Understanding Medicare Costs

If you are an End-Stage Renal Disease (ESRD) patient, you are eligible for Medicare. So of course you want to know which of your costs Medicare covers.

Here are the three most common questions people like you ask about their Medicare coverage.

What does Medicare cover?

Medicare Part A (Hospital Insurance) Medicare Part B (Medical Insurance)
  • Inpatient care in hospitals
  • Inpatient care in skilled nursing facilities (not custodial or long-term care)
  • Hospice care
  • Home health care
  • Services from doctors and other health care providers
  • Outpatient care
  • Home health care
  • Training, support services, and equipment for home dialysis
  • Some preventive services

Are presciption drugs covered?

  • Medicare Part B (Medical Insurance) covers a limited number of outpatient prescription drugs under limited conditions. Generally, drugs covered under Part B are drugs you get at a doctor's office or hospital outpatient setting. Drugs not covered under Part B may be covered under a Medicare Prescription Drug Plan (Part D). Learn more about Medicare Part B and Medicare Part D.

When does my Medicare coverage begin?

  • In-Center Hemodialysis patients typically receive coverage on the first day of the fourth month of their dialysis treatment.
  • Home Dialysis patients can receive coverage as soon as the first month of their treatment.
  • Kidney Transplant patients can receive coverage as soon as they are admitted to a Medicare-approved hospital for the transplant operation. Coverage lasts for 36 months.

The information above is adapted from the CMS publication Medicare Coverage of Kidney Dialysis & Kidney Transplant Services and from www.medicare.gov.