Does Medicare Cover Home Dialysis? 

Kidney failure is also known as end-stage kidney disease (ESKD) or end-stage renal disease (ESRD). When you reach this stage of chronic kidney disease, the condition is irreversible, but having dialysis or getting a kidney transplant can extend your life for years. Medicare benefits are available to help cover the cost of both treatments. 

Treatment in a dialysis facility

When you have ESRD and Part B coverage, you are eligible for three weekly kidney dialysis treatments. The dialysis center coordinates the services at home or in an external facility. Covered dialysis services in a facility include nursing services, equipment and supplies for the procedure, drugs to treat or manage ESRD-related conditions, lab tests, heart monitoring, oxygen as needed, monitoring and nutritional services.

In some cases, Medicare covers round-trip ambulance transportation for dialysis in a facility.  

Medicare Part A covers dialysis in a hospital or skilled nursing facility if you are an inpatient. Patient responsibility is the Part A deductible for each benefit period, which begins after 60 consecutive days of no inpatient hospital care. Daily coinsurance applies for stays over 60 days.

Does Medicare cover dialysis at home?

Medicare beneficiaries who undergo dialysis at home and have Part B get help with the cost of training, equipment and supplies. Medicare will only cover home dialysis training conducted by a dialysis facility. Part B covers equipment and supplies like a dialysis machine, standard recliner, water treatment system, wipes, rubbing alcohol, sterile drapes, scissors and rubber gloves.

The dialysis facility provides various types of support for home dialysis. Covered support includes visits from hospital or dialysis facility personnel trained in monitoring dialysis treatments, access to emergency assistance as needed, maintenance checks for equipment and water supply, and monthly face-to-face healthcare provider visits.

Your Part B out-of-pocket expense is the 20% coinsurance payment and the annual Part B deductible. 

Medicare coverage for dialysis-related services

If your doctor prescribes oral medication to take at home, check your prescription drug coverage (Part D) for coverage information. Medicare Advantage members may have some additional benefits for over-the-counter medicine.

Kidney disease education is a Part B benefit for Medicare beneficiaries with Stage IV chronic kidney disease requiring kidney dialysis or transplant. You must have a referral from your doctor and receive the service from a qualified healthcare provider. 

Costs excluded from Medicare coverage

Original Medicare excludes the cost of dialysis aides for in-home treatments, loss of pay during home dialysis training, accommodation charges during treatment, and home dialysis blood not part of a physician’s service.  

Medicare Advantage (MA) benefits can add to the coverage available under Original Medicare. MA plans also have different out-of-pocket costs and network provider requirements. If you are an MA member, contact your plan administrator and review the policy documents to learn more.