The federal program that reimburses living organ donors for what a donation costs them now spells out a long list of covered expenses, from four weeks of lost wages to the care of a donor’s pets. A notice from the Health Resources and Services Administration (HRSA), published September 29 and applied to applications reviewed from September 30, also sets three priority tiers that decide who is served first when funds run short.
Everything on the list is a reimbursement of an expense the donor actually incurred. Nothing in the program pays anyone for donating, and the combined total is capped.
Four weeks of wages, two more after complications
Lost wages are the largest line. According to the HRSA notice in the Federal Register, donors may receive up to four weeks of reimbursement for lost wages, and for child care and elder care expenses, tied to the surgery and recovery period. A donor who needs follow-up visits and hospitalization because of complications or other health-related issues may receive up to two additional weeks, which brings the ceiling to six.
The wage coverage reaches beyond steady paychecks. Donors with non-traditional or irregular income, including work that depends on tips, can be reimbursed if they supply sufficient documentation of the wages they expected to earn.
Travel, care costs and a household budget that keeps running
The travel category covers travel, lodging, meals and incidental expenses for the donor and for accompanying persons. Child care and elder care are covered for the donor and for accompanying or assisting persons, and the notice extends the care category to other dependents, giving disabled adult care as an example.
A second group of costs targets what continues while a donor is out of action. The notice lists out-of-pocket medical expenses incurred by the donor candidate or by members of the household, pet care costs during the evaluation, donation and recovery period, and other non-discretionary household expenses, with child support named as the example. Pet care appears by name, which is the detail most donors would not expect to find in a federal reimbursement schedule.
One $6,000 ceiling across every category
The categories do not each carry their own allowance. The notice states that total federal reimbursement for all qualifying expenses shall not exceed $6,000 per potential donor evaluated or organ donated. A donor who spends heavily on lodging and loses the full six weeks of pay therefore draws from one shared pot, and anything above the ceiling falls on the donor.
The ceiling applies to evaluation as well. A candidate who goes through testing and is then unable to donate is still counted, and the notice says intended donors who proceed in good faith but cannot finish, because of health issues, acts of God or a voluntary withdrawal, may be reimbursed as if the donation had been completed.
Priority tiers set by household income
Who gets served first turns on household income measured against the HHS Poverty Guidelines in the donor’s state of primary residence at the time of the eligibility determination. Applicants at or below 350 percent receive the highest priority. If program resources allow, applicants above 350 but no higher than 500 percent are also eligible to apply, and those above 500 but no higher than 750 percent may apply through a financial hardship waiver. At the start of each budget period, the program accepts and processes applications from all three categories.
The top tier is the only one with a stated priority; the other two depend on resources being available. The waiver is reviewed case by case. A transplant social worker or other appropriate transplant center representative submits the written request, attesting that the donor has documented significant expenses that reduce household income to 500 percent of the guidelines or less.
What the claim must be backed by
The notice ties payment to paperwork. Wage reimbursement rests on appropriate documentation, such as pay stubs, and the hardship determination is based on attestation and documentation of expenses the donor or candidate incurred. Because the benefit repays costs already borne, the receipts and pay records matter more than the category names. Non-directed donors, who give without an identified recipient, are exempt from recipient-related criteria and documentation but must meet the other requirements.
The program is run through a cooperative agreement by Mayo Clinic Arizona and the National Living Donor Assistance Center. The notice reports more than 21,000 applications since inception, with nearly 89 percent approved, and more than 12,000 living donations facilitated. It was signed by HRSA Principal Deputy Administrator Ann M. Sheehy, and questions go to Allison Hutchings of HRSA’s Division of Transplantation, Health Systems Bureau, at 240-290-2179 or livingdonorsupport@hrsa.gov.
The expenses a federal program will and will not reimburse
Donor reimbursement is one example of a benefit that pays back only documented costs and only within a set limit. Older households face the same pattern in other programs, where a missed record or an unfamiliar rule keeps help from reaching them. The Benefits Checklist is a separate guide for that wider job and does not cover organ donation reimbursement.
The Benefits Checklist is a 69-page guide to 11 benefit programs, including Medicare Savings Programs and SNAP at 60+, with the 2026 income limits, a 50-state phone directory and a printable tracker that comes with the download.
Get The Benefits Checklist to review other benefit programs →
This article was produced with AI assistance and checked against the primary sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
