Dialysis facilities administer dialysis treatments to patients with end-stage kidney disease (aka “kidney failure”) in an outpatient setting.
Dialysis is a blood-cleaning treatment that replicates the function of human kidneys in order to keep patients alive. With the exception of a kidney transplant or palliative care, dialysis is currently the only treatment option for people with irreversible kidney failure.
The services offered by dialysis facilities vary greatly depending on the provider, but often include:
Additionally, many dialysis providers also offer:
Dialysis facilities do not typically provide the following services:
On average, dialysis costs range from approximately $75,000 to $90,000 per patient per year*. Although the cost of care is high, patients of all ages are able to have the vast majority of expenses covered by Medicare.
People often use the following methods, or a combination of the following methods, to pay for dialysis:
Medicare will cover at least 80% of the cost of dialysis for everyone with end-stage-renal-disease, regardless of age or income. It is one of very few situations where you do not need to be 65+ years old in order to receive Medicare coverage.
For the first 30 months on dialysis, patients who have an Employer Group Health Plan (EGHP), retiree health coverage, or COBRA health insurance can choose to delay Medicare enrollment and continue with their existing insurance provider as the primary insurer. After this “coordination period” ends, Medicare becomes the primary insurer. However, since Medicare coverage for end-stage-renal-disease is often better than the coverage provided by private health insurance plans, most patients enroll in Medicare immediately following their diagnosis.
Patients with end-stage-renal-disease who qualify for Medicaid may have some of their dialysis-related expenses covered by Medicaid, depending on the state’s specific programs. For patients with both Medicare and Medicaid, Medicare is the primary insurer and Medicaid is the secondary insurer.
*United States Renal Data System, https://www.usrds.org/2017/view/v2_09.aspx
Find dialysis clinics near you. The typical in-center dialysis patient spends four hours a day, three days a week in the dialysis chair. Reduce the amount of time you add to this already time-consuming schedule by choosing a clinic close to your home and/or work.
Tour more than one facility. If there’s more than one dialysis center located near you, tour all of the available facilities and choose the center that you find most welcoming. Consider your view from the dialysis chair—are there windows or artwork on the walls? Is there a waiting area for friends and family? What amenities are offered to help improve your comfort during treatment (TVs, Wi-Fi, etc.)?
Ask about home hemodialysis and peritoneal dialysis. Dialysis affects each patient differently, and everyone has their own unique treatment schedule that works best. Some people feel the most comfortable dialyzing in a clinic, with the support of dialysis technicians and nurses. Others feel better dialyzing at home, either with home hemodialysis machines or peritoneal dialysis treatments. Choosing a facility that offers all three options—in-center hemodialysis, home hemodialysis and peritoneal dialysis—will give you the opportunity to discover which type of treatment works best for you.
Review the facility’s Medicare ratings and patient surveys. Each year, Medicare assigns quality ratings for overall patient care at dialysis facilities. Search Care Listings to view profiles of dialysis facilities near you and view the facility’s ratings over time. The profile will also include a link to the facility’s page on Medicare.gov, where you can read the results of patient surveys for that specific facility.
Look into nonprofit providers. Check to see if any dialysis clinics near you are managed by a nonprofit organization. In some cases, this can mean a higher quality of care and a broader range of services beyond dialysis itself (e.g. education for caregivers and families, home training programs, social work services).