When your kidneys stop functioning normally, your body enters End-Stage Renal Disease (ESRD). Dialysis is a treatment designed to help your body function by washing your blood when your kidneys stop working on their own.

In addition to helping your body maintain a proper fluid balance and control blood pressure, dialysis helps remove harmful waste products, fluids, and salts that accumulate in your body.

While dialysis treatments can help you live longer and feel better, they are not a cure for permanent kidney failure.

Continue reading to learn more about Medicare coverage for dialysis and its treatment, including eligibility requirements and costs.

Medicare Eligibility

Medicare eligibility requirements differ if your eligibility is based on End-Stage Renal Disease (ESRD).

If You Do Not Enrol Immediately

If you are eligible for Medicare due to ESRD but did not enrol during your Initial Enrollment Period, you may be eligible to receive retroactive coverage of up to 12 months once you do enrol.

If You Are Receiving Dialysis

If you are registering in Medicare due to ESRD and are currently receiving dialysis, your Medicare attention usually starts on the first day of the fourth calendar month of your dialysis treatment. Coverage may begin in the first month if:

If You Are Receiving a Kidney Transplant

If you are admitted to a Medicare-certified hospital for a kidney transplant and the transplant is performed that same month or within the following 2 months, Medicare coverage could begin that month.

Medicare coverage could begin 2 months before your transplant if the transplant is delayed by more than 2 months after your hospital admission.

When Medicare Coverage Ends

If you are eligible for Medicare solely due to permanent kidney disappointment, your coverage will end:

Medicare coverage will continue if:

Dialysis Facilities and Supplies Covered by Medicare

Original Medicare comprises Part A (Hospital Coverage) and Part B (Medical Insurance). It covers many of the provisions and services necessary for dialysis. Part A protections inpatient dialysis treatments, while Part B covers the following services:

Medicare should cover ambulance facilities to and from your home and the nearest dialysis centre, provided that your doctor provides written orders certifying that it is a medical necessity.

Services and supplies not endangered by Medicare include:

Medication Coverage

How much will I pay for dialysis?

If you receive dialysis after being admit to a hospital as an inpatient, Part A covers the costs. Outpatient medical services are covered by Part B.

You are responsible for various costs, including premiums, annual deductibles, coinsurance, and copayments:

Regarding training services for home dialysis, Medicare generally pays a fixed fee to your dialysis facility for providing such training.

Once the annual Part B deductible has been met, Medicare will pay 80% of the bill, and you will be responsible for the residual 20%.

In Summary

Medicare covers most treatments—including dialysis—for End-Stage Renal Disease (ESRD) or kidney failure.

Your healthcare team can review the details regarding coverage for treatments, services, and supplies, as well as your share of the costs. While receiving dialysis, you may work with:

For more information, visit Medicare.gov or call 800-MEDICARE (800-633-4227).