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Medicare covers most forms of dialysis treatment. Medicare will cover a range of treatments, including tests, medications, and equipment.
We know how important it is to understand your coverage. You need to know what isn’t covered just as much as you need to know what is covered.
Below we’ll review how Medicare works with each treatment you may need. Then, you can make decisions for your care based on services that have coverage.
Does Medicare Cover Kidney Dialysis
Yes, Medicare will cover you should you need dialysis treatments. Dialysis can come in many different forms.
Below we’ll go over different types of dialysis treatments that have coverage.
Medicare will cover:
- Inpatient dialysis within a hospital
- Outpatient dialysis at a dialysis center
- Self-dialysis training
- Dialysis equipment and supplies for home use
- Prescriptions related to your treatment
- Immunosuppressant medications
What Dialysis Care Isn’t Covered by Medicare?
While Medicare covers a lot of dialysis services, but it doesn’t cover everything.
For instance, Medicare doesn’t cover:
- Home health care aides for in-home dialysis
- The cost of housing for in-home dialysis
- Costs associated with loss of income while doing self-dialysis training
Does Medicare Cover Dialysis Treatment
Does Part A Cover Dialysis
Part A will cover dialysis treatments at an approved center. Any doctor fees you get with dialysis Part B benefits cover.
Can I Enroll in Part C When I Have End-Stage Renal Disease
Those that already have a Part C policy when they develop ESRD can keep the plan they have or possibly enroll in another plan offered by the same company. If that company or policy leaves the service area, you have a one-time right to join another plan.
Employer or Union Medicare Advantage plans may offer you coverage.
If you have a successful kidney transplant and are determined to no longer have ESRD, you might be able to join a Part C plan. Now, there are Part C Special Needs Plans that cater to ESRD patients, but those aren’t available everywhere.
In 2021, Medicare Advantage plans will cover ESRD patients without restrictions.
Does Medicare Pay for Outpatient Dialysis
When you go to dialysis in an outpatient setting Part B will cover 80% of the costs, and you’ll pay the rest.
Part B pays for lab tests, equipment, and other supplies.
Immunosuppressant Drugs for Dialysis
You’ll need immunosuppressant drugs for life when you get a kidney transplant. While this sounds scary and costly, you can take a breath of relief.
Part B will cover these drugs under a few different factors:
- Part A benefits covered your transplant.
- You have Part B coverage when it’s time to fill the prescription.
- You’re eligible for Medicare ESRD.
Part B wouldn’t cover immunosuppressants if you didn’t have Part A during your surgery. If this situation applies to you, you may need to buy a Part D plan to cover the medications you need.
Part B will cover any necessary medications you’ll need to conduct self-dialysis. Medicare will cover most of the costs.
Some of these medications can include:
- Topical Anesthetics
- Erythropoiesis-Stimulating Agents
How to Choose a Medicare Dialysis Center?
You can get dialysis in several different types of facilities.
If you qualify, your dialysis can take place within the comforts of your own home. Or, you can also get dialysis at a certified dialysis center.
For Medicare to cover your treatment, though, the center must be Medicare-certified.
Does Medicare Cover Transportation to Dialysis?
Medicare will cover ambulance transportation that you may need to get to your dialysis facility.
If you need non-emergency transportation, your doctor needs to provide the ambulance company with a written order. Your doctor will need to specify that transportation is medically necessary.
Often, Medicare Advantage plans will cover transportation services too.
Additional Dialysis Services & Equipment
In addition to your actual dialysis treatment, Part B will cover all other services.
Durable Medical Equipment, all lab tests, and transportation can fall under Part B benefits.
Dialysis Treatment and Traveling
You still have coverage if traveling in the United States. You can contact your dialysis center to help find other centers along your trip.
The dialysis center needs to be Medicare-certified for you to continue getting coverage. Medicare may only cover dialysis nationally or on an emergency basis.
How Much Does Medicare Pay for Dialysis
Just one year of hemodialysis may cost you $72,000. And a single year of peritoneal dialysis can cost you around $53,000 each year.
Keep in mind, Medicare will only cover 80%, you’ll be left with the remaining costs. Even with the majority of your treatment covered, you’ll still have costly bills.
You can opt into buying a Medigap plan, or Advantage policy. If you’re on costly medications, a Part D drug plan can help lower your costs.
Get Help Today with Your Out Of Pocket Costs
Dialysis treatments can put a strain on you. Medigap can help ease some of the financial burdens you may be facing.
We want to make sure you find the policy that gives you the most benefit and saves you the most money.
We’ll compare all carriers and plans that in your area. Our goal is to help you feel confident in your insurance plan.
Contact one of our agents today at the number above. Or, fill out an online rate form to get your rates now!