Your Medicare Coverage
Is my test, item, or service covered?
Kidney disease education
How often is it covered?
Medicare covers up to 6 sessions of kidney disease education to help you delay dialysis and prevent kidney disease complications when the service is given by a doctor, certain qualified non-doctor providers, or a rural provider. Your doctor must refer you for the service.
Kidney disease education teaches you how to take the best possible care of your kidneys and gives you information you need to make informed decisions about your care. Here are 5 topics you'll learn about:
- How to manage health conditions like heart disease, diabetes, high blood pressure, and anemia
- How your kidneys work
- What you should and shouldn’t eat
- How your medications work
- Your treatment options if your kidneys get worse:
- Peritoneal dialysis
- Access options for hemodialysis and peritoneal dialysis
- Kidney transplant
You can also ask about these other topics:
- How you feel
- How to maintain your kidney function
- What your test results mean
- Your family and social life
- Work and finances
- How kidney disease affects your mental health
- Your right to refuse treatment
People with Medicare who have Stage IV chronic kidney disease that will require dialysis or a kidney transplant are covered. The doctor or other health care provider who manages your kidney disease must refer you for the service.
Your costs in Original Medicare
To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.