People with chronic kidney disease (CKD) who require dialysis may qualify for Medicare and other financial assistance. Other sources of support include state and organizational programs and prescription discounts.
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- medications
- dialysis
- transplant
CKD treatment can be costly, especially in the United States: A 2023 study found that, depending on the stage of CKD, treatment could cost upward of $18,000. That was more than double the average of the other 30 countries in the study.
Research also suggests that the out-of-pocket costs can be a barrier for some people to keep up with or even start their CKD treatment. But that doesn’t need to be the case.
Here are some tips to help you manage the costs of CKD treatment so you can manage your condition and live your best life.
According to data from the Centers for Disease Control and Prevention (CDC), about 4 in 5 people with CKD have health insurance.
If you have an insurance plan, your first step should be to check with your provider. Depending on your plan, they may cover all or part of your treatment.
Even with insurance, most people still have some out-of-pocket costs for CKD treatments. It’s important to read through your plan or talk with a representative to understand:
- what your plan covers
- what your copays will be for prescriptions and dialysis sessions, if needed
- if you have a deductible before your insurance kicks in
Tip: Save by staying in network
You can lower your costs significantly by choosing healthcare professionals who are in network. To confirm whether your doctor or specialist is in your insurance company’s network, you can speak with the medical office directly or call your insurance provider.
If your CKD progresses to stage 5, aka end stage renal disease (ESRD), you may be eligible for Medicare, regardless of your age. According to the American Kidney Fund, more than 90% of U.S. people with ESRD have Medicare.
Medicare Part B covers 80% of the cost of your dialysis sessions. Coverage kicks in on the first day of the fourth month of dialysis if you go to a dialysis center. Medicare can backdate coverage to the first month if you:
- learn to do self-dialysis treatment at home by attending a Medicare-approved training program
- expect to finish home dialysis training
- begin home dialysis before your third month of dialysis
If you need a kidney transplant, Medicare parts A and B cover various parts of the process.
If you qualify for Medicaid, it can help you cover your Medicare premiums, deductibles, and some items that Medicare may not cover.
Medigap plans are private insurance plans that help cover what Medicare doesn’t, like premiums, copays, and deductibles. Depending on your specific needs, a Medigap plan might help reduce your ESRD treatment costs.
For example, Medigap plans will cover the 20% of dialysis treatments that Medicare doesn’t cover. However, they won’t cover:
- prescriptions (other than immunosuppressants for kidney transplant recipients)
- dental, vision, or hearing care
- long-term care
- transportation services
People under 65 years old with ESRD may not qualify for Medigap plans in each state.
CKD treatment may involve needing to take medications for high blood pressure, diabetes, or other complications. People on dialysis may need to take 10 to 12 different prescription medications each day. A 2024 study found that the average out-of-pocket cost for CKD medications was $783.77 per year.
If you have Medicare, you can save a lot on your prescription costs. Prescription drugs for CKD are covered under Part D of Medicare. In 2023, the average out-of-pocket spending on prescription drugs for someone with CKD with Medicare was
Medicare Part D also offers additional assistance through its Extra Help program. You can qualify for the Extra Help program if you meet certain income and financial requirements. Extra Help eliminates your premium and deductibles and caps prescription refills at $4.90 for generic drugs and $12.15 for brand-name drugs.
Many drug manufacturers also offer direct assistance programs to help you purchase their medications at lower prices.
You may also benefit from drug discount cards, which can often reduce prescription costs significantly. However, you can’t use them in combination with Medicare Part D.
Several states offer programs that provide additional assistance to people with CKD or ESRD, including:
For some state programs, you may need to apply through a social worker or financial counselor at a dialysis center. Some states have online applications.
Beyond financial assistance for treatment, state and local programs may also offer:
- help with transportation
- meal delivery services
- help meeting other basic needs, like rent, mortgage, or utilities
Even if your state isn’t listed above, there may be options at the local, regional, or state level to help you. Check with the National Kidney Foundation to learn more about services available in your area.
There are different types of dialysis, though some people with kidney disease may not be well informed regarding the options.
Several factors may influence whether you and your doctor settle on hemodialysis or peritoneal dialysis. If both treatments may be equally effective, it’s worth noting that peritoneal dialysis is usually less expensive.
However, this may depend on specific details of your coverage. For example, people on Medicare may pay more for prescription drugs if they’re on peritoneal dialysis.
Dental care and oral hygiene are especially important for people with CKD. Infections that enter through the mouth can become serious. You also typically need a dental exam before a kidney transplant.
And while standard insurance plans may cover treatment for many other CKD complications, they often don’t include coverage for dental care.
Several organizations offer assistance programs or reduced cost dental care, including:
- Dental Lifeline Network
- Give Kids a Smile program by the American Dental Association
- community health centers
- local dental schools
If your child has kidney disease, you may have access to unique resources, including:
- Children’s Health Insurance Program (CHIP) for children whose parents earn too much to qualify for Medicaid
- Social Security Income (SSI) payments
- American Kidney Fund grants for children
Managing symptoms and coordinating treatment of CKD can be challenging enough. Understanding the associated costs can also be overwhelming. However, many resources are available to help you overcome any financial barriers.
Your treatment team is usually a good place to start if you have any questions regarding financial assistance. They can usually direct you to the appropriate resources. You can also enlist the help of local, state, and national organizations devoted to supporting people with CKD.
Some of the best places to start include:
- National Kidney Foundation
- American Kidney Fund
- BenefitsCheckUp from the National Council on Aging
