Health Insurance Options
Choosing the Right Coverage
Navigating insurance after an End-stage Kidney Disease (ESKD) diagnosis can feel overwhelming. At U.S. Renal Care, we understand the importance of managing kidney disease treatment costs while prioritizing your kidney health. Whether you’re a new patient or supporting a loved one, this page was made with you in mind. We aim help every one of our patients find the best health insurance coverage for their own unique needs.
Watch this video to learn more about health insurance options.
Insurance Options for People Living with ESKD
If you have End-stage Kidney Disease (ESKD), understanding your insurance options is key to getting the care you need. Several types of health coverage may be available to you, depending on your personal situation. Check out the National Kidney Foundation website to learn more about the most common insurance types for people living with kidney disease.
Considerations When Choosing Insurance for Dialysis
Dialysis Coverage
Not all plans treat dialysis the same. Make sure:
- In-center and home dialysis are both covered
- You understand how often and how much the plan will pay
- Understand the difference between HMO’s, PPO’s, EPO, POS, High Deductible Plans
Total Cost
Don’t just look at the monthly premium—also check:
- Deductible: The amount you pay before insurance starts covering costs
- Copays/Coinsurance: What you pay at each visit
- Out-of-pocket max: Your total yearly limit
Transplant Coverage
Not all plans offer the same transplant benefits. If you’re on the transplant list or thinking about it, you need:
- Coverage for evaluation and surgery
- Post-transplant medications (anti-rejection drugs can be expensive)
Easy Support
A good insurance plan should make it easy to:
- Reach customer service
- Find providers
- Understand your bills and claims
- Provider networks and access to specialist
Other Benefits Offered
- Some medical plans offer dental, vision and better Rx needs
- Others even offer hearing, fitness programs and telehealth support
Understanding Your Health Insurance Responsibilities
Review the tips below to better understand your health insurance responsibilities. For more information, review the Insurance Coverage Basics guide.
Ensure you understand what costs you may be responsible for.
Bills from your providers are based on your insurance coverage.
You might qualify for Medicare—even if you're under 65.
Check with your insurance provider to understand coverage and out-of-pocket costs.
Some charitable programs can support premium costs if facing financial hardship.
Keep your insurance information current to prevent gaps in care or surprise costs.
Get Helpful Answers to Common Questions
Health insurance pays for some, if not all, of your dialysis treatment. There are different types of health insurance and insurance plans including Medicare, Medicaid, Employer group and Affordable Care Act policies. Each insurance plan may have different costs such as premiums, deductibles and coinsurances. There are also patient resources available in some areas that we can review as potential options.
Traditional Medicare is a fee-for-service program that consists of two parts: Part A (hospital insurance\acute care) and Part B (medical insurance\outpatient services). Both Parts A and B charge coinsurance amounts (20%) once you’ve met the annual deductible and traditional Medicare does not cover most prescription drugs, dental care, vision care, or hearing aids. It also does not place a limit on your annual maximum out-of-pocket expenses. Patient may qualify for Medicare Supplements \ Medigap plans that can cover the patient liability and Part D plans will assist with pharmacy cost.
Medicare Advantage, also known as “Part C,” is an alternative way to receive your Original Medicare benefits, and most Medicare Advantage plans include Part D prescription drug coverage as well. These plans are offered by private insurance companies approved by Medicare. Medicare Advantage plans cover the same services as Original Medicare plus additional benefits, such as dental care, vision care, and transportation benefits, among others. These plans also typically have annual deductibles and OOP patient liability.
U.S. Renal Care recognizes the burden of patient liability and has an array of avenues to limit these cost. Some programs may include Medicare and\or Medicaid attainment, setting up payment arrangements, or possibly help you determine if you are eligible for financial assistance programs.
Learn more about Medicare
Medicare & You Handbook
Learn moreMedicare Basics
Learn MoreUnderstanding Medicare Advantage Plans
Learn moreUnderstanding ESRD Medicare and Transplant
Learn moreHave questions? We're here to help.
Complete the Insurance Support Form and a representative will be in touch with you.
Ready for open enrollment?
A licensed insurance agent can help at Eldercare.
Want to learn more about Medicare?
Visit medicare.gov or 1.800.MEDICARE.