Dialysis Insurance Help in California: A Simple Guide for ESRD Patients
If you’re on dialysis — or preparing for it — insurance can feel overwhelming. The good news: people living with ESRD in California may qualify for Medi-Cal and/or Medicare support that can lower costs and help avoid coverage gaps.
1) Medi-Cal “Dialysis/TPN Special Treatment Program”
California Medi-Cal offers a program that may help cover dialysis (and in some cases TPN) even if you don’t qualify for full Medi-Cal.
What it may help with:
Dialysis-related coverage
Cost support depending on your situation
Important to know:
This program often focuses on dialysis/TPN care
Other medical services may not be covered unless you also qualify for full Medi-Cal or Medicare
✅ Ask your dialysis clinic social worker: “Do I qualify for Medi-Cal Dialysis Only / the Special Treatment Program?”
2) Medicare for ESRD (including under age 65)
Many people with ESRD qualify for Medicare Part A and Part B, even if they’re under 65 — depending on work history (yours or a spouse/parent’s) and medical eligibility.
Timing matters: Medicare may begin after a waiting period for dialysis, but coverage can start earlier in certain situations (like some home dialysis training or transplant timing).
✅ Ask your clinic team or Social Security: “Am I eligible for Medicare because of ESRD, and when would it start?”
3) If You Have Private Insurance, this still matters
Private insurance doesn’t always cover everything. Public programs may still help with:
Out-of-pocket costs
Coverage gaps
Keeping care consistent if employment or insurance changes
✅ Ask your clinic team: “How do my benefits coordinate — what’s primary and what’s secondary?”
What to Do Next (Quick Checklist)
This week, take these 3 steps:
Talk with your dialysis clinic social worker
Ask about Medi-Cal dialysis support + Medicare ESRD eligibility
Start early — don’t wait for a crisis
This information is educational and not legal advice. Coverage depends on your situation, eligibility, and county rules.
This article was written by Tim Grant, ReMend Mentor and retired attorney who brings a practical, patient-centered lens to navigating kidney disease. To read the complete article click the button below..
