Table 1.

Recommendations for Designing Effective Benefits Plan for HCT

Transplantation Coverage	Donor Search–Cell Procurement	Medications	Clinical Trials	Travel and Lodging
Coverage of HCT and subsequent therapeutic infusions for all medically necessary indications	Unrelated donor: full coverage of tissue typing/testing through NMDP or other approved registry; full coverage of cell procurement	Coverage of all necessary medications throughout HCT process, including post-transplantation medications, without copayment or coinsurance	Coverage of clinical trials appropriate to patient stage, indication, and clinical condition	Full coverage of travel and lodging costs for member and caregiver for transplantation visit, in addition to necessary pre-and post-transplantation evaluations
No limit on inpatient stays or outpatient visits	Related donor: full coverage of tissue typing; full coverage of cell procurement, including travel and lodging for selected donor		Minimum: coverage of routine care for patients in clinical trials, per requirements in Affordable Care Act
	Autologous collection: full coverage of preparation, harvest, and storage of cells			Cover costs for second caregiver if patient is age < 18 years
	No limit on typing/testing costs if potential donors are in covered categories

NOTE. Data adapted.⁹

Abbreviations: HCT, hematopoietic cell transplantation; NMDP, National Marrow Donor Program.