Living with renal failure is exhausting, not just physically and emotionally, but financially as well. Between the costs of regular dialysis treatments, prescription medications, and the potential for a kidney transplant, many patients find themselves struggling to keep up with mounting health care expenses. For those navigating the complexities of end-stage renal disease (ESRD) or kidney failure, understanding the options for financial assistance can make a world of difference.
The good news is that help is available. From Medicare coverage and health insurance premiums to charitable organizations and solutions like viatical settlements, there are resources to help kidney patients manage the cost of care.
The Financial Challenges of Kidney Disease
Managing kidney disease or end-stage renal disease (ESRD) can place an enormous financial strain on patients and their families. The costs of dialysis treatments, hospital stays, and medications quickly add up, often leaving patients feeling overwhelmed. According to the National Kidney Foundation, the average cost of dialysis services can exceed $90,000 per year, while a kidney transplant can cost over $400,000, including pre-surgery and post-surgery care.
For many, dealing with the intricacies of health insurance and out-of-pocket expenses adds another layer of stress. Even with Medicare benefits or private health insurance, patients may face high health insurance premiums, yearly deductibles, and additional costs for prescription drugs not covered by their plans. Medications can be expensive, with annual costs potentially exceeding $10,000.
Unfortunately, these financial challenges often coincide with periods when patients are unable to work, further reducing their income and ability to cover these significant health care expenses. For those with limited income, accessing financial assistance becomes an important safety net. Programs like Medicare Part B, state kidney programs, and aid from organizations such as the American Kidney Fund can provide some relief, but understanding these resources often requires the help of a social worker or a knowledgeable advocate.
While these systems offer some support, many kidney patients still find themselves trouble paying for necessary care. This is where additional options, such as viatical settlements, can make a meaningful difference by providing immediate financial assistance.
Viatical Settlements
For kidney patients facing mounting medical bills and reduced income, traditional forms of financial assistance may not always be enough. This is where viatical settlements offer a unique and impactful solution. A viatical settlement allows you to sell your life insurance policy to a private company in exchange for a lump sum of cash. This immediate access to funds can provide significant relief, especially for those struggling to cover costs like dialysis services, prescription drug coverage, or the expenses of a potential kidney transplant.
How Do Viatical Settlements Work?
If you qualify for a viatical settlement, you can sell your life insurance policy for a percentage of its face value. Unlike traditional insurance payouts, which are only available after the policyholder passes away, viatical settlements let you access this money while you’re alive, offering financial flexibility when you need it most.
Key Considerations:
- The percentage payout depends on factors such as:
- The insured’s life expectancy (shorter life expectancy typically leads to a higher percentage payout).
- The policy terms (type of policy, premiums, and coverage details).
This lump-sum payment can provide immediate financial relief to cover medical bills, living expenses, or other essential expenses without restrictions on usage. By opting for a viatical settlement, patients avoid the need to apply for multiple assistance programs and provide a substantially higher amount of money, streamlining your access to a large sum of immediate funds.
Why Consider a Viatical Settlement?
- Immediate Cash: Funds can be used for any purpose, paying off health care costs, handling daily expenses, or simply easing financial stress.
- No Restrictions: Unlike other forms of financial aid, viatical settlements are not limited to specific uses.
- Empowerment in a Difficult Time: For patients who feel stressed by rising health care expenses, this option offers a sense of relief and security.
Government-Sponsored Financial Assistance Options
The U.S. government offers programs to help kidney patients manage the high costs of dialysis treatments, kidney transplants, and other health care expenses.
Medicare for ESRD Patients
Patients with end-stage renal disease (ESRD) or permanent kidney failure can qualify for Medicare benefits regardless of age. Key features include:
- Inpatient Services: Covers hospital stays for treatments like kidney transplants or dialysis after meeting a deductible of $1,632 per benefit period in 2024 (Medicare Interactive).
- Coinsurance: For hospital stays beyond 60 days, daily coinsurance applies.
- Outpatient Services: Covers outpatient dialysis treatments and doctor services.
- Costs: After the annual deductible, typically $226 in 2024, Medicare covers 80% of approved costs, leaving patients responsible for the remaining 20%.
- Example: If outpatient dialysis costs $500 per session, Medicare would pay $400, and the patient would owe $100 per session.
As of January 1, 2023, individuals whose Medicare entitlement based on End-Stage Renal Disease (ESRD) ended 36 months after a successful kidney transplant may be eligible for the Medicare Part B Immunosuppressive Drug (Part B-ID) benefit. This benefit provides coverage solely for immunosuppressive drugs (CMS).
Premiums and Costs: The monthly premium for Part B-ID is $97.10 in 2023. Beneficiaries are also responsible for the annual Part B deductible and 20% coinsurance for immunosuppressive drugs.
Travel Expenses for Treatment
Managing the financial aspects of renal failure involves significant expenses, particularly for treatments, medications, and associated travel. Here’s a breakdown of these costs and available assistance programs:
- Cross-Country Travel Costs:
- Airfare: Domestic flights within the U.S. can range from $75 to $300 per person, depending on factors like distance and booking time (Nonprofit Point).
- Additional Expenses: Costs for lodging, meals, and local transportation can add up, especially for extended treatment periods.
- Assistance Programs:
- Mercy Medical Angels: Provides free or discounted air transportation for patients requiring distant medical care.
- National Patient Travel Center: Facilitates charitable medical air transportation across the U.S. (Cares Foundation).
- HealthWell Foundation: Offers copayment assistance for travel expenses related to treatment (Health Well Foundation).
Employer and Private Health Insurance Options
For some kidney patients, employer group plans or private health insurance can help cover health care costs, including dialysis treatments and prescription drugs. Employer plans often work alongside Medicare, with one acting as the primary payer during a coordination period.
If you’re covered by a private health insurance plan, reviewing your benefits to make sure coverage for necessary services is key. Speak with a benefits administrator to clarify how your plan aligns with Medicare.
Support from Charitable Organizations
For many kidney patients, charitable organizations offer a safety net when health care costs become unmanageable. These groups provide financial assistance, resources, and emotional support to help ease the burden of living with end-stage renal disease (ESRD) or kidney failure.
American Kidney Fund
The American Kidney Fund helps patients with limited income by providing grants to cover essential expenses like health insurance premiums, transportation to dialysis treatments, and medications. They also offer resources to navigate financial aid programs.
Health Insurance Premium Program (HIPP): AKF provides grants to help patients cover the cost of health insurance premiums, including Medicare Part B, Medigap, employer group health plans, and COBRA. The grant amount corresponds to the actual premium cost, which can vary based on the specific insurance plan.
Safety Net Grant Program: This program offers grants of up to $200 per year to assist with health care expenses not covered by insurance, such as transportation to dialysis, over-the-counter medications, and other necessities.
National Kidney Foundation
The National Kidney Foundation provides educational materials, advocacy programs, and financial resources for patients managing kidney disease and permanent kidney failure. Their support extends to both patients and caregivers, guaranteeing access to important information and services.
Local Charities and Nonprofits
In addition to national organizations, many local charities partner with dialysis centers and health care providers to offer financial aid, free services, and even help with day-to-day needs. Speaking with a social worker or patient advocate can help connect you to these resources.
Additional Ways to Reduce Health Care Costs
In addition to insurance and charitable programs, there are practical strategies kidney patients can use to lower their health care costs and manage expenses more effectively.
Work with Health Care Providers
- Many health care providers and dialysis centers offer payment plans or sliding scale fees based on income.
- Transplant centers may assist in coordinating lower-cost services for patients undergoing a kidney transplant.
Seek Financial Aid from Drug Manufacturers
- Some pharmaceutical companies provide financial aid programs to reduce prescription drug costs for eligible patients. Ask your doctor about options or visit drug manufacturers’ websites for details.
Explore Local and State Programs
- Beyond state kidney programs, many states offer financial assistance for transportation, medication, and home care. These resources often work in conjunction with Medicare or private insurance.
Leverage Secondary Coverage
- If you have multiple forms of insurance, make sure they’re coordinated to maximize coverage. Programs like Medicare often work as a secondary payer, helping to offset costs your primary insurance doesn’t cover.
Finding Financial Relief for Kidney Patients
Living with end-stage renal disease (ESRD) or kidney failure comes with significant emotional and financial challenges. While programs like Medicare, state kidney programs, and support from organizations like the American Kidney Fund provide much-needed assistance, many patients still face gaps in coverage for health care costs, prescription drugs, and daily expenses.
Viatical settlements offer an immediate and flexible solution for kidney patients seeking financial stability. By accessing the value of your life insurance policy, you can relieve the stress of mounting bills and focus on your health, well-being and family.
If you’re ready to explore how a viatical settlement can provide financial relief, our team at American Life Fund is here to help. Call us today at 877-261-0632, or click here to learn more. Together, we can help you find the financial peace of mind you deserve.