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Paying for Kidney Disease and Dialysis Treatment

The costs of dialysis and kidney transplant are high, but most kidney patients are able to get some form of insurance.  Work with your dialysis social worker or transplant coordinator to learn about your insurance options.  To help you get started, here is a quick look at some of the options.

Types of Insurance

Medicare
Private or Group Insurance
Medigap
Medicaid

Help With:

Medicines
Kidney Transplants
Other Costs

 

Medicare

Medicare is a type of insurance for people who are over age 65 or who have certain disabilities.  Most people with permanent kidney failure (called end-stage renal disease or ESRD) are able to get Medicare coverage.

  • Medicare Part A usually covers 100% of approved hospital costs.
  • Medicare Part B usually covers 80% of medical expenses, including dialysis.  Medicare Part B requires a monthly premium (fee).  You may be able to get help with this premium from Medicare, Medicaid or the American Kidney Fund’s Health Insurance Premium Program.
  • Medicare Part D can help with prescribed medicines.  Medicare Part D also requires a monthly premium and may require co-payments.

Medicare may help with many costs, but it is not enough to cover everything.  You will also need to have a second kind of insurance.  There are a few options to think about.

Private Insurance

Most private and group insurance plans will also help pay for dialysis or a kidney transplant.
 
In most cases you can have both Medicare and a private or group insurance.  Usually, your private or group insurance plan will be the primary payer (pay 80%) for the first 30 months.  During that time, Medicare will be the secondary payer (pay the remaining 20%).  At the end of the 30 months, the two will likely switch.  Medicare will become the primary payer (pay 80%), and the group insurance will be the secondary payer (pay 20%).
 
Work with your private or group insurance and Medicare to find out if this is the case for you and to learn what other rules might apply.

Medigap

Medigap is a type of “extra” insurance to help fill the gaps in Medicare.  Medigap plans may help pay Medicare deductible s or co-payments (the 20% that Medicare does not cover).
 
You must have Medicare before you can get a Medigap plan.  Also, Medigap plans are not available to all people with Medicare.  In some states, you must be 65 or older to get a Medigap plan.

Medicaid

Medicaid is a kind of health insurance for people with low income and savings.  Medicaid can be a second type of insurance for people who have Medicare.  In this case, Medicaid can help pay the 20% that Medicare does not pay.  Or, Medicaid can be a person’s only type of insurance and can pay 100%.
 
Each state has its own Medicaid program and rules.  Work with your dialysis social worker or transplant coordinator to learn more about the Medicaid rules in your state.

Medicines

American Kidney Fund Safety Net Grants Program:

The American Kidney Fund Safety Net Grants help dialysis and transplant patients with their treatment-related costs, like transportation, medications and nutritional supplements.

Other Programs:

HealthWell Foundation
National Organization for Rare Disorders
Partnership for Prescription Assistance
Patient Access Network Foundation
Patient Advocate Foundation

Kidney Transplants

American Kidney Fund Safety Net Grants Program:

The American Kidney Fund Safety Net Grants help dialysis and transplant patients with their treatment-related costs, like transportation, medications and nutritional supplements.

Other Programs:

Children’s Organ Transplant Association
National Foundation for Transplants
National Living Donor Assistance Center
National Transplant Assistance Fund
Patient Access Network Foundation

Other Costs

American Kidney Fund Safety Net Grants Program:

The American Kidney Fund Safety Net Grants help dialysis and transplant patients with their treatment-related costs, like transportation, medications and nutritional supplements.

Other Programs:
 
Kidney and Urology Foundation
National Kidney Foundation
United Way

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