Managing Finances With Chronic Kidney Disease
Reviewed by: HU Medical Review Board | Last reviewed: February 2023
Managing chronic kidney disease (CKD) can be expensive, especially if you need dialysis or a kidney transplant. That is why financial hardship is common among people who have CKD. Most people need extra help paying for their care once their kidneys have failed.1,2
One of the things that makes kidney disease expensive is that it often must be treated along with other health conditions. The most common are diseases like diabetes and high blood pressure.2
A 2021 national study of adults ages 18 to 64 found that high medical bills from CKD led to:2
- Distress about paying bills
- Choosing between eating and paying bills (food insecurity)
- Skipping doses of medicine to make prescriptions last longer, or avoiding filling needed prescriptions
- Delayed care or avoiding care altogether
This study also found that nearly half of people with CKD faced financial hardship. In fact, 1 in 5 could not pay their medical bills. These experiences were worse for people without insurance, low-income people, and people living with multiple health conditions. But even people with insurance faced problems paying all the costs of living with kidney disease.2
Common out-of-pocket costs
Healthcare costs for chronic kidney disease can add up quickly. Even if you have insurance, you will still need to pay your share of:1
- Doctor's visits and tests (called a co-pay)
- Deductibles (the amount you have to pay before your insurance begins to pay)
A 2017 study found that median out-of-pocket costs for adults with CKD who were not on dialysis were $1,439 per year. These out-of-pocket costs were higher than those of people with cancer who did not have CKD. They were also higher than those of people who had had a stroke but did not have CKD.3
Programs that help pay for treatment
Since people can live for years with kidney disease, it is important to find help paying for treatment. Insurance is the most common way to reduce costs. Options include:1
- Medicare – Government insurance for people 65 and older, those on disability, and those with end-stage kidney disease who need a transplant or dialysis (even if younger than 65)
- Medicaid – Government insurance for children and families with low incomes, pregnant people, and people with disabilities
- Social Security Disability Insurance and Supplemental Security Income – SSDI and SSI are government programs that provide income to people who cannot work for long periods of time.
- State programs – Most states have programs that help people with kidney disease pay for treatment. Visit shiptacenter.org to learn about programs in your state.
- Private insurance – Insurance provided by an employer or union, or bought by the individual on the open market on HealthCare.gov.
Getting health insurance is more complicated than buying other types of insurance. It can take days or months to find a plan that covers your specific healthcare needs. If you are not already covered, sign up for a plan as soon as possible to avoid treatment delays.4
Paying for medicine
If you have concerns about paying for all the drugs you need to take, the first step is to talk with your doctor. They may be able to prescribe less expensive drugs or suggest other options to lower your costs.1
There are also several drug discount programs that may help you get medicines at a lower cost or for free. These include:1
- Medicine Assistance Tool
- State Pharmaceutical Assistance Program
Tips for finding care when you need it
Doctors who care for people with kidney disease (nephrologists) and dialysis centers often have social workers on staff. These are professionals who help people with CKD find care they can afford. Your kidney social worker may help you learn easier ways to keep track of your care and finances.4
Tips to avoid delays in care include:4
- Talk to your doctor right away if you notice any new or worsening symptoms. The sooner you get treated, the more likely you are to avoid costly complications and the better your health will be.
- Track the names and phone numbers of the people you speak with about your health and your insurance.
- Keep all records and paperwork related to your treatments, prescriptions, finances, and insurance.
- If you work and your company is large enough, you may be able to use the Family and Medical Leave Act (FMLA) to take time off for doctor's appointments, dialysis treatments, and more. FMLA benefits may help you keep working while you receive CKD care.
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