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Author Topic: Average Cost of Dialysis?!  (Read 13764 times)
cytoxin
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« on: January 25, 2011, 09:44:39 AM »

I just started Dialysis in November with what I thought was good private insurance, but now seeing the bills I wonder how anyone can afford to keep this up?  The surgery to put the catheter in cost about 1500 after insurance, and now I've gotten bills for EPO (670.00) and Dialysis Outpatient/Home (1,500.00) and that was just for 1 week.  The other bill for supplies said around 2,000.  These plus the costs of all the meds is getting crazy! 

How are people able to afford all this?! 
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cariad
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« Reply #1 on: January 25, 2011, 10:01:43 AM »

How are people able to afford all this?! 
They get Medicare. Have you applied for it yet?
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« Reply #2 on: January 25, 2011, 10:02:52 AM »

I just started Dialysis in November with what I thought was good private insurance, but now seeing the bills I wonder how anyone can afford to keep this up?  The surgery to put the catheter in cost about 1500 after insurance, and now I've gotten bills for EPO (670.00) and Dialysis Outpatient/Home (1,500.00) and that was just for 1 week.  The other bill for supplies said around 2,000.  These plus the costs of all the meds is getting crazy! 

How are people able to afford all this?!
Welcome to the forum.  Could you please introduce yourself in the introduction forum so that we may know your situation a little better, such as location, approximate age, gender, type of kidney disease and mode of dialysis?  http://ihatedialysis.com/forum/index.php?board=14.0

Member Zach has been helpful in tracking many aspects of dialysis including cost.  Here are some of the links to prior discussions.

Dialysis is expensive all over the world, but especially so in the US.  Quite often the for profit dialysis center will bill a huge number to you, say $60,000.00 a month and what they settled with the insurance company and/or Medicare is quite different, usually a magnitude lower, say $3000 a month.

Here are some "old" threads about dialysis cost:
http://ihatedialysis.com/forum/index.php?topic=154.msg660#msg660
http://ihatedialysis.com/forum/index.php?topic=1994.msg27668#msg27668
http://ihatedialysis.com/forum/index.php?topic=13273.msg229434#msg229434
http://ihatedialysis.com/forum/index.php?topic=1102.msg12803#msg12803
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Newbie caretaker, so I may not know what I am talking about :)
Caretaker for my elderly father who has his first and current graft in March, 2010.
Previously in-center hemodialysis in national chain, now doing NxStage home dialysis training.
End of September 2010: after twelve days of training, we were asked to start dialyzing on our own at home, reluctantly, we agreed.
If you are on HD, did you know that Rapid fluid removal (UF = ultrafiltration) during dialysis is associated with cardiovascular morbidity?  http://ihatedialysis.com/forum/index.php?topic=20596
We follow a modified version: UF limit = (weight in kg)  *  10 ml/kg/hr * (130 - age)/100

How do you know you are getting sufficient hemodialysis?  Know your HDP!  Scribner, B. H. and D. G. Oreopoulos (2002). "The Hemodialysis Product (HDP): A Better Index of Dialysis Adequacy than Kt/V." Dialysis & Transplantation 31(1).   http://www.therenalnetwork.org/qi/resources/HDP.pdf
Cordelia
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« Reply #3 on: January 25, 2011, 03:51:52 PM »

Yikes!   :o

No charge in Canada, I'm so thankful I live in Canada! :cheer: :yahoo;
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Diagnosed with Polycystic Kidney Disease at age 19.
Renal Failure at age 38 (2010) came about 2 hrs close to dying. Central line put in an emergency.
Began dialysis on Aug 15, 2010.
Creatine @ time of dialysis: 27. I almost died.
History of High Blood Pressure
I have Neuropathy and Plantar Fasciitis in My Feet
AV Fistula created in Nov. 2011, still buzzing well!
Transplanted in April, 2013. My husband and I participated in the Living Donor paired exchange program. I nicknamed my kidney "April"
Married 18 yrs,  Mom to 3 kids to twin daughters (One that has PKD)  and a high-functioning Autistic son
cytoxin
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« Reply #4 on: January 25, 2011, 08:05:02 PM »

How are people able to afford all this?! 
They get Medicare. Have you applied for it yet?

I had a phone call with someone from SS and they said about waiting 3 months or something and that it would cost approx 250 a month, since I'm already paying 260 a month for insurance, which is supposed to cover 80% of the dialysis costs, which would still leave 20% which is a lot since PD seems to cost atleast 10k a month!
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Bill Peckham
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« Reply #5 on: January 25, 2011, 08:48:41 PM »

So we're talking about the 20% not covered by your insurance?

Most of us who have Medicare as our primary insurer have a secondary insurer who pays all or some of the 20%. And when I say pay that is understanding that insurance policies have different copays and payment percentages and premiums. The thing that having Medicare does is that it sets a reasonable, allowed charge for the treatment.

Under the new Medicare payment each treatment generates $250 on average in allowed revenue (Medicare pays 80% and you or a secondary insurer are responsible for the 20%). By accepting that payment the unit is agreeing to not only safely provide the treatment, as per the Conditions for Coverage, but they are also being paid, among other things, to keep your hemoglobin between 10 and 12 and provide the medications you need to manage your bone health - zemplar, hectrol. A private payer can be charged just about any amount for the same services, and how much they pay depends on the insurer's buying power in the market, vs the units pricing power in the market.

There is an exception to the three month rule. If you enroll in a home training program, that three month waiting period is waived. You mentioned PD. If you started dialysis on PD you would immediately be Medicare eligible. I assume the $1,000/week is your 20% copay? 20% of the average Medicare approved charges for a week of PD would be $225, with an exception - Medicare payment policy is nothing but exceptions - in the first 120 days Medicare rates are increased by ~50%, thus your copays would increase 50%.

After the first 120 days there are other things that change the actual rate allowed by Medicare e.g. geography, age, certain other medical conditions, so the exact price could vary by ~20%.
« Last Edit: January 25, 2011, 09:15:38 PM by Bill Peckham » Logged

http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
tyefly
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« Reply #6 on: January 26, 2011, 12:45:55 PM »

  I hate that medicare is secondary for the first 30 months...since I have private insurance...   since I have started D.... my rates when up 38 percent....   I am now paying 541.00 for private insurance and 110.00 for medicare part B.... and roughly 260.00 per month for medications.....  And I am doing home Nxstage.... 

 I have tried to drop the medicare part B but was told that I would loose my insurance ....or my rates would go  up.....   I was also told that If I didnt have private insurance I would not beable to do Nxstage..

 I dont know if that is completely true....but....  I cant take the chance.....If this keep going  I will have to move out of my house and rent it out and live in a RV....    Where's   Harvey........LOL
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IgA Nephropathy   April 2009
CKD    May 2009
AV Fistula  June 2009
In-Center Dialysis   Sept 2009
Nxstage    Feb 2010
Extended Nxstage March 2011

Transplant Sept 2, 2011

  Hello from the Oregon Coast.....

I am learning to live close to the lives of my friends without ever seeing them. No miles of any measurement can separate your soul from mine.
- John Muir

The clearest way into the Universe is through a forest wilderness.
- John Muir
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« Reply #7 on: January 26, 2011, 04:11:26 PM »

Serious question. Do many Americans on dialysis emigrate to Canada to take advantage of the no cost procedure?. I am also lucky that in Australia, all dialysis costs are met by he government. Has been a push to compensate for travel costs.
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Started Hemodialysis Anzac Day 2005
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Started PD New Year 2010
Taken off transpalnt list, Jan 211
GraphicBass
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« Reply #8 on: January 26, 2011, 06:47:01 PM »

Wish I could emigrate to Canada (but it's a little cold for me) or Australia (that might be nice). It would certainly save me a ton of money to be a U.S. citizen living abroad, but I doubt if any progressive country would take me....

My insurance costs in Georgia are:

Primary private: $1,400/month
Primary copay and deductibles: About $400/month (meds, initial annual copay, etc.)
Medicare (just started in January): $158/month
Industry association membership (to qualify for group insurance): $100/month

So about $2,200/month just to keep me alive. Doesn't include wife or daughter, who are on separate policies. Thankfully, I'm still able to work in my business and bring in income, but the tide is rising fast! We're doing some serious consideration of dropping the primary, but don't want to do so until we know the downside of having Medicare only.

I was so disappointed by the failure of the public option for medical insurance last year. The United States doesn't even match so-called "third world" countries in providing health care for it's citizens.

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cytoxin
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« Reply #9 on: January 27, 2011, 06:20:44 AM »

I'm married to a German citizen and we are seriously considering moving to Germany for healthcare as an option in dealing with the costs.
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greg10
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« Reply #10 on: January 27, 2011, 10:16:08 AM »

I'm married to a German citizen and we are seriously considering moving to Germany for healthcare as an option in dealing with the costs.
Germany has an interesting health insurance system, with both private and public funded option, so you can choose.  Apparently by law, most of the health care insurance companies are not allowed to make a profit, although I couldn't confirm that in the wikipedia but the NYT article called them "some 200 .. non-profit .. funds".

http://economix.blogs.nytimes.com/2009/04/17/health-reform-without-a-public-plan-the-german-model/
"In Germany, statutory health insurance, which covers 90 percent of the population, is financed by a payroll tax. The individual’s premium is not a per-capita levy, as it is in the United States. It is purely income-based. Ostensibly, about 45 percent of the premium is contributed by employers, although economists are persuaded that ultimately all of it comes out of the employee’s take-home pay (See this and this).

An employee’s non-working spouse is automatically covered by the employee’s premium."
"Currently 85% of the population is covered by a basic health insurance plan provided by statute, which provides a standard level of coverage. The remainder opt for private health insurance, which frequently offers additional benefits. According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004."

http://en.wikipedia.org/wiki/Health_in_Germany
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Newbie caretaker, so I may not know what I am talking about :)
Caretaker for my elderly father who has his first and current graft in March, 2010.
Previously in-center hemodialysis in national chain, now doing NxStage home dialysis training.
End of September 2010: after twelve days of training, we were asked to start dialyzing on our own at home, reluctantly, we agreed.
If you are on HD, did you know that Rapid fluid removal (UF = ultrafiltration) during dialysis is associated with cardiovascular morbidity?  http://ihatedialysis.com/forum/index.php?topic=20596
We follow a modified version: UF limit = (weight in kg)  *  10 ml/kg/hr * (130 - age)/100

How do you know you are getting sufficient hemodialysis?  Know your HDP!  Scribner, B. H. and D. G. Oreopoulos (2002). "The Hemodialysis Product (HDP): A Better Index of Dialysis Adequacy than Kt/V." Dialysis & Transplantation 31(1).   http://www.therenalnetwork.org/qi/resources/HDP.pdf
Bill Peckham
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« Reply #11 on: January 27, 2011, 11:44:58 AM »

This Frontline is great and includes Germany among the five countires it profiles
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/view/
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
MooseMom
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« Reply #12 on: January 27, 2011, 12:25:13 PM »

I was so disappointed by the failure of the public option for medical insurance last year. The United States doesn't even match so-called "third world" countries in providing health care for it's citizens.

Sorry, but access to affordable health care was not addressed by the Constitution, so you don't have a right to it.  You have the right to carry a gun, but you don't have a constitutional right to dialysis.  You have a right to life, liberty and the pursuit of happiness, but not to health.  Of course, if you think that good health enables you to have life, liberty and happiness, well, that's just unpatriotic and unAmerican, you socialist, you. :sarcasm;
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"Empathy is the soul of democracy."  Jeremy Rifkin
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