Dialysis Medicare Coverage for People with ESRD
You are eligible for Medicare at age 65—or earlier if you have certain health conditions. People who are diagnosed with end stage renal disease (ESRD) at any age are usually eligible for Medicare after 3 months of dialysis or after completing home dialysis training. Talk to your insurance coordinator to find out more.
Understanding Medicare: Parts A, B, C, & D
Medicare Part A
Type of coverage: Hospital coverage
What it covers: Inpatient hospital care, hospice care, and some nursing home and home healthcare
Premium: No
Coverage: 80%
Annual Deductible: Yes
Medicare Part B
Type of coverage: Medical coverage
What it covers: All outpatient care, including dialysis services and doctor visits
Usually chosen: Together with Medicare Part A
Premium: Yes
Coverage: 80%
Annual Deductible: Yes
Medicare Part C
What it covers: Hospital and medical coverage, plus many plans offer coverage for prescription drugs and other benefits not typically covered by Medicare.
Replaces: Separate traditional Medicare Parts A, B, and D, plus Medigap plans.
Premium: Yes
Coverage: Co-pays and co-insurance, with a cap on annual out-of-pocket costs
Annual Deductible: None for many plans, but there may be a deductible for prescription drug coverage.
Medicare Part D
What it covers: The cost of prescription medications that aren't covered by Part B which may cover dialysis or transplant medications
Usually chosen: Chosen with Parts A and/or B. Cannot be combined with Part C or a Medigap plan that includes drug coverage.
Premium: Yes—varies by income
Coverage: Co-pays that vary, based on the drug tier and your total spend on drugs annually.
Annual Deductible: Usually, though some Part D plans don't have a deductible
Before you make any health insurance changes, Talk to your insurance coordinator
Have insurance through your employer?
