What dialysis costs if you have no insurance

What dialysis is and how often you need it

MedlinePlus, a health site from the National Library of Medicine, says dialysis treats kidney failure. It removes waste from your blood when your kidneys can no longer do the job. In hemodialysis, your blood passes through a filter that cleans it, and then the clean blood returns to your body.

MedlinePlus says most people have hemodialysis at a treatment center, about three times a week for 3 to 4 hours each time. Some people can have it at home instead. You do not have to buy the home machine. MedlinePlus says Medicare or your health insurance pays for most or all of the cost, at home or in a center.

What one treatment costs

Most dialysis clinics do not post a price for people who pay on their own. We found no government list of cash prices either. The best public number comes from Medicare, the federal health plan for people 65 and older and some younger people with disabilities. Medicare makes one payment per treatment to the dialysis clinic. That payment covers the equipment, the supplies and the related care.

The Centers for Medicare and Medicaid Services set the 2026 base rate for that payment at $281.71 per treatment. The base rate is adjusted for each patient and for the local area, so real payments differ. Three treatments a week make 156 a year. At the base rate that adds up to roughly $44,000 a year. That is our own math, and it leaves out doctor visits, medicines and hospital stays.

The Medicare rate is not a cash price. MedPAC is a group that advises Congress on Medicare. It says private insurers generally pay dialysis clinics much more than Medicare does. A bill sent to a person with no coverage could therefore be far above $281.71. A university health policy research center studied insurance claims from 2016. It found that individual insurance plans spent about $10,149 a month on outpatient dialysis, which is over three times what Medicare pays. If a hospital outpatient department bills the treatment instead of a clinic, Medicare pays about $701 for one session in 2026.

Kidney failure can qualify you for Medicare at any age

NIDDK is a kidney research agency of the federal government. It says a 1972 law guarantees Medicare coverage for most people with kidney failure, even people under 65. Medicare.gov says your kidneys must no longer work, and you must need regular dialysis or have had a transplant. You must also meet one of these conditions.

• You have worked long enough in a job covered by Social Security, railroad retirement or government work.
• You already get or are eligible for Social Security or Railroad Retirement benefits.
• You are the spouse or dependent child of someone who meets either condition.

Medicare.gov says coverage usually starts on the first day of the fourth month of dialysis. With home dialysis training it can begin in the first month. If you are eligible but do not sign up right away, coverage can start up to 12 months before the month you apply. You can sign up with the Social Security Administration at 1-800-772-1213.

Medicare does not pay the whole bill for dialysis. After you meet a yearly deductible, which is an amount you pay first, you usually pay 20 percent of the approved cost of outpatient dialysis. Medicare Savings Programs can help people with low incomes pay that share. You can learn how in our guide on Medicare Savings Programs.

Medicare.gov says Part B helps cover outpatient dialysis treatments and home dialysis training. It also helps cover home dialysis equipment and supplies, and many of the drugs given during dialysis. It does not cover paid dialysis aides at home, lost pay or a place to stay during treatment.

Other ways to get coverage or help

NIDDK says Medicaid may pay for care that Medicare does not. Medicaid is a program for people with low incomes. Our guide on who qualifies for Medicaid walks you through it. NIDDK also suggests asking the social worker at your dialysis clinic about a state kidney program. Some states give money and other help to people with kidney disease.

Nonprofit hospitals must have a financial assistance policy. It can lower a bill for people with limited incomes. To learn how to ask, read our guide on hospital financial assistance.

A group health plan from a job can pay first for dialysis. NIDDK says group plans pay for the first 30 months after you become eligible for Medicare because of kidney failure. If you lost job coverage, our guide on health insurance without a job lists your options.

If you do not qualify for regular coverage

Some people with kidney failure cannot get full Medicaid or Medicare because of their immigration status. Federal law still lets Medicaid pay for an emergency medical condition for many of these people, and each state decides what that covers. In some states that means dialysis only when it becomes an emergency, and in other states it means regular scheduled dialysis. If this describes you or a family member, please ask a hospital social worker or your state Medicaid office what your state covers.

You can find low-cost care near you with our tool. A cash-pay doctor can also help with your medicines and referrals for a known monthly fee. Direct primary care usually costs $50 to $200 a month, and you can search for a cash-pay doctor near you.

When to get care right away

MedlinePlus says to contact your provider if you have bleeding from your access site or signs of infection around it. It also lists a fever over 100.5 degrees Fahrenheit. In an emergency, such as chest pain or trouble breathing, call 911 or go to the nearest emergency room. Emergency rooms must see you whether or not you have insurance. Please do not skip a dialysis treatment because of cost. Call your clinic's social worker first and say that money is the problem. This page gives general information and is not medical advice.