30 Approved In - Network Provider All Other Providers Live Donor Health Services • Inpatient Facility Services 20% Coinsurance after Deductible Not Covered • Outpatient Facility Services 20% Coinsurance after Deductible Not Covered Donor Health Service Limit For Human Organ and Tissue Transplants, Medically Necessary charges for getting an organ from a live donor are covered up to our Maximum Allowed Amount, including complications from the donor procedure for up to six weeks from the date of procurement.