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Health insurance for kidney dialysis
If you need kidney dialysis, both Medicare and private health insurance can help lower the costs.
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Medicare can cover kidney dialysis in Australia. However, the current Medicare benefit for home dialysis is only $129.70 (up to a maximum of 12 claims per year).
Luckily, private health insurance can help. All gold level policies must cover dialysis for chronic kidney failure, but some silver tiered policies will cover you too — we've listed them below.
Policies start at $160 and all have a 12 month waiting period, so consider buying now if you have chronic kidney failure.
How much is private health insurance with cover kidney dialysis?
Below you can find sample quotes from Finder partner funds. All policies include treatments for chronic kidney failure.
*Quotes are based on single individual with less than $90,000 income and living in Sydney.
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When you get your quotes on the next page, just click refine search and then choose kidney dialysis under hospital cover.
Contents of this guide
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 treatment | Top hospital | Medium hospital | Basic hospital |
|---|---|---|---|
Dialysis for chronic renal failure:
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Surgical procedures:
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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 progression | Physiological changes | Physical symptoms |
|---|---|---|
| Stage 1 |
| No symptoms |
| Stage 2 |
| Usually no symptoms |
| Stage 3 |
| In some cases no symptoms |
| Stage 4 |
| Abnormal function of organ systems |
| Stage 5 |
| 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:
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Full list of health funds that cover kidney dialysis
| Health fund | Which policies from these funds include cover for kidney dialysis? | Find out more |
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 Restricted fund** |
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 Restricted fund** |
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 Restricted fund** |
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*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.
Data last correct as of 21 Septemeber, 2019.
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