• Insurance Coverage for Dialysis

Welcome to the DaVita® Insurance Coverage for Dialysis guide.

Understanding how insurance works can be difficult on its own. Understanding insurance as it relates to dialysis and kidney disease can be especially complicated. Here are the answers to some of the financial questions about being on dialysis.

Maintaining your health insurance is very important

Typically, medical insurance pays for some, if not all, of your dialysis treatments, labs and medications. To help you understand all of your insurance benefits and the different options that may be available to you, relay all insurance coverage information to your insurance counselor or social worker (if a DaVita patient) or patient advocate (if a person with chronic kidney disease) so that they can properly review your needs and answer any questions you may have.

Information you need to know about your insurance

  • What type of insurance do you have?
  • Who is the policy holder?
    • You, your spouse, or a parent?
  • Where does the coverage come from?
    • Is the coverage through active employment, retirement policy, COBRA or government insurance such as Medicare or Medicaid?

Things to consider when reviewing your health insurance options

1. Dialysis benefits: Make sure the plans you are considering cover dialysis as a benefit.

2. Transplant options

a) If you are considering a transplant, make sure plans you are reviewing cover transplant services and are contracted with your preferred transplant center.

b) Make sure you consider both pre- and post-transplant out-of-pocket costs when selecting coverage options, as they may vary by plan.

c) Advise your transplant center immediately if you are planning to make an insurance change.

3. Network/access: It is important to review the physician and hospital network when considering a plan to ensure your preferred providers are covered. This includes your dialysis center, nephrologist, primary care physician, and any other health care provider services you need.

4. Family vs. individual coverage: If you want to cover other family members in addition to yourself, it will be important to consider plans that provide more than individual coverage.

5. Prescription benefits: Not all plans cover the same drugs, so make sure to review the prescription benefits and full medication list for each plan.

6. Other benefits: If non-medical benefits are important to you, such as dental and vision, consider these benefit options when reviewing available plans.

7. Out-of-pocket costs: It is important to review all out-of-pocket costs when going over plan options, which can include the deductible, coinsurance, copay and the premium.

Freedom of Choice (FOC)

People like to know that they have choices in life. We like to make our own decisions—from which grocery store we shop at to what neighborhood we live in. Every day we make choices and many of them are related to health care.

Choices about our health care are some of the most important decisions we can make. Having a doctor who will truly listen to your concerns, an insurance plan that will cover all your health needs, and receiving care where you feel safe and provided quality services all play into this matter.

Dialysis is no different when it comes to having a choice. As a dialysis patient, you should receive treatment at the dialysis center of your choice.  While finding the right dialysis center, you should consider things such as distance, if your nephrologist rounds at the center, and if the center is in-network with your insurance.

As a patient, know that you have rights and we are here to help you with your insurance questions.

Types of Insurance Coverage

 Want to learn more about different types of insurance coverage? The link below outlines the most common types of insurance for patients on dialysis:

  • Get to Know the Types of Insurance Coverage

Insurance plans can be very complicated, and changes to your insurance may have a substantial impact on dialysis coverage. It is important to understand your insurance plan and options before making any health insurance changes.

  • Patients with chronic kidney disease (CKD) who have not yet started dialysis, please call the Patient Advocate Helpline 1-888-405-8915.
  • Dialysis patients with end stage renal disease (ESRD), please contact your insurance counselor or social worker OR fill out our Insurance Support Form.

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