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In most cases, Medicare Part A does cover dialysis in a Medicare-approved hospital. Medicare Part B covers outpatient dialysis treatment, supplies and doctor visits.
A Medicare Supplement (Medigap) plan can help cover dialysis costs such as Medicare deductibles, copays, coinsurance and more.
You may be able to apply for Medigap plans in some states if you have ESRD, but insurance companies aren't required to sell Medigap plans to beneficiaries under age 65 in all states.
Medicare Part A and/or Part B can cover dialysis, depending on where you receive treatment.Or call now to speak with a licensed insurance agent:
The chart below shows which dialysis services and supplies are covered by either Medicare Part A or Part B, according to Medicare.gov, and the costs you would face (in addition to Medicare Part A and Part B premiums and deductibles).
| Service or supply | Covered by Medicare Part A | Covered by Medicare Part B | Your Costs With Medigap | Your Costs Without Medigap |
|---|---|---|---|---|
| Inpatient dialysis treatment (if admitted to a hospital for special care) | ✓ | $0 for up to 365 days after Medicare coverage ends | $408 per day in 2024 if hospital stay lasts longer than 60 days. Costs based on the number of days you spend in the hospital. | |
| Outpatient dialysis treatment in a Medicare-approved dialysis facility | ✓ | 0-10% of Medicare-approved amount for service | 20% of Medicare-approved amount for service | |
| Outpatient doctors’ services | ✓ | 0-10% of Medicare-approved amount for service | 20% of Medicare-approved amount for service | |
| Home dialysis training for you and the person helping you | ✓ | 0-10% of Medicare-approved amount for service | 20% of Medicare-approved amount for service | |
| Home dialysis equipment and supplies (such as the dialysis machine, water treatment system, basic recliner, alcohol, wipes, sterile drapes, rubber gloves, and scissors) | ✓ | 0-10% of Medicare-approved amount for service | 20% of Medicare-approved amount for service | |
| Certain home support services (such as home visits by trained medical professionals to check dialysis equipment) | ✓ | 0-10% of Medicare-approved amount for service | 20% of Medicare-approved amount for service | |
| Most drugs for home dialysis | ✓ | 0-10% of Medicare-approved amount for service | 20% of Medicare-approved amount for service | |
| Other dialysis-related services and supplies (such as lab tests) | ✓ | 0-10% of Medicare-approved amount for service | 20% of Medicare-approved amount for service |
Although Medicare provides significant coverage for dialysis and related treatments, there are several things that Medicare does not cover, including:
Or call now to speak with a licensed insurance agent:
The chart below shows which kidney transplant services and supplies are covered by either Medicare Part A or Part B, according to Medicare.gov, and the costs you would face (in addition to Medicare Part A and Part B premiums and deductibles).
| Service or supply | Covered by Medicare Part A | Covered by Medicare Part B | Your Costs With Medigap | Your Costs Without Medigap |
|---|---|---|---|---|
| Inpatient services in an approved hospital | ✓ | $0 for up to 365 days after Medicare coverage ends | $408 per day in 2024 if hospital stay lasts longer than 60 days. Costs based on the number of days you spend in the hospital. | |
| Kidney registry fee | ✓ | No cost | No cost | |
| Laboratory and other tests needed to evaluate your medical condition | ✓ | No cost | No cost | |
| Laboratory and other tests needed to evaluate the medical condition of potential kidney donors | ✓ | No cost | No cost | |
| The costs of finding the proper kidney for your transplant surgery (if there is no kidney donor) | ✓ | No cost | No cost | |
| The full cost of care for your kidney donor (including care before, during, and after surgery) | ✓ | No cost | No cost | |
| Any additional inpatient hospital care for your donor in case of surgery complications | ✓ | No cost | No cost | |
| Blood (whole or united of packed red blood cells, blood components and the cost of processing and giving you blood) | ✓ | ✓ | No cost | No cost if the hospital gets blood from a blood bank for free. Special conditions apply. |
| Doctors’ services for kidney transplant surgery (including care before, during, and after surgery) | ✓ | 0-10% of Medicare-approved amount for service | 20% of the Medicare-approved amount for that service | |
| Doctors’ services for your kidney donor during their hospital stay | ✓ | No cost | No cost | |
| Immunosuppressive drugs (for a limited time after the surgery) | ✓ | Cost is dependent on several factors. | Cost is dependent on several factors. |
Medicare coverage for dialysis treatments typically begins the first day of the fourth month of your dialysis treatments.
You may be able to reduce this waiting period if you complete training from an approved Medicare dialysis provider to give yourself in-home dialysis.
Although Medicare is widely known as a government-issued health insurance program for seniors, it also provides health insurance benefits to individuals under the age of 65 who have ESRD.
According to Medicare.gov, you can get Medicare no matter how old you are if:
Your kidneys no longer work
You have had a kidney transplant or need regular dialysis
One of these applies to you:
You're the spouse or dependent child of a person who meets either of the requirements above
You've worked the required amount of time under Social Security, the Railroad Retirement Board (RRB), or as a government employee
You are eligible to receive or are already receiving RRB or Social Security
In order to receive the full Medicare coverage for ESRD-related treatment such as dialysis and transplants, you must enroll in both Medicare Part A and Part B (Original Medicare).
Or call now to speak with a licensed insurance agent:
Original Medicare (Part A and Part B) requires recipients to pay several out-of-pocket costs.
Medicare Supplement Insurance (Medigap) plans help cover some of these out-of-pocket costs to save Medicare recipients money and provide them with more predictive health care costs.
A person with ERSD who is under the age of 65 may be able to enroll in a Medigap plan, depending on which state they live in.
The following states require insurance companies to offer at least one kind of Medigap policy to people with Medicare who are younger than 65 with ESRD:
The level of Medigap benefits depends on which Medigap plan you choose (and which plans are available in your state). All 10 standardized Medigap plans provide at least partial coverage for:
Medicare Part A coinsurance and hospital costs
Medicare Part B coinsurance or copayment
First three pints of blood
Medicare Part A hospice care coinsurance or copayment
Learn more about Medicare coverage of common procedures
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.
Or call 1-800-995-4219 to speak with a licensed insurance agent.
Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareSupplement.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.
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