Dialysis (children)

Your child will need 

Medicare Part A (Hospital Insurance)

Medicare Part B (Medical Insurance)

, and possibly 

Medicare Part D (Medicare Prescription Drug Coverage)

 to get the full benefits available to them. 

Part A covers dialysis treatments when your child is in the hospital. Part B helps pay for these dialysis services: 

Important: Find out if your child is eligible for Medicare.

Your costs in Original Medicare
  • Inpatient hospital services — Generally, Part A pays for these services. You pay a deductible [glossary]
  • Doctors' services — Generally, Part B pays 80% of the Medicare-approved amount, after you pay the Part B yearly deductible. You pay the remaining 20% coinsurance . This is in addition to the Part B monthly premium
  • Dialysis services — The amount you pay may vary based on your child's age and the type of dialysis they need. The rates Medicare pays to dialysis facilities are adjusted based on your child’s age and the type of dialysis they get. These adjustments allow for the special care needs of children. Your 20% coinsurance will be based on these special rates.
  • Prescription drugs — To get Medicare drug coverage for your child, your child must have Part A or Part B, and you must enroll your child in a Medicare drug plan during an enrollment period. This would cover immunosuppressive and oral only drugs, but only if Part B doesn’t cover them. If your child joins a Medicare Advantage Plan with drug coverage, they'll get their drug coverage through their Medicare Advantage Plan, and can't enroll in a separate drug plan.

In most cases, Medicare doesn’t pay for transportation to dialysis facilities.

 

Note
Starting January 2021, if your child has ESRD you can choose either Original Medicare or a Medicare Advantage Plan when deciding how to get Medicare coverage. If your child is in a Medicare Advantage Plan, what you pay may be different. Learn more about Medicare Advantage Plans if your child has ESRD.

 

note:

To find out how much your test, item, or service will cost, talk to your doctor or 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
  • Where you get your test, item, or service
Things to know

note:

If you have a problem finding a dialysis facility that’s willing to take you as a patient, you have the right to file a complaint (grievance).

Is my test, item, or service covered?

Find out who to call about Medicare options, claims and more.

Medicare

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