Dialysis And Life Insurance: What You Need To Know

While it is possible to get life insurance if you're on dialysis, it can be challenging. People on dialysis have a pre-existing high-risk condition, which means they are unable to qualify for traditional term or whole life insurance policies. However, there are still options available. For instance, dialysis patients can purchase guaranteed issue life insurance, although the premiums tend to be higher and the death benefit may be limited. Additionally, those who have received a successful kidney transplant and maintained stable health for several years post-transplant may eventually become eligible for traditional coverage.

Guaranteed issue life insurance

Dialysis patients can purchase whole guaranteed issue life insurance, but the rates are high, starting at $474 per month. This is because insurance providers consider dialysis patients high-risk clients, as most people on dialysis live for only five to ten years.

The specific qualifications for guaranteed issue life insurance vary based on age and location. Typically, applicants must be US citizens, aged between 40 and 85, and live in a state where the insurance is available.

There are some drawbacks to guaranteed issue life insurance. Firstly, there is a mandatory graded period or waiting period, usually of two years, but this can be as high as 2.5 years. If the policyholder dies during this period from natural causes, the beneficiaries will only be paid the premiums paid to date, plus interest, which is typically 10%. However, if death occurs from an accident during the graded period, beneficiaries will receive the full policy amount. Secondly, there is a cap on policy coverage amounts, with a maximum upper limit of $25,000 in protection for people on dialysis.

Medicare Advantage plans

People with kidney disease are eligible to apply for a Medicare Advantage plan. These plans provide all your Medicare Part A and Part B benefits and also often offer additional coverage benefits to their members, such as prescription drug coverage or dental benefits.

• Annual out-of-pocket expenses are capped, lowering overall costs.
• Plans are managed by private health insurance companies approved by Medicare.
• Additional benefits are available and may include routine dental, vision, and hearing.
• Medications for dialysis or post-kidney transplant are often covered, however, it’s important to make sure your medications are included in the plan you choose.
• Plans use networks, like employer group health plans, so it’s important to make sure your nephrologist and other doctors are in-network.
• Affordable monthly plan premiums.

If you have End-Stage Renal Disease (ESRD) and are interested in enrolling in a Medicare Advantage Plan, it is important to consider provider networks and costs as you evaluate plans. Each type of Medicare Advantage Plan has different network rules. A network is a group of doctors, hospitals, and medical facilities that work with a plan to provide services. Your costs are typically lowest when you use in-network providers and facilities. Before enrolling in a Medicare Advantage Plan, make sure your providers, including your dialysis facility, are in-network. Ask your current providers which plans they accept. While some plans offer coverage outside their network, costs and restrictions are often higher.

Group life insurance

If you are on dialysis, you won't be eligible for traditional life insurance coverage. However, you can still get coverage through group life insurance.

If you are on dialysis, you may also want to consider guaranteed issue life insurance. This type of insurance does not require a medical exam or health questions, and you are not required to disclose that you are on dialysis. However, premiums for guaranteed issue policies tend to be higher, and the death benefit may be limited.

Spousal insurance rider

While receiving insurance protection is largely dependent on one's current health, it is still possible to get life insurance while on dialysis. In fact, guaranteed issue life insurance policies do not ask any medical or health questions, meaning that you are not required to disclose that you are on dialysis.

Now, on to spousal insurance riders.

A spousal insurance rider is an add-on to your life insurance policy that covers your spouse under the same policy. The beneficiary of a spousal rider is the surviving spouse. Spousal riders are usually added to aid with burial and funeral costs.

Spousal riders are becoming less common, with insurance companies pushing spouses towards obtaining their own policies. Spousal riders are also rather costly compared to regular individual policies. For example, United Omaha offers a spousal rider, but the minimum coverage is around $100,000.

If your spouse is in good health, a separate term life insurance policy may be the most beneficial option. Your spouse's risk class and age may impact how much your premium policy will cost, and your spouse will have to take a medical exam, which may also impact the rider cost.

The main disadvantage of a spousal rider is the loss of coverage. If the primary insured individual passes away, the rider is no longer in effect, leaving the spouse to find new coverage, which could be extremely costly. In the case of divorce, the rider will not cover the spouse either.

Therefore, obtaining a separate life insurance policy for both spouses ensures that both individuals are covered, regardless of death or divorce.

You and your spouse should calculate all your loans and debts, consider how many people rely on your income, and whether one of you could live off a single income. These factors are essential when trying to find the most beneficial coverage for you and your loved ones.

Private health insurance

If you have an Employer Group Health Plan (EGHP), it will be your primary insurance for 30 months after starting dialysis, after which Medicare will become your primary insurance and your EGHP will become secondary. Private insurance can be maintained for up to 30 months, which is important as it incentivises health plans to detect and treat chronic kidney disease, preserve kidney function, and ensure a safe transition to End-Stage Renal Disease (ESRD). Dialysis patients may prefer to maintain their private insurance to continue dental or dependent coverage unavailable with Medicare or to take advantage of lower cost-sharing.

Medicare Part B pays for 80% of the costs of dialysis, leaving you responsible for the remaining 20% unless you have a supplemental plan. Private insurance can help cover these costs.

Frequently asked questions