Dialysis services & supplies

Dialysis services & supplies

Medicare covers many kidney dialysis services and supplies if you have 

End-Stage Renal Disease (ESRD)

, including:

  • Inpatient dialysis treatments (if you’re admitted to a hospital for special care)
  • Outpatient dialysis treatments (in a Medicare-approved dialysis facility) & outpatient doctor’s services
  • Home-dialysis training (includes instruction for you and the person helping you with your home dialysis treatments)
  • Home dialysis equipment & supplies (like the dialysis machine, water treatment system, basic recliner, alcohol, wipes, sterile drapes, rubber gloves, and scissors)
  • Certain home support services (may include visits by trained hospital or dialysis facility workers to check on your home dialysis, to help in emergencies when needed, and to check your dialysis equipment and water supply; may include a face-to-face visit between you and your doctor (or certain non-doctors like physician assistants and nurse practitioners) once a month)
  • Most injectable drugs and their oral forms for outpatient or home dialysis (like an erythropoiesis stimulating agent to treat anemia)
  • Other services and supplies that are part of dialysis (like laboratory tests)
  • Dialysis when you travel in the U.S. (in a Medicare-approved facility)
Note

In most cases, Medicare doesn’t pay for transportation to dialysis facilities. Learn more about medically necessary ambulance transportation to a dialysis facility.

Important: You need Part B to get the full benefits, including regular dialysis, available under Medicare for people with ESRD, and you must pay the premium to get Part B.

Paying for dialysis services

These Part B covered services and items are included in the ESRD payment system and must be provided by your dialysis facility:

  • All equipment and supplies used in the treatment of ESRD and defined as dialysis services by Medicare
  • Injectable and intravenous drugs and biologicals and their oral forms, including erythropoiesis stimulating agents used for ESRD dialysis treatment*
  • Laboratory tests and other items and services provided for ESRD dialysis treatment
  • Home dialysis training by a Medicare-certified home dialysis training facility (if you choose to get dialysis at home)

*Medications that are only available in oral form will continue to be covered under 

Medicare prescription drug coverage (Part D)

. Talk with your doctor or health care team about the use of any drugs, including over-the-counter products.

 

Note

Your 20% 

Copayment

 covers all of the services and items listed here. Since these services and items are included in the bundled payment system, you can’t be billed separately for them. You also don’t need to get the drugs that are included in the bundle from your Medicare drug plan (if you have one).

 

Your costs in Original Medicare

What will I pay for dialysis services in a dialysis facility?
If you have Original Medicare, you’ll continue to pay a 20% 

Coinsurance

 of the 

Medicare-approved amount

 for all covered dialysis related services. Medicare will pay the remaining 80%.

The dollar amount of your coinsurance may vary. If you’re in a 

Medicare Advantage Plan (Part C)

 or have a Medicare Supplement Insurance (Medigap) policy that covers all or part of your 20% coinsurance, then your costs may be different. Read your plan materials or call your benefits administrator to get your cost information. You must also continue to pay your monthly Medicare Part B and Part D (if applicable) premiums.

What will I pay for dialysis in a hospital?
If you’re admitted to a hospital and get dialysis, your treatments will be covered by 

Medicare Part A (Hospital Insurance)

 as part of the costs of your covered inpatient hospital stay.

What will I pay for inpatient doctors’ services In Original Medicare? 
Your kidney doctor bills separately for the Medicare-covered ESRD services you get as an inpatient. In this case, your kidney doctor’s monthly payment will be based on the number of days you stay in the hospital.

What will I pay for outpatient doctors’ services in Original Medicare?
Medicare pays most kidney doctors a monthly amount. After you pay the Part B yearly deductible, Medicare pays 80% of the monthly amount. You pay the remaining 20% coinsurance. In some cases, your doctor may be paid per day if you get services for less than one month.

What will I pay for home dialysis training services?
In Original Medicare, Medicare pays your dialysis facility a flat fee to supervise home dialysis training. After you pay the Part B yearly deductible, Medicare pays 80% of the flat fee and you pay the remaining 20%.
 

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

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

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

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).

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