Portrait of young male dialysis patient holding glass of crushed ice during renal dialysis at hospital

Health insurance for dialysis patients

Do you require health insurance for chronic kidney disease and dialysis? Find out what your policy options are and get covered.

Chronic kidney disease is any problem or condition leading to reduced kidney function lasting for more than three months, which generally requires a treatment called dialysis to manage it. Dialysis replaces the function of the kidneys by removing waste products and fluids from the body, and can be performed either in a hospital or at home.

Compare policies that cover kidney dialysis

Funds from the finder.com.au panel that cover kidney dialysis

Health fundWhich policies from these funds include health insurance for dialysis patients?Find out more
HIF Logo
  • Hospital only policies
    • GoldStar Hospital
    • Gold Hospital
    • GoldSaver Hospital
    • GoldStarter Hospital
More info
health.com.aulogo
  • Hospital only policies
    • High Hospital
  • Combined hospital + extras policies
    • High
More info
ahm
  • Hospital only policies
    • Top Hospital
    • White Deluxe
  • Combined hospital + extras policy
    • Black + White Deluxe Flexi
More info
Australian Unity
  • Hospital only policy
    • Gold Hospital
  • Combined hospital + extras policies
    • Smart Combination
    • Smart Start (restricted benefit*)
More info
GMHBA
  • Hospital only policy
    • Gold Hospital
More info
HCF
  • Hospital only policy
    • Premium Hospital
More info
nib
  • Hospital only policies
    • Top Hospital
    • Advantage Hospital
More info
Transport Health Logo
  • Hospital only policies
    • Top Hospital
    • Top Hospital with Excess
    • Top Hospital with Co-Payment
More info

*Benefit only applies if you are treated as a private patient in a public hospital. If you attend a private hospital you will incur significant out-of-pocket expenses for your treatment. Products subject to change. 

How is chronic kidney disease and dialysis covered?

There are several ways for you to potentially receive benefits for chronic kidney disease and dialysis, both through the public and private health systems.

  • Medicare. The government funded health system includes dialysis treatment in the Medicare Benefits Schedule (MBS).
  • Medicare Chronic Disease Management Plan (CDM). If you are suffering from kidney disease for six months or more and require ongoing, structured care, your GP may suggest a CDM plan, and you may be eligible for rebates to cover the ongoing cost of your treatment.

Below you can see the various types of dialysis treatment and surgical procedures covered by Medicare.:

  • Dialysis for chronic renal failure
    • Haemodialysis
    • Haemofiltration
    • Haemoperfusion
    • Peritoneal dialysis
  • Surgical procedures
    • Explorative kidney surgery
  • Private health insurance. The amount of cover you receive for kidney related treatments will depend on how comprehensive your hospital insurance is:
    • Top hospital policies must pay a benefit for all procedures covered under the MBS, which includes dialysis.
    • Medium hospital policies may include dialysis treatment and renal surgery but will only pay a restricted benefit.
    • Basic hospital cover generally excluded dialysis treatment and renal surgery.

You can use the table below as a quick reference for seeing which levels of health insurance fully and partially cover, or exclude, kidney related treatments:

Kidney treatmentTop hospitalMedium hospitalBasic hospital
Dialysis for chronic renal failure:

  • Haemodialysis
  • Haemofiltration
  • Haemoperfusion
  • Peritoneal dialysis
  • This policy type should always include cover
  • May be partially covered with a restricted benefit
  • Typically excluded
Surgical procedures:

  • Explorative kidney surgery
  • This policy type should always include cover
  • May be partially covered with a restricted benefit
  • Typically excluded

Can I access my superannuation early to pay for treatment?

Early access to preserved superannuation is available in the event of financial hardship. Superannuation savings can help pay for the cost of chronic kidney disease treatment if:

  • You have been receiving Centrelink benefits for six months or longer and you can no longer pay your living expenses.
  • You need your superannuation to cover loan payments so you can keep your home.
  • You require palliative care resulting from chronic kidney disease.

If your superannuation fund includes benefit payments for total and permanent disablement, you can claim these if your chronic kidney disease prevents you from returning to your regular job. You may also be able to claim a disability benefit lump sum if your chronic kidney disease reaches stages four or five and you have to stop work.


Any other insurance options I can make use of?

Additional sources of financial support may be available to you if you are undertaking home dialysis treatment. These include:

  • Water and electricity cost reimbursement from the state government.
  • Centrelink Sickness Allowance.
  • Centrelink Carers Payment – Long-term Dialysis Support.
  • Centrelink Essential Medical Equipment Payment.
  • Paid sick leave from your employer.

What are the five stages of chronic kidney disease?

Chronic kidney disease has five stages. Stages one to three can be managed with medication, while stage five is the most severe and requires a kidney transplant or ongoing dialysis treatment.

Disease progressionPhysiological changesPhysical symptoms
Stage 1
  • No decrease in GFR*
No symptoms
Stage 2
  • Small reduction in GFR*
  • Defects in other organ systems
  • High blood pressure
Usually no symptoms
Stage 3
  • Significant reduction in GFR*
  • Defects in other organ systems
  • High blood pressure
  • Increase in proteins in urine
In some cases no symptoms
Stage 4 
  • Significant reduction in function of kidneys
  • Defects in other organ systems
  • High blood pressure
  • Significant increase in proteins in urine
Abnormal function of organ systems
Stage 5
  • Kidney failure
Abnormal function of organ systems, fatigue, swelling, change of skin colour

*GFR: Glomerular Filtration Rate is an indicator used to measure kidney function.


What are the common treatments for kidney related ailments?

Chronic kidney disease treatments vary based on the severity of the condition. However, patients suffering end-stage kidney disease (ESKD) will require kidney replacement therapy (KRT). Haemodialysis and peritoneal dialysis are two types of KRT treatments:

  • Haemodialysis. Although this can be done at home with assistance, haemodialysis is generally carried out at a medical facility. A patient’s blood is filtered using an external machine and transferred back into the body. Patients requiring this type of treatment may be required to visit a hospital or clinic multiple times per week and the procedure can last up to six hours each session.
  • Peritoneal dialysis. This type of dialysis is performed in the home and can be done by the patient. Unlike haemodialysis, peritoneal dialysis filters the patient's blood using PD fluid in the stomach. Two types of peritoneal dialysis exist:
    • Home continuous ambulatory peritoneal dialysis (CAPD), which is performed during the day.
    • Home automated peritoneal dialysis (APD), which is performed overnight while the patient is asleep.

What are the symptoms of reduced kidney function?

Chronic kidney disease can often go undetected in the early stages due to lack of or few symptoms. Some symptoms are indicative of kidney failure, while other symptoms such as high blood pressure can be confused with other conditions. Symptoms can include:

  • Kidney pain
  • High blood pressure
  • Headaches
  • Swelling in the legs and ankles
  • Change in the frequency and appearance of urination
  • Bad breath and a metallic taste in the mouth
  • Disturbed sleep and tiredness
  • Appetite loss and problems concentrating

Some sobering statistics relating to chronic kidney disease

The number of Australians suffering from chronic kidney disease is unfortunately on the rise. There are more than three times the number of cases today than there was in the early 90’s. The Australian Institution for Health and Welfare provides some concerning statistics surrounding the rates of chronic kidney disease:

Compare health insurance that covers chronic kidney disease with help from an adviser

Full list of health funds that cover kidney dialysis

Health fundWhich policies from these funds include cover for kidney dialysis?Find out more
ahm
  • Hospital only policies
    • Top Hospital
    • White Deluxe
  • Combined hospital + extras policy
    • Black + White Deluxe Flexi
More info
Australian Unity
  • Hospital only policy
    • Gold Hospital
  • Combined hospital + extras policies
    • Smart Combination
    • Smart Start (restricted benefit*)
More info
Bupa
  • Hospital only policies
    • Top Hospital
    • Standard Hospital (restricted benefit*)
    • Budget Hospital (restricted benefit*)
  • Combined hospital + extras policies
    • Ultimate Health Cover
    • Prime Plus
    • Established Family
    • All other Bupa combined policies have restricted benefits*
More info
cdhlogo
  • Hospital only policies
    • Gold Hospital
    • Silver Hospital
    • Bronze Hospital
    • Thrifty Hospital (restricted benefit*)
  • Combined hospital + extras policy
    • Smart Cover
More info
cua
  • Hospital only policies
    • 100% Private Hospital Cover
    • 90% Private Hospital Cover
    • 75% Private Hospital Cover
    • Public Hospital Cover (restricted benefit*)
More info
GMHBA
  • Hospital only policy
    • Premium Hospital
More info
Frank
  • Hospital only policy
    • Best Hospital
More info
gmflogo
  • Hospital only policy
    • Complete Hospital
More info
HBF
  • Hospital only policy
    • Top Hospital
More info
HCF
  • Hospital only policy
    • Premium Hospital
More info
health.com.aulogo
  • Hospital only policies
    • High Hospital
  • Combined hospital + extras policies
    • High
More info
HIF Logo
  • Hospital only policies
    • GoldStar Hospital
    • Gold Hospital
    • GoldSaver Hospital
    • GoldStarter Hospital
More info
 medibank
  • Hospital only policies
    • Top Hospital
    • Top Hospital Essentials
  • Combined hospital + extras policies
    • Ultra Health Cover
    • Security Comprehensive
    • Growing Family Comprehensive
    • Everyday Comprehensive
More info
mildurahealthfundlogo
  • Hospital only policies
    • Five Star Hospital
    • Basic Hospital (restricted benefit*)
More info
onemedifundlogo
  • Hospital only policies
    • Private Plus Hospital
More info
nib
  • Hospital only policies
    • Top Hospital
    • Advantage Hospital
More info
peoplecare provider page link
  • Hospital only policies
    • Premium Hospital
    • Mid Hospital (restricted benefit*)
More info
phoenix health fund provider link
  • Hospital only policy
    • Top Hospital
  • Combined hospital + extras policies
    • Top Cover
    • Value 500
More info
St. Lukes Health Logo
  • Hospital only policies
    • Hospital Platinum
    • Hospital
    • Budget 500 (restricted benefit*)
  • Combined hospital + extras policies
    • Platinum Plus
    • Platinum
    • Gold
    • Silver
    • Packaged Bronze Plus
    • Packaged Budget 500 (restricted benefit*)
More info
Transport Health Logo
  • Hospital only policies
    • Top Hospital
    • Top Hospital with Excess
    • Top Hospital with Co-Payment
More info
CBHS Health Fund LogoRestricted fund**
  • Hospital only policies
    • Comprehensive Hospital
    • Active Hospital
    • Limited Hospital
    • Basic Hospital (restricted benefit*)
  • Combined hospital + extras policies
    • Prestige
    • StepUp
    • KickStart (restricted benefit*)
More info
defencehealthlogoRestricted fund**
  • Hospital only Policy
    • Premier Hospital
More info
navyhealthlogoRestricted fund**
  • Hospital only policies
    • Premier Hospital
    • Healthy Hospital
    • NT Hospital (Northern Territory only)
    • NT Hospital 300 (Northern Territory only)
More info
policehealthlogoRestricted fund**
  • Hospital only policy
    • Top Hospital
  • Combined hospital + extras policies
    • Platinum Plus
    • Platinum Health
More info
teachersRestricted fund**
  • Hospital only policies
    • Top Hospital
    • Mid Hospital (restricted benefit*)
    • Basic Hospital (restricted benefit*)
More info
tuhRestricted fund**
  • Hospital only policy
    • Total Care Hospital
  • Combined hospital + extras policies
    • Ultimate Choice
    • Easy Choice
More info

*Benefit only applies if you are treated as a private patient in a public hospital. If you attend a private hospital you will incur significant out-of-pocket expenses for your treatment.
**Restricted funds only provide cover to members of specific industries, groups and organisations. In some cases family members may also be eligible to join.

Compare health insurance that covers chronic kidney disease with help from an adviser

Picture: Shutterstock

Jacob Joseph

Jacob is a writer and video journalist with finder.com.au. Credit cards, personal loans and savings accounts are his bread and butter, and he likes nothing more helping people understand the sometimes overly complex world of personal finance.

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