Cost

How does one pay the deductable on dialysis supplies under the new prescription rules. My only income is $1290/month SS. I’m sure the deductable on the supplies will be more than that. :?:

Do you have Medicare or other insurance?

If you have Medicare, you might want to read the Medicare FAQs at http://www.homedialysiscentral.com/v1/medicare/faqs-pat.shtml. Medicare has a $110 deductible in 2005. In 2006, the Medicare deductible is $124. Medicare pays 80% of the allowed charge for PD. Many people have Medigap plans that pay the other 20%.

If you have other health insurance, your dialysis provider will likely charge that insurance more than Medicare allows. You might want to think about signing up for Medicare as a secondary payer. If you have Medicare as a primary or secondary payer, the dialysis clinic must write off any part of its charge to commercial payers that is over 100% of what Medicare allows. This can save you money.

Depending on your assets, you may also qualify for Medicaid (state medical assistance) with a “spenddown” if you have large medical bills. Talk with your dialysis social worker. He/she can help you look at options.

I don’t have other insurance and I expect the 20% that I will have to pay to go well over $1000/mo

When you say you don’t have “other insurance,” do you mean you do have Medicare? If I were you, I’d talk with the clinic billing person (or in the case f a dialysis corporation, the billing department) and ask what the average cost/month is for a patient that has Medicare or that has your type of insurance.

The 20% of dialysis for a person who has Medicare is around $100 a week give or take. The clinic should be able to give you more exact figures for this as well as for any medicines they give PD patients that can be billed separately – most can’t be billed separately. There may be patient assistance programs to help you. Some require that you not have any insurance to qualify.

Medicare is going to be helping people pay for drugs in 2006. You might want to visit www.kidneydrugcoverage.org to read more about that.

You might want to talk with your state’s insurance department and see if you can get other insurance – Medigap (Medicare supplement) or high risk insurance. If your healthcare costs are high, like I said before, you may qualify for Medicaid (state medical assistance).