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Insurance Article

How can health insurance be helpful for kidney diseases

June 01 2009

What is chronic renal failure?

The kidney attempts to compensate for renal damage by excessively straining the blood within the remaining functional enthrones, the filtering units in the kidneys that remove waste matter from the blood. This process is called hyper filtration and causes further loss of kidney function. Chronic kidney disease, also known as chronic renal disease, is a progressive loss in renal function over the period of months or years.

Closely linked with lifestyle related disorders, some of the common causes behind CKDs are diabetes, blood pressure and high cholesterol level. The symptoms of worsening kidney function are not specific and might include feeling generally unwell and experiencing the reduced appetite. Overtime the kidneys start to shrink in size and scaring appears in the all part of the kidney. It is not until over 70% of the normal combined function of both kidneys is lost that most patients begin to experience symptoms of kidney failure.

What is dialysis?

Dialysis is required when your kidneys are no longer able to function on their own. Dialysis removes waste product and extra water from the blood by filtering the blood through a special membrane to remove waste products. There are two forms of dialysis available:

1. Peritoneal dialysis
2. Haemodialysis

In both type of dialysis, you will need to undergo surgery in order to have a catheter inserted into your body. If you opt to be treated with haemodialysis, you will also need surgery in order for a fistula to be created.

What health insurance covers for you?

It is important that you make sure you have an adequate level of health cover that doesnot exclude or restrict this feature in order to be fully covered by your insurer.

When you undergo these procedures as a privet patient, health insurance will pay 75% of your medical bill for each item provided as a part of your treatment. Your health fund will pay the additional 25%. If your doctor charges above the gap, you may have to pay the extra amount, unless your health fund can provide extra benefits to help cover this gap. Many health funds have agreements with doctors who are willing to participate in the health fund’s gap cover scheme.

Remember in most cases there will be more than one doctor involved in your treatment. Along with your surgeon, you can also expect an anaesthetist and pathologist to be involved. Each will have their own bill, so it is important to find out about the charges associated with each specialist.

Provided that your health fund has an agreement in place with the hospital which you will be treated in, theatre and accommodation cost will be covered. You are entitled to and should ask from your doctor an estimate in advance of the entire cost of the procedure.

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