The question might seem indelicate. But transplant centers find it is necessary these days to know the answer even before they place a patient on the list for an organ transplant.

“How will you pay for the anti-rejection drugs?”

These are patients with insurance — they need it to pay for the transplant itself — so it might seem obvious that their insurer would pay. But if, as often happens, the patient gets an organ transplant with private insurance and later enrolls in Medicare, she may be in for a shock.

Necessary anti-rejection drugs may not be covered under Medicare. And without those medications, the body may reject the organ, with deadly consequences.

It is “an emerging and alarming problem,” according to the American Society of Transplantation — another maddening twist in our convoluted, contradictory and confusing health care system.