Dialysis (kidney) services & supplies

Dialysis (kidney) services & supplies

How often is it covered?

Medicare covers these:

 

 covers a variety of services if these apply:

  • You get routine maintenance dialysis
  • You get the dialysis from a Medicare-certified dialysis facility

 

 covers training if you're a candidate for self-dialysis. Part B covers training provided during the course of your regular treatments for:

  • You
  • The person helping you with your self-dialysis treatments

A dialysis facility that's been certified by Medicare to provide self-dialysis training must provide the training. Only dialysis facilities can bill Medicare (directly or under arrangement) for providing home dialysis training.

 

 covers self-dialysis support services provided by your dialysis facility. This may include visits by trained hospital or dialysis facility workers to:

  • Check on your self-dialysis
  • Help in emergencies, when needed
  • Check your dialysis equipment and water supply

 

 covers all dialysis equipment and supplies for as long as you need dialysis at home. Covered equipment and supplies include:

  • Alcohol
  • Wipes
  • Dialysis machines
  • Sterile drapes
  • Rubber gloves
  • Scissors

Note

Part B will pay for home dialysis equipment.

Medicare doesn't cover these:

  • Paid dialysis aides to help you with self-dialysis
  • Any lost pay to you or the person who may be helping you during self-dialysis training
  • A place to stay during your treatment
  • Blood or packed red blood cells for self-dialysis unless part of a doctors' service

Note

In some cases, Medicare may cover ambulance transportation when these apply:

There are some types of insurance that may pay some of the health care costs that Medicare doesn't pay.

Who's eligible?

All people with Part A and/or Part B who have 

 are covered.

Your costs in Original Medicare

Outpatient maintenance dialysis treatment includes the cost of these:

  • Self-dialysis
  • Self-dialysis training
  • Self-dialysis equipment and supplies

You pay 20% of the Medicare-approved amount, and the Part B deductible applies. Only dialysis facilities can bill Medicare (directly or under arrangement) for providing self-dialysis training.

Outpatient maintenance dialysis treatment includes the costs of self-dialysis drugs and biologicals. You pay 20% of the Medicare-approved amount.

ESRD-related drugs that only have an oral form of administration are covered only by 

. This means drugs taken by mouth that only come in capsule, tablet, or liquid forms.

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

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