Hi,
Thank you for your question.
The fees charged will depend whether you are doing it privately or obtaining government subsidies.
For example, the fees for haemodialysis in the private sector can range from 200-500 dollars per session, depending if it is a satellite basic dialysis centre or a centre inside a private hospital with more comfort and other features and/or more capabilities to respond to emergencies. A centre located inside a private hospital will be more responsive to emergencies, than a centre in the local neighbourhood.
In addition, some centres charges vary depending on whether the patient is Singaporean, foreigner residing in Singapore or a tourist. The fees will be paid out of your pocket minus any total or partial coverage by your insurer or employer’s benefits, if such.
Overall, the typical satellite dialysis centre end up charging patients or insurance companies around 2500 dollars per month; obviously more, in more high end dialysis centres. My practical advice is talk to:
1) your insurance company,
2) your employer, and
3) your chosen or potential dialysis centres, so you can gauge how much coverage you have and how much out of your pocket you need to pay.
The fees you will end up paying if performing haemodialysis by government institutions like in the National Kidney Foundation (NKF) Singapore depending on the degree of subsidies you are eligible to depending on your household income and expenses and different government insurance and benefits. The basic cost of the dialysis is similar, approximately 180 dollars per session, but that will be minus whatever amount your medishield can cover, then minus what the NKF subsidy can cover, which can range from 0-100% subsidy, then minus your medisave and if still something left to pay, it will come out of your pocket.
Dialysis is expensive, but Singapore government and institutions like NKF, the Kidney Dialysis Foundation (KDF) and some charities or donors always try their best to help patients in the need for financial protection, and for many patients dialysis end up to be totally free. But to make that happen there is a lot of kindness behind absorbing the costs from patients. My practical advice is talk to:
1) NKF or KDF directly,
2) dialysis coordinators and medical social workers in the hospital you are on follow up, and
3) any other charity group willing to help you with moral or financial support.
Peritoneal dialysis, which does not involve a specific centre and the use of expensive machines, it is cheaper for patients, and the healthcare budget. The costs goes around 1500-2000 dollars per month, depending on the modality of dialysis you are using (manual or automated-with the aid of a machine-), type of dialysis solutions you are using, the vendor you have chosen and the dose of dialysis your body needs, minus insurance and government subsidies as applicable, in a similar fashion as explained above for haemodialysis. My practical recommendation is, once your doctor gives you a prescription and recommendation of the type of dialysis appropriate for you, to talk to:
1) dialysis coordinators and medical social workers in the hospital you are on follow up,
2) a government agency like NKF to check whether you are eligible for financial support,
3) your insurance company, and
4) the specific peritoneal dialysis vendor of your choice.
I would like to end up by saying that financial matters are important determinant factors for your decision regarding the type the dialysis therapy, but not the only one. You need to choose the therapy you feel comfortable with and blends better with your lifestyle, work life and personality. I expand on this in another of the questions on this series.
Dr Francisco, wishing you the best possible health.
