Medicare & Dialysis Coverage

With Part A Medicare, you can get coverage for in-patient dialysis treatment provided you’re receiving the care in a hospital that is approved by your Medicare.


Part B Medicare pays for the below items & services:


  1. Outpatient services, which includes lab tests along with other services required for standard ESRD dialysis procedures when suggested by the doctor for treating your disorder. This comprises biologicals & dialysis medications (except oral drugs). Make sure you choose a Medicare authorized dialysis facility to receive the required coverage.


  1. Dialysis training at home if you are eligible for it & get the necessary approval from your physician.


What’s covered?


Self-dialysis medications along with their biologicals. Besides, erythropoiesis-stimulating agents which are used for treating anemia associated with your ESRD can also be covered.


  1. Supplies and equipment for home-dialysis including dialysis machines, wipes, & other stuff essential to conduct self-dialysis.


  1. Support services for home-dialysis like house visits by the staff of dialysis facility in order to carry out an inspection of your dialysis gear & offer assistance in the event of emergencies.


Part D Medicare prescription plan covers drugs which are provided only in oral form, like a tablet, capsule or liquid medications. Consult with your healthcare provider about the usage of these medications & along with OTC medicines.


Medicare does not cover:


Any income that you (or individual helping you) might lose in the self-dialysis training.

Housing that might be required during the treatment.

Packed RBC’s or blood you might require for dialysis at home (unless it’s a major element in a service offered by your physician).

Remember that if you just have Medicare coverage because of end-stage renal disorder (i.e., you aren’t above the age of 65 or facing a disability), then Medicare will terminate 36 months after the month of your kidney transplant or 12 months after you’ve stopped dialysis.


The costs of Medicare for the supplies and the treatment of dialysis:


Seniors with Original Medicare will need to pay twenty percent of the amount approved by Medicare for each of the outpatient dialysis-associated services approved by Medicare. The remaining 80 percent will be covered by your Medicare plan. Part B deductible will also be applicable.


With 2019 Medicare Supplement Plans, the cost is likely to be less. Be sure to consult with a trusted Medicare agent who can help you get the right info in terms of the final costs you’ll be paying for the treatment.


You will also need to continue paying your Part D & Part B Medicare premiums each month if they are applicable.