Will Medicare pay for more than 3 treatments per week?

[Unregistered]

Will Medicare pay for more than 3 treatments per week? Such as 5 to 6 treatments per week on Next Stage?

[MiracleMan]

Will Medicare pay for more than 3 treatments per week? Such as 5 to 6 treatments per week on Next Stage?

Yes, but your nephrologist has to justify the extra treatments...Many people are on 5 and 6 days per week and the centers are being reimbursed. Im sure Beth will be more specific, but yes, they will pay for more than 3 treatments.

///MM

[Beth Witten MSW ACSW]

Employer health plans typically pay for the number of treatments a patient does. Medicare routinely pays for 3 hemodialysis treatments a week. There are different insurance companies that pay Medicare claims in differnet areas of the U.S. I've heard of some that pay for 5 or 6 treatments with medical justification and others that won't pay for more than 3, even with medical justification. Some clinics accept what Medicare and insurance pay as payment in full. Others may charge you for extra treatments when Medicare doesn't pay for all of the ones you do. There is a special form called an Advance Beneficiary Notice that the clinic should have you sign if it thinks Medicare may not pay for all treatments. This form alerts you that the clinic may charge you for treatments Medicare doesn't cover. Medicare makes dialysis clinics discount their bills for the treatments it covers. However, the clinic could charge you the full commercial charge for dialysis if Medicare doesn't cover some treatmetns. Ask your clinic what it will charge you if Medicare doesn't pay for all the treatments you do.