Health Insurance Options

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.

Medicare is a federal government health insurance program for people who are age 65 and older or have, Kidney failure, also called end-stage kidney disease (ESKD) or other disabilities.

Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding.

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.

Health insurance pays for some, if not all, of your dialysis treatment. There are different types of health insurance and insurance plans.  Typical insurances are through Medicare, Medicaid, Employer Group Health Plans, Affordable Care Act plans and VA.