Medicare covers dialysis and most treatments that involve end stage renal disease (ESRD) or kidney failure.

When your kidneys no longer function naturally, your body enters into ESRD. Dialysis is a treatment to help your body function by cleaning your blood when your kidneys stop functioning independently.

Along with helping your body retain the correct amount of fluids and controlling blood pressure, dialysis helps eliminate harmful waste, fluids, and salt that build up in your body.

Although they may help you live longer and feel better, dialysis treatments are not a cure for permanent kidney failure.

Keep reading to learn more about Medicare’s dialysis and treatment coverage, including eligibility and cost.

The eligibility requirements for Medicare are different if your eligibility is based on ESRD.

If you don’t enroll right away

If you’re eligible for Medicare based on ESRD but miss your initial enrollment period, you may be eligible for retroactive coverage of up to 12 months once enrolled.

If you’re on dialysis

If you enroll in Medicare based on ESRD and are currently on dialysis, your Medicare coverage usually begins on the first day of your dialysis treatment’s fourth month. Coverage can start the first month if:

  • you participate in home dialysis training at a Medicare-certified facility during the first 3 months of dialysis
  • your doctor indicates that you should finish training so you can do your own dialysis treatments

If you’re getting a kidney transplant

If you’re admitted to a Medicare-certified hospital for a kidney transplant and the transplant takes place that month or in the next 2 months, Medicare can begin that month.

Medicare coverage can begin 2 months before your transplant if the transplant is delayed more than 2 months after being admitted to the hospital.

If you’re only eligible for Medicare due to permanent kidney failure, your coverage will stop:

  • 12 months after the month you stop dialysis treatments
  • 36 months following the month you have a kidney transplant

Medicare coverage will resume if:

  • within 12 months after the month, you stop getting dialysis, start dialysis again, or have a kidney transplant
  • within 36 months after the month you get a kidney transplant, you get another kidney transplant or start dialysis

Original Medicare (Part A, hospital insurance, and Part B, medical insurance) covers many of the supplies and services needed for dialysis, including:

  • inpatient dialysis treatments: covered by Part A
  • outpatient dialysis treatments: covered by Part B
  • outpatient doctors’ services: covered by Part B
  • home dialysis training: covered by Part B
  • home dialysis equipment and supplies: covered by Part B
  • certain home support services: covered by Part B
  • most drugs for in-facility and at-home dialysis: covered by Part B
  • other services and supplies, such as laboratory tests: covered by Part B

Medicare should cover ambulance services to and from your home to the closest dialysis facility if your doctor provides written orders certifying that it’s a medical necessity.

Services and supplies not covered by Medicare include:

  • payment for aides to help with dialysis
  • lost pay during home dialysis training
  • lodging during treatment
  • blood or packed red blood cells for home dialysis (unless included with a doctor’s service)

Part B covers injectable and intravenous drugs and biologicals and their oral forms provided by the dialysis facility.

Part B does not cover medications that are available only in oral form.

Part D, which is purchased through a Medicare-approved private insurance company, offers prescription drug coverage that, based on your policy, typically covers this type of medication.

If you get dialysis after being admitted to a hospital, Part A covers the costs. Outpatient doctors’ services are covered by Part B.

You’re responsible for premiums, yearly deductibles, coinsurance, and copays:

  • In 2024, the monthly premium for Part A for most people is $0. If you don’t qualify for premium-free Part A, you’ll pay $278 or $505 monthly.
  • In 2024, the annual deductible for Part A (when admitted to a hospital) is $1,632. This covers the first 60 days of hospital care in a benefit period.
  • In 2024, the monthly premium for Part B is $174.70 and the annual deductible for Part B is $240.

For home dialysis training services, Medicare typically pays a flat fee to your dialysis facility to supervise home dialysis training.

After the Part B yearly deductible is met, Medicare pays 80% of the fee, and the remaining 20% is your responsibility.

Medicare covers most treatments, including dialysis, that involve ESRD or kidney failure.

The details regarding coverage of treatments, services, and supplies, and your share of the costs can be reviewed with you by your healthcare team, which includes:

  • doctors
  • nurses
  • social workers
  • dialysis technicians

For more information, consider visiting Medicare.gov or calling 800-MEDICARE (800-633-4227).