Travelling in the US on dialysis: Medicare, guest units and paperwork

If you dialyse in the US, travelling within the country is usually straightforward. Every state has dialysis units used to visiting patients, and Medicare follows you wherever you go. The main work is getting your records to the visiting unit in time.

What Medicare covers when you travel

Original Medicare covers outpatient dialysis at any Medicare-certified facility in the US, on the same terms as at home. You still pay your usual Part B coinsurance unless a supplement (Medigap) or secondary insurance covers it.

Medicare Advantage plans must cover dialysis while you're temporarily outside the plan's service area. Call your plan before you travel anyway: some want to be told in advance, and it saves arguments about the bill later.

If you have employer or private insurance, check whether the visiting unit is in network. Out-of-network dialysis can be very expensive.

Original Medicare generally doesn't pay for dialysis outside the US, including in Mexico, Canada and the Caribbean. If you're heading abroad, read how much holiday dialysis costs first.

How guest treatments work

A treatment at a unit that isn't your home unit is usually called a guest or transient treatment. Your home unit's social worker or travel coordinator normally handles the referral. The big dialysis chains have their own travel teams that can book sessions at their units in other states.

What the visiting unit will ask for

• Your current treatment orders (dialyser, blood flow, dry weight, access type, heparin)
• Recent lab results, including a hepatitis B surface antigen test, usually from the last 30 days
• Notes from your last few treatments
• A recent history and physical, medication list and insurance details
• Sometimes a recent EKG or chest X-ray

Units are strict about the hepatitis B test date. If your trip is delayed, you may need a new test before they'll treat you.

How far ahead to book

Four to six weeks is usually enough. Allow more for places that fill up in season, like Orlando during school holidays, Miami in the winter, or Las Vegas around big conventions.

National parks and remote areas

Some of the most popular trips are the hardest for dialysis. There's no unit inside Yellowstone: the nearest options are in towns like Bozeman. For the Grand Canyon, the nearest units are in Flagstaff. Plan where you'll stay on treatment days, not just the sights.

Want someone to find the chair for you? Request a booking with your dates and destination.