Dialysis Costs and Insurance Options

There are several factors to think through if you’re considering switching insurance. Looking at the big picture and comparing the total benefits and costs of each plan can help you choose the coverage that’s right for you. Here are 7 plan features to consider: 

1. Network of providers—see if the plan has a network of approved providers to choose from. Getting care from an “in-network” provider (instead of going to an “out-of-network” provider) can help you manage costs.
2. Out-of-pocket costs—this is the total amount of money you spend each year on medical services, including copays, coinsurance, deductibles, and premiums. The amount varies from plan to plan.
3. Prescription coverage—see whether your plan coverage includes prescriptions or if you’ll need to add a supplemental plan. Also look at whether the coverage for prescriptions is a fixed amount or percentage, or whether your costs may vary throughout the year. Consider that dialysis or transplant medications may be covered differently than medications for other conditions.
4. Medical supplies and equipment—depending on your treatment, you may need to have various supplies and equipment at home. Explore coverage for supplies, as well as delivery or shipment.
5. Transportation coverage—some plans cover emergency medical transportation, such as an emergency hospital visit. Also see if the plan covers the cost of transportation to and from doctor appointments or other health facilities—this can be important if you have regular visits to a dialysis center.
6. Family coverage—explore whether the plan offers spousal or family coverage, if you need it. If your spouse is covered by your current plan, you may need to think through additional options if you make a change.
7. Transplant coverage—if you’re considering a kidney transplant, look at the coverage for transplant surgery, as well as ongoing transplant medications and donor surgery.