FAQ about travel in Europe while on hemodialysis:
Who pays and how much does it cost?

Medicare will not pay for dialysis outside of the US and
Canada. In my case my insurance will reimburse me for any
dialysis related expenses not covered by Medicare, including
dialysis outside of the US. I have found the cost of
dialysis to range from $280 - $1,000 in Europe. On average
dialysis costs about $400. If you arrange dialysis through
a service - Holiday International or Dialysis at Sea - they
will tack on a $25 service fee.

How is the payment made?

A majority of the units I have visited accepted credit cards.
A couple of the units required payment after each treatment
in the local currency. When I arranged treatments in Spain
and Italy through Holiday International I prepaid by wire
transferring money to their bank in Turin. Dialysis at Sea
requires prepayment for their treatments. Payment can be made
by mail using a credit card. The best thing to do is ask the
units you will be visiting before hand how they would like
payment and be prepared.

How do you arrange dialysis?

There are a couple ways you can contact the units yourself.
You can FAX the units to request information, check availability
or reserve a spot. FAX numbers are available from the LIST or
other directories of dialysis units. You can also call European
units directly. Many of the Northern and/or smaller countries of
Europe use English as a second language. You can also contact the
units through AT&T's translation service. This service is
expensive but it allows you to contact units yourself when
English is not spoken.

Holiday International is a division of Fresenius International
and they will arrange for a fee, dialysis anywhere the world.
I used their service to set up dialysis in Spain and Italy. It
is very convenient because you can correspond with them over the
Internet. Their web site is: http://www.fresnet.it/dialysis/ .
I would suggest using them when possible, particularly when
traveling to Italy.

What is dialysis like in Europe?

I have found that dialysis is about the same in Europe and
the US. The amenities differ. Air conditioning is not
always present in Europe, however, you usually are offered
food during your run. The machines, kidneys and water
treatment are, in many instances, the exact same as what
I am use to at home. Other times the brands are the only
difference, the same sort of differences you would see
traveling around in the US. It is common to dialyze in a
bed in Europe but some units use chairs. Since I usually
run just a few times at each unit I visit, reuse is not an
issue. It is my understanding that reuse is less common in
Europe then it is in the US.

How do you arrange a trip to several cities?

The first step I take is decide the general outlines of the
trip. Where and when in general I would like to go, sketching
out a general itinerary. Then I check the various resources
- the LIST, etc. - on available dialysis units in the area I
will be visiting. In general I like to be in the city where I
will be dialyzing the night before I am scheduled for a
treatment and I want to maintain my three days a week schedule.
I then stay up late and call the units checking to see if they
can run me and what days and times are generally available.
The itinerary firms up over the course of weeks or even months.

Bill Peckham bpeckham@speakeasy.org

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