Costs

What does your water an electricity run on nocturnal dialysis?

I don’t really know yet. I don’t pay for water. I do pay for electricity though. However, due to a combination of factors from every two month billing to a really hot summer with added air conditioning cost in an apartment I only moved into before last winter, plus rate increases during that time, I haven’t yet been able to isolate the cost for electricity added by nocturnal hemo. It’s not insignificant though. Right now, I’m guessing it’s in the neighbourhood of $85 to $100 every two months. Nobody covers this cost or subsidizes it, but as I understand it, I should be able to deduct it from income tax as a medical expense. Under the income tax system here, that probably won’t amount to much because it won’t meet the treshold amount which triggers an actual deduction. So, I’m stuck with the bill.

When you’re doing nocturnal, from set-up to disinfection, both the dialysis machine and the water purifier are running about 10 hours every treatment day.
Pierre

My husband is on every other day nocturnal dialysis–nine hour runs–for the last eight months. Here’s what we’ve found. We live in Arizona, so we actually pay much higher rates for electricity in the summer, but it seems like our winter bills went up by about $10-$15 and our summer bills went up around $20-$25. As for water, our bills doubled, which still wasn’t horrible. We went from paying around $35 a month to around $70 after nocturnal. So I guess our total cost of nocturnal–utility-wise at least–is $45 to $60 a month. Ironically, with gas prices, our biggest single expense may be driving to our unit for monthly clinic visits as we live a couple of hours away.

Getting dollar costs is meaningless as everywhere charges different rates. Additionally some machines don’t use water and some do. Some r/o’s use more water some less. I am sure a maximum would be around $100-$150 with most being between $50 and $100, probably less than the cost of gas these days driving back and forth to dialysis 3x a week.

For people on a low, fixed income, the additional cost can mean cutting back on something else. I personally don’t save travel costs, since I only live 10 minutes from the dialysis centre, and I buy my monthly dialysis parking pass anyway. It’s something that should be considered, but it’s not insurmountable.

Pierre

I’ve heard an estimate of $1.20-$1.30 a day for the Aksys machine and I’ve heard the electricity usage for the NxStage compared to a light bulb. Other machines may be more or less.

Someone mentioned once on a social work listserv that I subscribe to that in their area the utility company gave people that needed to use medical equipment in their homes a special rate. You might ask your utility companies if they offer a special reduced rate for people on dialysis. If so, ask if they need a letter from your dialysis clinic as proof. I’m sure your clinic would be willing to do this and to tell other patients about it so they could save money too.

For people that have limited income (especially the elderly, disabled, or households with children) in the U.S. (sorry, Pierre) the Low Income Home Energy Assistance Program can help pay high utility bills so people don’t lose heat in the winter or cooling in the summer. I’m not sure if this program would help someone with high utility bills because they do dialysis in the home, but the worst they can do is say no. This is a federally funded program operated in the states. There is a phone number and email on this brochure:
http://www.acf.dhhs.gov/programs/liheap/brochure.pdf

Beth writes:
I’ve heard an estimate of $1.20-$1.30 a day for the Aksys machine.

Is that for a 2 hour daily tx or 8 hr nocturnal?

The Aksys is used now for daily dialysis usually around 2-2.5 hours. However, the machine heat disinfects and prepares for the next dialysis over the next 15 hours (may be less now). You might want to call Aksys to ask how much water and electricity the machine uses in a typical day so you can check with your own utility company.

As Beth noted I discovered that our utility, Pacific Gas & Elecric (Northern California) gives a special allowance for home life support equipment. For us they initially doubled the “base allowance,” the number of kwH for which they charge the lowest rate. I did an analysis and discovered the allowance was just a bit short of my estimated actual use for dialysis machine & R/O. Their response was to double the special allowance which was more than I requested, but they make the medical allowance only in multiples of the base allowance. They then asked me if I wanted a medical allowance for natural gas. I pointed out I didn’t use gas in any of our equipment. They said that didn’t matter and increased our base allowance for natural gas for heating and hot water as well. The moral, I guess, is be sure to talk to your utility.

A related recommendation is to also ask if your utility offers “time of use” metering for electricity. In our case this reduced our kwH charge by about 15% in exchange for paying about 250% more for usage between noon and 6:00 PM from May 1 to November 1. For us it saves money – and most home dialysis use is outside the peak hours. Our only concession is to try to avoid running the clothes washer and dryer and the dishwasher during peak hours. We also try to be frugal with the A/C during that time.

Neither of these special utility billing programs has anything to do with your income. They have additional programs for low income people. With soaring utility rates every little bit helps!

Mel