Health insurance resources
Health insurance rules have changed. A new federal law has made important updates to health insurance plans, including Medicaid and Affordable Care Act plans. You may have questions about changes to costs, coverage and paperwork. These resources can help you navigate recent changes, understand your options and get the support you need.
Medicare resources
Medicare is a federal health insurance program for people 65 and older and people with disabilities or certain medical conditions, including kidney failure, also called end-stage renal disease (ESRD) or end-stage kidney disease (ESKD). There are different parts of Medicare that cover different types of care, including hospital stays and prescription medicines.
- Medicare.gov: This site can help you understand coverage, enrollment, plan options and official notices.
- Medicare Beneficiary Ombudsman: This is an official federal office that helps when you are having ongoing problems with Medicare. They can review complaints and help you understand your options and rights.
- Medicare Rights Center: This organization offers free help to understand Medicare, fix coverage problems and navigate appeals.
- State Health Insurance Assistance Program (SHIP): This program provides free, one-on-one help from trained counselors who can explain Medicare and help resolve problems.
Medicaid resources
Medicaid is health insurance for people with limited income or resources. It is funded jointly by the federal government and the states, but run by each state, so benefits and rules can differ depending on where you live.
- Medicaid.gov: This site explains how Medicaid works and shares federal updates, but it does not show state-specific rules.
- State Medicaid Agency Directory: This directory will take you straight to your state Medicaid agency website and contact information.
- If you are confused about how new laws affect you, the best thing to do is visit your state's official website.
- An online search of "[Your State] Medicaid" usually brings up the official site.
- Look for sections like Eligibility & Renewals, Work Requirements or News & Updates.
Check for PDFs, FAQs or notices titled "What's Changing Because of the Federal Law (HR 1)."
Affordable Care Act Marketplace resources
Under the new law, some people may lose Medicaid coverage. When that happens, you may want to move to a Marketplace plan, also called an Exchange plan, outside of the usual enrollment period. Marketplace plans are health insurance plans sold by private insurance companies, created by the Affordable Care Act (ACA) to give people a place to compare and buy coverage. Check your Medicaid notice carefully to see why coverage ended and whether you can appeal (a request for the decision to be reviewed again).
- Healthcare.gov: Use this site to see if you qualify for a Marketplace plan and to apply for coverage. If your state runs its own Marketplace, this site will send you to the correct place.
- Local navigators and assisters: Trained helpers can explain plan options, costs and next steps. This can be especially helpful if you switched coverage after losing Medicaid. An online search of "[Your State] insurance navigators" usually brings up the official site.
American Kidney Fund resources
These tools are designed for people living with kidney disease and focus on real-life insurance challenges. They can help you understand costs, coverage and where to turn for help.
- Health Insurance Premium Program (HIPP): If you have kidney failure and cannot afford insurance premiums, this program may help pay premiums through American Kidney Fund grants.
- Insurance tips for kidney disease of an unknown cause: Learn how to get coverage for testing and services when the cause of kidney disease is unclear.
- Insurance and costs for dialysis: Learn how different types of insurance can help pay for dialysis and what costs you may face.
- Understanding health insurance: This page explains how insurance works, what rights you have and how to use your coverage.
- Prescription assistance programs for common kidney medicines: This page lists prescription assistance programs and resources that may help lower medicine costs for people living with chronic kidney disease (CKD).
- State kidney policy map: An interactive legislation map to see what kidney-related laws and bills are being considered in your state.
- Understanding your insurance and navigating challenges webinar: This webinar explains insurance terms and barriers, with real stories from American Kidney Fund Ambassadors.