Dialysis

Aetna covers hemodialysis or intermittent peritoneal dialysis for renal failure up to three times per week, home hemodialysis and CAPD/CCPD for end‑stage renal disease when physician‑prescribed, and dialysis more than three times per week only for specified conditions (hyperkalemia, hypophosphatemia, pregnancy, fluid overload, acute pericarditis, congestive heart failure, pulmonary edema, or severe catabolic/age‑related debility) that are refractory to thrice‑weekly dialysis, with periodic skilled nursing home monitoring per a physician care plan. Key requirements/limits: >3×/week dialysis must be refractory to 3×/week treatment; home dialysis equipment is usually rented during the first 30 months (Medicare primary after 30 months); both deionization and RO systems won’t be covered together, water softeners only if RO and home water is inadequate, and backup equipment provided solely as a precaution is not medically necessary.

"Hemodialysis or intermittent peritoneal dialysis for renal failure up to 3 times per week."