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.

If your child is in a hospital: 

  • Part A covers dialysis treatments.
  • Part B covers doctors' services.

If your child isn't in a hospital, Part B covers these dialysis services:

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

Your costs in Original Medicare

  • Inpatient hospital services: Part A pays for these services after you pay the hospital inpatient deductible .
  • Doctors' services: Part B generally 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

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
  • If your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

What it is

Dialysis is a treatment that cleans the blood when the kidneys don’t work. It gets rid of harmful waste, extra salt, and fluids that build up in the body. It also helps control blood pressure and helps the body keep the right amount of fluids. Dialysis treatments may help your child feel better and live longer, but they aren’t a cure for permanent kidney failure.

Things to know

If your child is eligible for Medicare due to permanent kidney failure, Medicare coverage will end:

  • 12 months after the last month of your child’s dialysis treatment.
  • 36 months after the month of your child’s kidney transplant.

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?