What do I need to know about Medicare coverage for dialysis?
- Medicare covers dialysis when it’s medically necessary for kidney problems such as ESRD, also called end stage renal disease, or permanent kidney failure.
- You are able to enroll in Medicare before you turn 65 if you have ESRD, or if you need regular dialysis or have had a kidney transplant.
- Original Medicare (Parts A and B) and Medicare Advantage (Part C) both cover dialysis, but your costs and plan rules can be different.
What is dialysis?
Dialysis is a treatment that cleans your blood when your kidneys don’t work well enough on their own. The two main types are:
- Hemodialysis: Uses a machine and filter to clean the blood.
- Peritoneal dialysis: Uses the lining of your belly to help filter blood inside the body.
Depending on your care plan, you may get dialysis in a clinic or hospital, or in your own home.
How do I easily search for in-network dialysis centers?
For help finding a doctor or dialysis provider in the Aetna® network, you can use our provider search to find Medicare providers and hospitals near you.
Does Original Medicare (Part A and Part B) cover dialysis treatments?
Original Medicare includes Part A (hospital insurance) and Part B (medical insurance).
Part A covers inpatient dialysis if you get treatment during a covered hospital stay.
Medicare Part B covers outpatient dialysis you get in a Medicare-certified dialysis facility or at home, plus related services like lab tests and many dialysis drugs. Part B can also cover home dialysis training, and the equipment and supplies you need for home dialysis.
To get coverage, your dialysis facility must be Medicare-certified, and your care team needs to bill Medicare the right way.
Want to review Medicare plan options in your area? Shop for Medicare plans
Does Medicare Advantage (Part C) cover dialysis treatments?
Medicare Advantage (Part C) plans are offered by private companies approved by Medicare. Plans must cover all medically necessary services that Original Medicare covers, including dialysis for people with ESRD.
Many Medicare Advantage plans also include prescription drug coverage (Part D).
Your costs can be different than Original Medicare, and Medicare Advantage plans have a yearly out-of-pocket maximum for covered Part A and Part B services.
Depending on the plan, you may need to use in-network providers and dialysis facilities, and you may need prior approval for certain services.
Shopping for a plan? Compare Medicare Advantage plans
Already an Aetna Medicare member? Log in to review your plan benefits
Common questions about dialysis types, treatment and Medicare coverage
-
Medicare may cover dialysis equipment when it’s medically necessary to treat kidney failure. If you receive dialysis at a clinic, the dialysis equipment cost is usually included in the treatment services rather than billed separately.
If you qualify for home dialysis, Medicare may help cover supplies and a dialysis machine for home use, along with training to perform treatment safely. The dialysis equipment price and your out-of-pocket costs can vary depending on your coverage and where you receive care.
Learn more about how Medicare and Aetna Medicare plans may cover durable medical equipment
-
Here are some things to consider about the costs of dialysis and Medicare coverage:
- Medicare Part B covers most dialysis care when you get it in a dialysis clinic or at home. After you meet the Part B deductible ($283 in 2026), you usually pay 20% of the approved amount for covered dialysis care.
- Medicare Part A covers dialysis you receive during a covered hospital stay.
- A Medigap policy, or Medicaid if you qualify, may help pay some of your share.
- If you have Medicare Advantage, your plan sets the copays or coinsurance, so check your plan details.
- Medicare usually doesn’t cover routine transportation to dialysis, but Part B may cover an ambulance when any other ride could put your health at risk.
Want to explore plan costs and benefits in your area? Shop for Medicare plans near you
-
Medicare dialysis coverage includes both main dialysis types and may include care in a facility or at home.
If you’re comparing hemodialysis vs peritoneal dialysis, your care team can explain which option fits your health needs and lifestyle. Medicare may cover in-center hemodialysis, home hemodialysis or peritoneal dialysis.
If you do dialysis at home, Part B can cover home dialysis equipment and supplies, and certain home support services from your dialysis facility. Medicare Part B also covers certain drugs for outpatient and home dialysis, while other prescription drugs may be covered by a Medicare drug plan (Part D).
Want to learn more about what drugs are covered by Medicare? Review our drug list
-
Home dialysis can be a good choice for many people with end‑stage renal disease (ESRD). Doing dialysis at home instead of in a center may help you feel better and save money.
If you get dialysis training, you may be able to do dialysis at home. Medicare Part B helps cover many of the services and supplies needed for home dialysis, including:
- Training for home dialysis, when provided by a Medicare‑certified dialysis facility
- Home dialysis equipment, such as the dialysis machine, water treatment system and a basic recliner
- Supplies needed for treatment, including sterile wipes, drapes, gloves and scissors
- Home support services, like staff visits to monitor your equipment, check your water supply and help during emergencies
- Dialysis‑related medications, such as heparin or topical drugs (for anemia, for example)
- A required monthly face‑to‑face visit with your doctor or care provider to oversee your treatment
- Coverage of 80% of home dialysis costs after you meet your Part B deductible; you pay 20% coinsurance
-
Medicare can cover dialysis when your doctor says you need it, whether you get Medicare because:
- You’re 65 or older
- You have a disability with 24 months of Social Security Disability Insurance (SSDI)
- You have ESRD
If you get Medicare because of ESRD, coverage often starts in the fourth month of dialysis. It can start sooner if you do home dialysis training early.
If you’re wondering how long Medicare pays for dialysis, it depends on why you have Medicare.
Your Medicare coverage can end 12 months after you stop dialysis or 36 months after a kidney transplant if you have Medicare only because of ESRD.
Social Security can tell you if you can get Medicare because of ESRD.
If you have ESRD and need dialysis, you can get coverage through Original Medicare (Part A and Part B) or through Medicare Advantage (Part C). In some cases, an Institutional Special Needs Plan (I-SNP) may be an option if you live in a long-term care facility.
