UniCare has designated certain hospitals as Quality Centers and Designated Hospitals for organ transplants. These hospitals were chosen for their specialized programs, experience, reputation and ability to provide high-quality transplant care. The purpose of this program is to facilitate the provision of timely, cost-effective, quality services to eligible members in UniCare’s Basic, PLUS and Community Choice plans.
Transplants at Quality Centers and Designated Hospitals are covered at 100% after the copay and deductible. Transplants at other hospitals are covered at 80% after the copay and deductible. Although members have the freedom to choose any health care provider for these procedures, their coverage is highest when they use one of these Quality Centers or Designated Hospitals.
Participating transplant facilities are selected based on their ability to meet defined clinical criteria that are unique for each transplant type. Providers must pass a rigorous review of their processes, performance, and expertise at delivering quality care.
Important! Massachusetts providers must use the following forms for Quality Centers and Designated Hospital for transplants:
For more information, please contact UniCare Provider Relations at 800-480-7587 or UniCareProviderRelations@anthem.com.