HD at home

I currently have dialysis at a center and would like to do it at home. If insurance normally covers all expenses at the center would it cover it if I did it at home? I have called several times and they keep giving me the run around and I am unable to get an answer out of them.

Hi, does your clinic now offer nocturnal? Our clinic picks up the difference.
Where are you from? Have you thought of the Nxstage. I would keep bugging them. Do dialysis at home is so much better.
Can you give us some more info so others can jump right in and answer.

In most cases, an insurance plan that covers in-center treatment will also cover it at home. Sometimes different arrangements need to be made as far as coverage networks, etc., depending on which companies your health plan has contracts with. If you have a case manager, you might ask to talk with that person.

If you do reach someone who seems to have a clue, and they need more information about home dialysis, please feel free to refer the person to us at the Medical Education Institute. We’re happy to talk with them, and it wouldn’t be the first time.

Well I guess i found out my answer. This is there answer. I am really surprised at this because I am fortunate enough to have the best insurance coverage probably in all of Ohio.

>The only dialysis that would be covered at home is peritoneal dialysis.
>If that is what you are referring to then yes, it would be covered but
>OSUMHC would need to know who is providing the supplies for you to use.
>Conventional hemodialysis is not covered in the home setting unless you
>were completely homebound. The best thing would be for you to call me
>directly so that I can answer your questions.

There are centers in Ohio that offer home hemo dialysis. I think you should call one of them and ask to talk to the Nurse in Charge of the home hemo program. I think someone is giving you wrong information. If you decide to do home hemo, you’ll need a center that offers it.


Neil, who was that quote from - your insurance company or your current dialysis provider? I’m not sure why the insurance company would choose to deny you a healthier option - was that quote from someone at your dialysis unit?

I notice that they didn’t mention daily or nocturnal home hemo. I suggest that you call the person and ask about those treatments, and get a name and phone number. We can explain the other options to this person. Also feel free to give the person you talk to this website.

If you have Medicare, it covers dialysis in-center and it covers 3 HD a week at home routinely – more if they are medically justified. It can pay as a primary insurer or as a secondary insurer when someone has an employer group health plan (EGHP). If the EGHP denies coverage, Medicare will become the primary payer. However, as primary payer, Medicare only pays 80% of the allowed charge for dialyisis.

If you have other insurance, your policy may say that it covers one type of dialysis or another. However, with prior authorization (medical justification), usually insurance plans will cover home dialysis. Some realize that it is more cost effective to cover home dialysis than in-center dialysis because home patients generally have fewer hospitalizations and access surgeries and may need fewer drugs to stay healthy.

Like Dori said, we’re always happy to advocate with insurance companies and providers to help patients get home dialysis. The Renal Network (http://www.therenalnetwork.org/) may also be able to help advocate for you. I worked with the ESRD Network of New England and we helped a patient get approval from her HMO for home hemo.

I am still working on getting home hemo. I have asked my doc to look into. I might have to transfer to a unit that performs the training. Do i have to use what machine they tell me to use. We use the large machines at the center and I don’t want to have to have that huge thing in my home. Plus i have read where many machines now don’t require any modifications to pumbing or electiric.

Hi Neal,

Many programs–but not all–offer smaller, easier to use machines that were designed to be used at home (not in a center). You will have to use whatever machines your program has, since the staff are trained to train you in how to use them. Sometimes there is more than one option. You may as well see what the other center has and then look around further if you’re not finding what you want.

Recently there was an announcement that DaVita has bought 7% of NxStage and the machines its patients have been using. It sounds like DaVita is planning to use more of these machines in its DaVita at Home (home hemo) program. The NxStage machine is the one that is small and doesn’t require home modification. Most people using the NxStage machine do short daily dialysis 5-6 days a week, but some are using it to do nocturnal dialysis 5-6 nights a week. Medicare pays routinely for 3 treatments a week (may pay for more with medical justification). Some other insurance companies may pay for more treatments with a doctor’s prescription. You might want to see if there are any DaVita clinics in your area that say on our database (see Find a clinic in your area from the Home Dialysis Central home page) that say they train patients for daily or nocturnal home hemo. The number of clinics offering these treatment options is growing.

I talked to the social worker and they are halting training for home hemo. So i was never able to validate if my insurance covers home hemo. They stopped training because the people who were training for home hemo complained that there water bill was sky high. I told him that was not an issue for me and I would be willing to pay for it. He told me that he will let the trainers know that but at this point though they are still certified for training they no longer are doing it for the time being.

I’ve been using the Pure Flow since September and I haven’t noticed any significant difference in my water bill. Sixty liters isn’t enough to fill a bathtub.

How does the cost of 60L of water compare to the cost of gas to get to the dialysis unit and back?

Has anybody else noticed a difference in their water bill? Pat, I know you make 60L a day. How’s your water bill?

If water costs are an issue, it might also be worth seeing if your town’s water utility has a special rate for life-saving medical need. They might be willing to offer a discount. It’s not as if you’re filling a swimming pool, after all, and there’s nothing to lose by asking.

I am just frustrated that this entire situation. It is not in my personality to rely on someone else for treatment. I am to involved in my care to let it be in the hands of someone else. I was on PD before and was fine. Now that I am on HD I don’t feel as well as I did when I was on PD. I know that if i can do hemo at home I can feel better. I have to miss work and have to make it up on weekends. I am able to do this from home but I am still very active and this cuts in to my time for my family. I could not even get them to install internet access at the dialysis center. It just seems they don’t want to do that because it would cost them money. I am not the only one who can use the access. I guess I am just tired of venting to my wife and needed to vent to others. To have them tell me that my water bill would be to high seems to be lame excuse. I myself would not be able to put a price on feeling healthy.

Where do you live, Neal?

Columbus Ohio

Hi Neal,

There are a total of 11 centers in Columbus, OH that offer some type of home dialysis, and 6 have some form of home HD. Here are the search results I got from our “Find a Center” database: http://www.homedialysis.org/locate/search_results.php?clinic_name=&clinic_city=Columbus&clinic_state=OH&clinic_zip=&clinic_owner=&form_action=search.

Only one (Mid-America) currently says it offers daily home HD (this would use the small, NxStage machine). But the Fresenius centers offer nocturnal home HD, which is an excellent treatment that would leave your days free for working, and the DaVita centers may be able to offer you daily home HD if you call and ask them.

We have not gotten our water bill since starting Pureflow.
But I can tell it will be a lot less.
As soon as we do I will let you know how it is.
I know when we were using the Freni it was expensive but well worth it.