Chronic Kidney Disease and Medicare

Written by: Alison Shmerling; Medical Director
Last updated: October 11, 2026
Read time: 5 min

Key points

In 2021 to 2023, about 1 in 3 people 65 and older (34%) had chronic kidney disease, most without knowing it, the Centers for Disease Control and Prevention (CDC) says.
With a doctor's referral, Medicare pays the full cost of a dietitian when your kidney test number is 15 to 59.
At stage 4, Medicare pays for up to 6 classes on your choices, at 20% after the $283 deductible in 2026.
In 2026, the most you pay for covered drugs is $2,100, and two kidney drugs have prices Medicare set.

Medicare pays for kidney care long before you would need dialysis. It pays for lab tests, kidney doctor visits, a dietitian and classes about your choices. Dialysis and a transplant are covered too, and you usually pay 20%. If a lab report just said your kidneys are slowing down, you may have more questions than answers right now.

Medicare pays for kidney care if

You have Part B, the part of Medicare that pays for doctor visits and lab tests.
Your doctor orders the test or refers you. For a dietitian, it must be a doctor.
You meet the rule for that service, as the table below shows.

Not sure Medicare will pay? Ask anyway, because your doctor's office can check before you start. Or a Pair Team advocate can check with you.

What Medicare pays for (2026)

Service	Who it is for	What you pay
Kidney blood and urine tests	Anyone whose doctor orders them	Usually nothing for lab tests Medicare approves
Kidney doctor visits	Anyone with Original Medicare, no referral needed	20% after the $283 deductible
Dietitian visits (medical nutrition therapy)	Kidney test number of 15 to 59, diabetes, or a kidney transplant in the last 36 months, with a referral	Nothing. 3 hours the first year, 2 hours each year after
Kidney disease classes	Stage 4, with a referral	20% after the deductible, up to 6 sessions
Dialysis	Kidney failure	20% after the deductible. Part B pays for most dialysis drugs
Kidney transplant	Kidney failure, at a Medicare-approved hospital	The $1,736 hospital deductible, then 20% for doctor care. Nothing for your donor
Drug coverage (Part D)	Anyone with a Medicare drug plan	No more than $2,100 a year for covered drugs

How does Medicare help before dialysis?

Medicare helps before dialysis by paying for care that helps your kidneys last. Your doctor checks them with a blood test and a urine test. The blood test gives a number called your estimated glomerular filtration rate (eGFR). Your doctor uses it, with the urine test, to find your stage.

When your number is between 15 and 59, a registered dietitian can plan meals with you at no cost, federal rules say. At stage 4, kidney disease classes teach you how dialysis and a transplant work, so you can choose before you have to. With two or more long-term health problems, your doctor's office may offer care coordination. You pay 20% a month after the deductible.

Medicare also has a newer option called Advancing Chronic Care with Effective, Scalable Solutions (ACCESS). It's for people with Original Medicare and stage 3 kidney disease, or some other long-term problems, the program's rules say. You can sign up yourself, and most groups charge $0 to $7 a month, Medicare.gov says.

What will kidney medicines cost?

Most kidney medicines go through your Medicare drug plan, and in 2026 the most you pay for covered drugs is $2,100. In 2027 that rises to $2,400. Farxiga and Jardiance are often used for kidney disease and diabetes. Since January 1, 2026, they have had prices Medicare set, Medicare's list shows. If your plan charges a percent of the price, your share may drop.

If money is tight, apply for Extra Help. In 2026 it caps your copays at $5.10 for generics and $12.65 for brand-name drugs. See Extra Help.

What does Medicare pay for dialysis?

Medicare pays most of the cost of dialysis, at a center or at home. You pay 20% after the deductible. Part B also pays for home training, supplies and most dialysis drugs. If you have Medicare because of your age, it pays for access surgery, like a fistula in your arm, before dialysis starts.

Medicare doesn't pay for regular rides to dialysis, but Medicaid and some local programs do. See rides to medical appointments. If you're on dialysis and can't afford your Medicare or Medigap premium, the American Kidney Fund may help. It gave premium grants to nearly 58,000 people in 2025.

What to do next

Ask for your kidney test results and what stage they mean. If you have diabetes or high blood pressure, ask how often to test.
Ask for a referral to a dietitian, since Medicare pays for it in full when you qualify.
At stage 4, ask about kidney disease classes, before you need to decide about dialysis.
Check your drug plan during Open Enrollment, each fall from October 15 to December 7. Plan changes start January 1.
Apply for help with costs, since Original Medicare's 20% has no yearly limit. See Medicare Savings Programs.

If you also have Medicaid

If you're a Qualified Medicare Beneficiary (QMB), no doctor or dialysis center may bill you for Medicare's 20%. Medicaid in California and New York may also pay for rides to dialysis. See Medicare and Medicaid together and the rules in California and New York.

What a Pair Team advocate does

Kidney disease often comes with diabetes or high blood pressure, CDC data show. When one visit or refill slips, all three can get worse. This is what we do:

Book your lab tests and kidney doctor visits, and follow up on the results with your care team.
Ask your doctor for the dietitian referral and kidney classes Medicare pays for.
Help with Extra Help and Medicare Savings Program forms, and check your drug plan each fall.
Set up rides to dialysis, and help with what usually comes with it: food and utility bills.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Does Medicare cover kidney disease before dialysis?

Yes, Medicare covers kidney disease before dialysis, including lab tests, kidney doctor visits and dietitian visits. At stage 4 it also pays for up to 6 kidney classes.

You don't need to sign up again if you already have Medicare because of your age. There's one exception, Medicare.gov says. If you pay a late penalty for Part B, signing up again because of kidney failure can end it.

Does Medicare pay for a kidney transplant at my age?

Medicare pays for a kidney transplant at a Medicare-approved hospital, and its coverage rules list no age limit. The transplant center decides if a transplant is safe for you.

Does Medicare pay for kidney-friendly food?

Medicare doesn't pay for food, but it pays a dietitian to plan meals with you. For help buying food, see food help. Many people 60 and older qualify for the Supplemental Nutrition Assistance Program (SNAP), or food stamps.

Can I do dialysis at home?

Yes, Medicare pays for home dialysis if your doctor says it's right for you. It covers the training, the machine, supplies and visits to check on you.

Who can I call with kidney questions?

You can call the National Kidney Foundation at 855-653-2273, Monday to Friday, 9 a.m. to 7 p.m. Eastern time. For free help with Medicare costs, call your State Health Insurance Assistance Program (SHIP) at 1-877-839-2675.

Sources

About the author

Alison Shmerling

Medical Director

Alison Shmerling is Pair Team's Medical Director. Since 2024, she has overseen its nurse practitioners, nurses and care managers.

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