe for your medical condition, the Alliance will cover the transplant and other related services. The following major organ transplants covered by the Alliance include, but are not limited to:

    • Bone marrow
    • Heart
    • Heart/lung
    • Kidney
    • Kidney/pancreas
    • Liver
    • Liver/small bowel
    • Lung
    • Pancreas
    • Small bowel

If you questions about major organ transplants, please call:

For provider updates, please see provider manual.