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Medicare Kidney Disease Treatment Coverage: What Benefits Are There for End Stage Renal Disease Patients?

kidney disease treatment

Medicare offers kidney disease treatment coverage for patients with renal failure. Call our licensed insurance agents today at (800) 950-0608 to learn more about options in your area.

Just the Essentials:

  • Medicare coverage is available for patients with End Stage Renal Disease (ESRD) to help them pay for kidney disease treatment.

  • The coverage for treatment for kidney disease through Original Medicare is somewhat limited.

  • Medicare Part B will only cover certain treatments, supplies, and medications for patients with End Stage Renal Disease.

  • You may find more coverage for ESRD treatment services with a Medicare Advantage plan.

It Can Be Tough to Find Good Coverage for Kidney Disease Treatment

For seniors suffering from End Stage Renal Disease, or ESRD, treatment for kidney disease is a necessity. It can mean the difference between a somewhat normal quality of life and a poor quality of life. However, kidney disease treatment can be hard to get for seniors with fixed lower incomes who need it.

Fortunately, for seniors suffering from ESRD, Medicare does provide some coverage for kidney disease treatment. You can receive Medicare coverage for chronic kidney disease treatment regardless of age if you suffer from End Stage Renal Disease. Depending on your plan, however, there are certain limitations to your coverage.

At MedicareInsurance.com, it is our mission to help you figure out what your Medicare plan may or may not cover related to specific illnesses. Today, we’re going to be discussing coverage of treatment for kidney disease for patients suffering from ESRD.

Original Medicare and Kidney Disease Treatment

Chronic kidney disease treatment is typically covered primarily by Medicare Part B. However, depending on your needs, both parts of Original Medicare can provide coverage for your treatment.

Medicare Part B will provide coverage for the following:

  • Outpatient dialysis treatments and doctor services*
  • In-home dialysis training
  • Home dialysis equipment and supplies
  • Some in-home support services
  • Certain prescription drugs to support outpatient or in-home dialysis
  • Specific services and supplies that support dialysis treatment
  • Services provided by a doctor for kidney transplant surgery
  • Services provided by a doctor for your kidney donor
  • Medications to assist with helping your transplant take**

Medicare Part A will cover inpatient dialysis treatments as long as you’ve been admitted to a hospital for special care. It will also cover transplant surgery and hospitalization related to having such a procedure. Medicare Part A will also help cover:

  • Kidney registry fees
  • Test to evaluate your condition and the condition of potential donors
  • The costs of finding a matching kidney
  • The full cost of care for your donor
  • Additional inpatient care should post-surgical complications arise

With that said, there are certain services that Original Medicare will not cover. For instance, Original Medicare will not cover:

  • Paid dialysis aides
  • Pay for you or the individual who assists you with in-home dialysis
  • Living accommodations during your dialysis treatment
  • Blood or packed red blood cells***

*To receive Medicare coverage for outpatient services, they must take place in your home or in a Medicare-certified dialysis facility.

**Medicare Part B only covers these medications for a certain amount of time after you’re discharged from the hospital following your kidney transplant.

***Medicare may cover blood or packed red cells for in-home dialysis if they’re part of a doctor’s service.

What Limitations Are There to Coverage of Treatment for Kidney Disease by Original Medicare?

Medicare coverage for ESRD differs slightly than any other type of Medicare eligibility. One primary difference relates to the limitations on this type of coverage.

For example, let’s say you qualified for Medicare because of your diagnosis of End Stage Renal Disease. Unlike traditional Medicare benefits, the Medicare benefits you receive for End Stage Renal Disease will eventually come to an end. Your coverage will typically end:

  • 12 months following the month your dialysis treatments end
  • 36 months following the month of your kidney transplant surgery

That’s not to say that you’ll never receive your coverage again. If you resume dialysis or receive a new kidney within a year after the month your dialysis treatments ended, your coverage may resume. It may also resume if you start dialysis or receive another kidney transplant within three years after the month of your original transplant procedure.

Original Medicare will cover certain dialysis and post-transplant medications, but it will not cover them all. It also will not cover transportation to and from treatment services.

Are There Ways to Get Extra Kidney Disease Treatment Coverage That I May Need?

If you’re in need of extra coverage related to your End Stage Renal Disease, you have options. Medicare Advantage, Part D Prescription Drug coverage, and Medigap supplemental plans can help you cover what Original Medicare does not.

Don’t let the fear of not being able to fully cover the costs of kidney disease treatment keep you from getting the care you need. Learn more about how other Medicare plans can help you manage your ESRD with treatment for kidney disease by speaking with one of our licensed agents. We’re always here to help.

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