I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Traveling Tips and Stories => Topic started by: gothiclovemonkey on June 27, 2016, 05:42:03 AM
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Hello,
With all of the planning going on for the meetup, I was wondering if anyone could tell me how much out of pocket cost dialysis is in vegas per treatment? When you have medicare (and medicaide)?
Just to kind of gauge whether or not one could afford the trip.
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Medicare pays 80% of the treatment cost, and medicaid should pick up the rest. The good news is that Medicare pays the lowest rate for dialysis - about $248 per treatment, so that 20% is about $50. The nephrologist gets about $8 to write the orders for each treatment and I think that is covered at 80% as well.
I recommend Desert Valley Inn dialysis in Las Vegas. It's at the north end of the strip near the Stratosphere (slightly NE of the hotel), and despite its name, is a stand alone rather large facility.
Forgot to mention: Medicare does not cover any treatments outside the US with the possible exception of US territories
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Medicaid usually will not reimburse outside of the state.
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I have never been charged for dialysis while traveling and I have been a few places in the US.
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Medicaid usually will not reimburse outside of the state.
I think the key here is Bill is talking about Medicaid not Medicare. I didn't make that distinction the first time I read his comment.
From what I've read Medicare works across the US, and doesn't work outside of the US. i.e. https://www.kidney.org/atoz/content/traveltip
Other sites say Medicaid will not pay out of state, for example in Ohio:
http://www.ckcdialysis.com/www/docs/125/transient-patients
If you have Ohio Medicaid, it will only pay for routine dialysis in OH. If you travel out of OH you will need to pay the out of town dialysis center any amount that Medicaid would normally have been charged. They usually want this payment prior to your dialysis appointment.
So I think that means you must be prepared to pay your Medicare copays yourself if Medicaid covers them normally.
This has a good description:
http://www.ckcdialysis.com/www/docs/125/transient-patients
•INSURANCE COVERAGE during your travel:
◦Medicare will cover 80% of your treatment costs within the U.S. and its territories.
◦Secondary insurance will cover the remaining 20%. Some policies may require you to pay that up front and bill the insurance later.
◦Most state Medicaid programs will not pay for treatment outside of your home state. If you have Medicaid as a secondary policy and choose to travel, you will likely have to pay your share (20%) up front.
◦Private or Employer Group policies will require prior approval for treatments away from your home facility.
◦Your social worker or “transient coordinator” will be able to tell you ahead of time what your financial obligations will be.
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I also have Medicaid from Illinois and they do not pay out of state. However, talk with your caseworker for wiggle room possibility. I was able to get them to payout of state pharmacy for a bit when I first had mytransplant. It was rocky to do back then. If you have a goodand nice caseworker it maybe worth sitting in the office to ask them than over the phone. You might want to use that your going to a funeral and not a meeting of friends. Hope you can make it again.