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State must guarantee Medigap for dialysis

2025-04-22T18:42:06+00:00April 18th, 2025|Categories: Medicare Advantage, Medigap Coverage, Patient Ambassadors, Patient Stories in the News, Promote Financial Security|

I have progressive chronic kidney disease (CKD). One day, my kidneys will fail. Dialysis — a life-saving treatment that removes waste from the blood when the kidneys fail — is in my future. Right now, I am doing everything I can to slow the progression of my disease. But one thing I can’t control is whether I’ll be able to afford very expensive dialysis treatment when the time comes. I recently lost my job, which means I lost my private insurance. I bought my own private plan to keep the care I need, but that’s only a temporary fix. My [...]

Letter to the Editor: Expanding Medigap Will Save Lives

2025-04-15T19:30:23+00:00April 15th, 2025|Categories: Medicare Advantage, Medigap Coverage, Patient Ambassadors, Patient Stories in the News, Promote Financial Security|

As a dialysis patient and healthcare professional, I urge California’s state legislature, especially Sen. Caroline Menjivar (CA-20) and Assemblymember Nick Schultz (CA-44), to support Senate Bill 242. This bill expands access to affordable Medigap plans for all dialysis patients, regardless of age. Kidney failure comes unexpectedly for most, as it did for me. Kidney failure requires routine dialysis treatment to stay alive while awaiting a transplant, and I spent two years on peritoneal dialysis before receiving a kidney and pancreas transplant. Without reliable healthcare coverage, my transplant wouldn’t have been possible and I would have died simply because I am [...]

Expand Medigap Coverage

2025-04-22T18:11:53+00:00March 10th, 2025|Categories: Medicare Advantage, Medigap Coverage, Patient Ambassadors, Patient Stories in the News, Promote Financial Security, Spotlight|

My husband and I have end stage renal disease, or kidney failure, and depend on dialysis to survive. It is difficult for Texans in similar situations to afford lifesaving dialysis, especially people who don’t qualify for Medicaid. Medicare covers only 80% of dialysis costs, leaving many patients responsible for the rest. It can cost thousands of dollars a year without proper coverage. Supplemental insurance plans called Medigap can help fill the gap that Medicare leaves open. However, Medigap plans remain unaffordable for dialysis patients younger than 65. To fix this, Texas must guarantee affordable Medigap access for dialysis patients. State [...]

Georgia Medigap Legislation Passes First Hurdle

2025-02-27T14:59:05+00:00February 25th, 2025|Categories: Article, Medicare Advantage, Medigap Coverage, Patient Ambassadors, Promote Financial Security, Protect Patient Care, State Advocacy|

On February 24, HB 323 was unanimously approved by the Health Committee of the Georgia House of Representatives. Sponsored by State Representative Karen Mathiak (R-82), this legislation will provide affordable access to Medigap coverage to the under 65 Medicare eligible population. DPC Patient Ambassadors Kristi Flynn and Christopher Richards shared their stories with the committee, helping legislators understand the unique challenges faced by both kidney transplant and dialysis patients. HB 323 will now go to the full House for consideration, and if approved, moves over to the Senate. Thank you, Kristi and Christopher, for traveling to Atlanta to advocate for all [...]

Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More.

2024-10-24T12:55:43+00:00October 21st, 2024|Categories: Article, Immunosuppressive Drug Coverage, Medicare Advantage, News, Promote Financial Security|

By Susan Jaffe October 21, 2024 When Pam McClure learned she’d save nearly $4,000 on her prescription drugs next year, she said, “it sounded too good to be true.” She and her husband are both retired and live on a “very strict” budget in central North Dakota. By the end of this year, she will have spent almost $6,000 for her medications, including a drug to control her diabetes. McClure, 70, is one of about 3.2 million people with Medicare prescription drug insurance whose out-of-pocket medication costs will be capped at $2,000 in 2025 because of the Biden administration’s 2022 Inflation Reduction Act, according [...]

DPC Comments to CMS Sound Alarm on Workforce Shortages

2024-08-22T14:11:27+00:00August 20th, 2024|Categories: Article, Comment Letter, Innovation, Medicare Advantage, Promote Financial Security, Protect Patient Care|

In our comments responding to Medicare’s annual ESRD Payment Rule, DPC took the government to task over payment updates that lag increases in labor costs and failure to effectively cover new drugs for dialysis patients. The proposed rule grants a net increase in the base rate of only 0.8% during a year in which wages, according to Bureau of Labor Statistics, rose 4.2%. The Medicare Payment Advisory Commission estimates a margin of zero for dialysis facilities in 2024, with many rural and low-volume facilities in the red. This occurs at a time in which a Supreme Court decision has emboldened [...]

Letter: Medicare, Medicaid not keeping up with inflation, hurting patient care

2024-06-06T16:32:28+00:00June 5th, 2024|Categories: Dialysis Funding, Medicare Advantage, Patient Stories in the News, Staffing Shortages|

Dear Editor, I was born with a rare genetic disorder that caused my kidneys and eyes to be underdeveloped. I have battled chronic kidney disease at all levels throughout my entire life. At age 25, I went into complete kidney failure (AKA End Stage Renal Disease) and began dialysis, which is a continuous and grueling treatment which does the work my kidneys can’t. The financial and emotional difficulties I’ve dealt with have been very challenging. Unfortunately, I must also worry about medical workforce shortages caused by a lack of federal funding. Over the past few years, the Centers for Medicare [...]

Letter: Medicare failed us

2024-05-10T15:08:12+00:00May 6th, 2024|Categories: Dialysis Funding, Medicare Advantage, Patient Stories in the News, Staffing Shortages|

As a program coordinator for the Kidney Foundation of Central Pennsylvania, I have made it my life’s mission to help kidney patients manage their condition. I see or hear stories of the inadequate standards of care currently practiced at clinics, hospitals and specialist practices in this country. Many patients I talk to are frustrated and feel like they have been forgotten. We must do better. The problem lies in the lack of health care workers. A severe lack of funding makes it more difficult to hire and keep doctors, nurses and technicians. Much of the problem is demographic. With fewer [...]

DPC Seeks Information on Patients’ Experience With Itching

2024-04-24T16:12:21+00:00April 24th, 2024|Categories: Advance Patient Choice, Article, Increase Quality of Care, Innovation, Medicare Advantage, Treatment Options|

A couple of years ago, a new drug was approved to treat ESRD-related pruritis. Medicare approved an additional payment for the drug Korsuva for a period of 2 years. But, because of the short expiration date, very few nephrologists prescribed the medication, so even fewer dialysis facilities dispensed the drug. As a result, Korsuva never took hold to become the standard of care for pruritis. We’d like to know (1) Have experienced pruritis? (2) If so, did your clinicians tell you about Korsuva? We would like to convey patients’ experiences as we ask for Medicare to revisit coverage: what it’s like [...]

Poor care? Blame Medicare payments

2024-04-16T15:09:10+00:00April 14th, 2024|Categories: Dialysis Funding, Medicare Advantage, Patient Stories in the News, Staffing Shortages|

My husband Raymond and I met on a blind date. Three months later, his kidney unexpectedly failed, and I have walked alongside him on his patient journey ever since. My husband’s life depends on dialysis, the treatment that does what his kidney can’t do. Unfortunately, we confronted problems with our dialysis center that reflect larger trends caused by insufficient reimbursements from the Center for Medicare and Medicaid Services (CMS). Our nation is confronting a demographic crisis, with fewer working-aged people and more patients, which is why we are seeing worsening shortages of health care workers. CMS’ reimbursements have been far [...]

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