Insurance and Kidney Disease: Keeping You Covered

When you have kidney disease, a good first step is to dive into insurance and understand your current benefits as well as the different options that may be available.

Be sure to relay all insurance coverage information to your healthcare provider or social worker so that they can properly review your needs and answer any questions you may have.

It is important that you understand your coverage and the impact a change in job may have on it. Stay on top of the most common insurance types and the circumstances that may change your coverage by getting the answers to these important questions.

What does insurance cover?

This is a very important question to ask, but one for which, unfortunately, there is no one answer. Insurance coverage and out-of-pocket costs can vary from plan to plan. Contact your current provider — or if you are insured through your employer, the point person for your health provider — to ask for a list of what is covered, such as doctor’s visits, medications and lab tests.

What if I change jobs?

Found your dream job? Great! Switching to a new job may mean a change-up in your insurance, but no need to worry. Speak to your new employer about insurance benefits they may offer. The Health Insurance Portability and Accountability Act (HIPAA) means you can’t be turned down for insurance because you have a “pre-existing” condition.

Quick Tip:If you are switching jobs and insurance, be sure to know when your current coverage stops and when your new coverage starts. If there is a gap in coverage, you may be able to work with your former employer, or your new employer, to cover it.

What if I lose my job?

If you lose your insurance coverage because of job loss or reduced hours, you may be able to keep your current coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA is the same health insurance you have through your employer group health plan, but be aware that your premium costs will increase when you elect COBRA. Speak with your social worker or insurance counselor to review programs that can assist in paying for these costs and services.

What if I don’t have insurance?

If you don’t currently have health insurance, or if you are nearing the end of your COBRA coverage, there are other health coverage options available.

• Medicare is a federal insurance program available to most people in the United States who are 65 or older, are disabled or have kidney failure (i.e., stage 5 kidney disease and need dialysis).
• Medigapplans, also known as Medicare supplements, are sold by insurance companies to cover all or part of the 20 percent “gap” that Medicare does not cover. Each state has different plans to choose from, with varying benefits and costs. Contact your state’s Department of Insurance or call 1-800-MEDICARE to learn which plans are available and if you are eligible.
• Medicaid is a state-funded medical assistance program that is based on financial need. You may qualify for Medicaid if you are 65 or older, are disabled, have dependent children, or have little income or savings. Programs vary from state to state and year to year. Your state may have a program to help pay for dialysis, medications and transportation. Speak with your social worker or state medical assistance office to determine what options are available to you.

Before switching insurance, consider that your coverage may change. Here are some things to consider as you look at other plans:

• What is covered?
• What's your financial responsibility with the new plan?
• When does the new coverage begin? Is there any gap when you may not be covered?
• How does the new plan affect dependents that are covered on your current insurance plan?

DaVita has insurance specialists and experienced social workers who can assist you in reviewing your insurance information. Contact an insurance specialist today by calling 1-855-534-2597or visiting DaVita.com/IMT.