Learning about insurance options and choosing a plan that is right for you can be confusing and overwhelming. The National Kidney Foundation has created this resource guide to help you learn more about insurance.

For people with kidney disease your insurance options may change as your kidney disease progresses. For example, when someone starts dialysis or has a kidney transplant they can apply for Medicare. Typically Medicare is an insurance option for people over 65 years old, but there is a special entitelment for people who have kidney failure - also known as End Stage Renal Dissease (ESRD).  Medicare pays 80% of the cost of dialysis treatment and 80% of the cost of immunosuppressant medications after transplant.

Insurance Options Basics: 

  • Uninsured? 
    • The ACA Marketplace is an option.  The Affordable Care Act (ACA), commonly known as Obamacare, helps people without health coverage find and enroll in an insurance plan that fits your budget and meets your needs.
    • Medicaid may also be an option for you if you meet income requirements.  Medicaid helps pay medical costs for people with low income and little savings. For people without insurance applying for coverage through the ACA website will also allow you to see if you qualify for Medicaid all in one application.  If you have Medicare, Medicaid can pay your Medicare premiums, deductibles, co-insurance and some costs Medicare doesn't cover.
  • Employed? Your company or your spouses company may offer an employee group health plan (EGHP).  This means your healthcare coverage is sponsored by an employer or union.  If you either you, your spouse, or your parent (for children up to age 26) are working you may be eligible for insurance through your (their) employer. Employers with 50 full-time employees or more must offer insurance to their employees.
  • Over 65 or on dialysis or have a kidney transplant? Medicare helps Americans and legal residents of all ages who have worked and paid taxes into the system, and need dialysis or a kidney transplant. More than 90 percent of Americans with kidney failure, what Medicare calls End-Stage Renal Disease (ESRD), have Medicare.
  • Other Insurance Options - Are you a veteran?  Child under 26 years old? American Indian?  

Medicare for Kidney Failure (ESRD)

Special Considerations for People on Dialysis and Kidney Transplant Recipients

Resources

Date Reviewed: 
February 14, 2017

The information shared on our websites is information developed solely from internal experts on the subject matter, including medical advisory boards, who have developed guidelines for our patient content. This material does not constitute medical advice. It is intended for informational purposes only. No one associated with the National Kidney Foundation will answer medical questions via e-mail. Please consult a physician for specific treatment recommendations.