The American Kidney Fund provides payment for patients who cannot otherwise afford insurance to maintain coverage that is essential for their care through our Health Insurance Premium Payment (HIPP). There has been growing pressure by the insurance industry to curtail third-party payment of premiums on behalf of patients. We believe it important that public discourse around this very important issue for kidney patients be informed by facts.

  • They say

    People with kidney failure are eligible for Medicare and often Medicaid for their health care.

  • We say

    People with kidney failure are allowed, by law, to enroll in the insurance plan of their choosing. We help qualified low-income people with any insurance product for which they request assistance—Medicare Part B, Medigap, Medicaid, Medicare Advantange, COBRA, employer group health, and commercial plans, including exchange plans.

  • They say

    Medicare and Medicaid are sufficient coverage for people with kidney failure.

  • We say

    The choice of insurance plan is an individual decision based on individual needs. Medicare coverage alone is not sufficient, and Medigap insurance is not available in all states to kidney failure patients who are under 65. Many patients are not poor enough for Medicaid, which also has limitations on availability of doctors. Most people with kidney failure face multiple health issues like diabetes, hypertension and heart disease and managing their disease involves numerous specialties in addition to nephrology. Finally, having comprehensive insurance coverage can help pave the way for a transplant which is often the ultimate goal for many patients. The ACA and Medicare provide that patients have this choice.

  • They say

    Dialysis providers are steering their patients onto insurance plans for their own financial gain by providing money for third-party payments.

  • We say

    Donations made to AKF for use in paying premiums for patients come without any conditions for use—in fact, we provide grants to patients for insurance premiums regardless of what type of insurance they have, who their provider is, or whether or not a provider is also a donor to the HIPP program. No patient has ever been turned away because their provider did not contribute to HIPP.

  • They say

    The federal government has stated that insurers do not have to accept third-party payments for insurance premiums.

  • We say

    Federal policy clearly allows third-party payments, but the insurance industry is interpreting federal language that is vague regarding nonprofits to their own advantage.

  • They say

    Non-profits have a financial interest in making sure patients have private insurance because they accept donations from industry.

  • We say

    Our only interest since we were founded 45 years ago is patient welfare. The fact that we receive donations from industry does not have any impact on who we help, when we help, or where we help. We spend 97 cents of every dollar we raise (from industry, from individuals, from foundations) on patients and programs.

  • They say

    Donations by dialysis providers are earmarked for steering patients onto private insurance.

  • We say

    Dialysis companies do support our HIPP program—and this occurs in compliance with standards laid out by the Health and Human Services (HHS) Office of the Inspector General (OIG) Advisory Opinion 97-1, under which our program was established. The key to our program is the strict firewall that separates donations to AKF from determinations of patient eligibility for assistance. Dialysis providers cannot earmark contributions. We help patients who are in financial need, without regard to whether their provider has donated to AKF and without regard to the type of insurance they have.

  • They say

    Third-party payments from AKF only cover patient premiums until they get a transplant, not thereafter, which is evidence that they exist only for the benefit of dialysis providers.

  • We say

    AKF was founded in 1971 to help one patient pay for lifesaving dialysis treatments. We have always helped dialysis patients, a unique and vulnerable population with very particular and daunting needs, and we are proud to be the nation’s leading source of assistance to these patients. Having comprehensive insurance coverage is an important factor in successfully getting a transplant, which is the best treatment for kidney failure. Without help from AKF’s HIPP program, transplant would be financially out of reach for most of our grant recipients. Our HIPP assistance continues until the patient is successfully post-transplant. HIPP coverage allows patients to have workups in preparation for transplants and also cover the cost of the transplant surgery itself.

  • They say

    Putting patients who are eligible for Medicare benefits into insurance skews the market for everyone.

  • We say

    In fact, insurers have consistently sought to exclude people with chronic illnesses like HIV, cancer and kidney failure from insurance coverage by denying coverage based on pre-existing conditions, by putting lifetime caps on coverage and now by refusing to accept third-party payments. We believe all patients deserve a right to be insured under the plans that best suit their needs.