Does Medicare Cover Transportation to Dialysis?
- Learn about Medicare coverage in relation to dialysis treatments and find out if Medicate covers the cost of transportation to dialysis treatment sessions.
Dialysis is a medical treatment that assists the kidneys in removing waste, toxins and fluids that cannot be effectively filtered out through natural body processes in individuals with kidney disease. Kidney disease in all stages can cause symptoms such as exhaustion and weakness, which can make it difficult for dialysis recipients to drive themselves to treatment appointments, resulting in the need for transportation assistance. In some cases, beneficiaries may need to pay for a service to take them to appointments, which can be a burden.
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Does Medicare Cover Transportation to Dialysis?
Medicare plans do not cover any type of transportation to and from medical appointments, including dialysis treatment appointments. Medicare will generally cover the cost of recipients in need of emergency ambulance transportation to hospitals, but all other transportation needs must be paid for out-of-pocket.
Alternative Transportation Assistance Options
In some cases, dialysis recipients may be able to secure free or low-cost transportation through organizations such as The Red Cross and The American Kidney Fund. The American Kidney Fund offers needs-based financial grants that help pay for transportation, health insurance premiums and prescriptions, and certain Red Cross chapters provide non-emergency transportation to medical appointments.
In addition to low-cost options, individuals can schedule transportation through licensed medical transportation companies that offer private transport to non-emergency medical appointments.
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Renal Disease Treatment Coverage Provided by Medicare
While Medicare does not cover transportation to dialysis, it generally provides coverage for certain treatments, medications and kidney transplant procedures. Transplant services covered by Medicare Part A include:
- Kidney registry fee
- Expenses of finding appropriate kidneys for transplant when donors are not available
- Complete care costs for kidney donors
- Inpatient services at Medicare-certified hospitals
Transplant services included by Medicare Part B include:
- Doctor's services before, during and after kidney transplant surgery procedures
- Immunosuppressive transplant drugs
- Blood transfusions
Recipients on Original Medicare plans may receive coverage for dialysis in-hospital and at Medicare-certified dialysis facilities. Plans may also cover the costs of dialysis equipment for at-home use.
How Does Dialysis Treatment Work?
There are two types of dialysis for individuals with renal disease: hemodialysis and peritoneal dialysis.
During a hemodialysis treatment, the person is connected to machines that draw out their blood, filter out the toxins and then return the healthy blood back into the body. In some cases, dialysis machines can be prescribed for at-home use, but treatments often require recipients to travel to dialysis centers, which is why transportation options are essential.
Peritoneal dialysis is a treatment in which individuals with kidney disease are fitted with a tube that funnels directly into their bloodstream and filters the blood with a dialysate solution. The tube is drained and replaced with fresh solution periodically to continue filtering the blood on a consistent basis.
What Is the Cost of Dialysis With Medicare?
The average cost of dialysis treatments is approximately $500 per treatment for individuals without insurance. Medicare recipients are generally required to pay a deductible of approximately $150 and a 20% coinsurance cost. Medicare covers the remaining 80%. Recipients who are part of a Medigap Supplemental plan may qualify for partial or full coverage of the required 20% coinsurance payment.
What Is Included in a Dialysis Bundle?
The dialysis bundle, technically referred to as the Medicare ESRD Bundle, is a bundled payment for the costs of dialysis, labs, supplies and medications. Medicare Part B pays for all bundled items in a single payment instead of making multiple separate payments for each individual service. Recipients are required to pay 20% coinsurance responsibility, and Medicare continues to pay 80% of the costs.