Quick answer
Yes. ACA plans, job-based plans, Medicare and Medicaid all cover dialysis. People with kidney failure who need regular dialysis can qualify for Medicare at any age if they or a spouse or parent have enough work history, usually starting the fourth month of dialysis. You’ll still owe your plan’s deductible and coinsurance: with Original Medicare, 20% of the approved amount after the $283 Part B deductible in 2026.
Key takeaways
- Dialysis is covered by ACA plans, and insurers can’t deny you because of kidney disease.
- Medicare covers people of any age with permanent kidney failure who need dialysis or a transplant, if work requirements are met.
- If you also have job-based coverage, it pays first for the first 30 months of Medicare eligibility.
- People with kidney failure can join Medicare Advantage plans, but check that your dialysis center is in network.
- Medicaid can help with Medicare costs for people with limited income.
On this page
How dialysis is covered
| Coverage | What to know |
|---|---|
| Job-based plan | Covers dialysis; stays primary for 30 months after you become eligible for Medicare |
| Marketplace plan | Covers dialysis as an essential benefit; can’t deny you for kidney disease |
| Original Medicare | Part B covers outpatient dialysis at 20% coinsurance after the deductible; Part A covers inpatient dialysis |
| Medicare Advantage | Available to people with kidney failure; networks apply |
| Medicaid | Covers dialysis and can help pay Medicare premiums and coinsurance for those who qualify |
Medicare for kidney failure
Medicare usually starts on the first day of the fourth month of dialysis. If you train for home dialysis, it can start the month you begin regular dialysis. For a transplant, it can start the month you’re admitted for the transplant. See who is eligible for Medicare.
If you have job-based coverage, it pays first for 30 months, and Medicare pays second; after that, Medicare becomes primary. Think carefully before dropping your employer’s plan, since the two together can cover most costs. See is it cheaper to get health insurance through your employer.
What you’ll pay
With private insurance, dialysis usually meets your deductible and out-of-pocket maximum quickly; you’ll pay coinsurance until then. See how to meet your deductible and whether a high or low deductible is better. Stay with in-network dialysis centers; see what to do about out-of-network costs.
With Original Medicare, the 20% coinsurance has no yearly cap, so many people add Medigap (availability for people under 65 varies by state), Medicaid or a Medicare Advantage plan with an out-of-pocket limit.
Transplant coverage
Health plans and Medicare cover kidney transplants, including the donor’s costs in many cases; see what type of health insurance covers surgery. Medicare covers immunosuppressive drugs after a transplant.
If your plan is self-funded
Large employers’ self-funded plans follow federal rules but may differ on how they pay dialysis providers; see is self-funded health insurance right for you. Buying a plan outside the exchanges gives the same ACA protections. Going without coverage isn’t realistic with dialysis; see the worst that can happen if you get sick without health insurance.
Compare plans and their networks: see quotes by ZIP code. For more help, see comparing health insurance.
Frequently asked questions
Does Medicare cover dialysis for people under 65?
Yes, if you have permanent kidney failure needing regular dialysis or a transplant and meet the work requirements.
How much does dialysis cost with Medicare?
With Original Medicare, you pay the Part B deductible ($283 in 2026) and 20% of the approved amount for outpatient dialysis, unless you have supplemental coverage.
Can I keep my employer’s insurance if I get Medicare for kidney failure?
Yes. Your employer plan pays first for 30 months, then Medicare pays first.
Sources
This article is general information, not medical advice. Talk with your care team’s social worker about your coverage. Last reviewed September 2026.