Dialysis is a long-term treatment. For most people on haemodialysis it means three sessions a week, every week. The cost can feel overwhelming, especially when the patient can no longer work full time. The good news is that Malaysia has several sources of help, and many patients qualify for more than one.
This guide explains what usually goes into the cost of dialysis, how government, NGO and private centres differ, and where to apply for help. Rates and conditions change over time and vary between centres, so always ask for up-to-date details in writing.
What dialysis costs are made up of
A monthly dialysis bill is usually made up of several parts. Some centres charge a single package price; others itemise. Ask clearly what is included.
The per-session fee
This is the charge for the treatment itself: use of the machine, treated water, nurses and technicians. Haemodialysis is usually done three times a week, so this fee is multiplied roughly 12 to 14 times a month.
Consumables
The dialyser (the filter), blood lines, needles and dialysis fluid. Some centres include these in the session fee; others charge extra.
EPO injections and medicines
Many kidney patients have anaemia and need EPO (erythropoietin) injections and iron. EPO is often charged separately and can be a large part of the monthly bill. Other medicines such as phosphate binders, blood pressure tablets and vitamins add to the total.
Blood tests and doctor reviews
Regular blood tests (usually monthly or every few months), hepatitis screening and nephrologist reviews may be billed separately.
Vascular access surgery
Before haemodialysis you need an access: an arteriovenous fistula (AVF), a graft or a catheter. Surgery to create or repair the access is an occasional cost that can be significant.
Transport and hidden costs
Three return trips a week, by taxi, e-hailing or a family member's car, add up. Don't forget the income a carer loses when taking time off to accompany the patient.
Government, NGO and private centres
Government hospitals and clinics charge citizens low fees. However, places in government units are limited, and admission is decided by the hospital's nephrology team. Many patients are then referred to NGO or private centres.
NGO centres are run by non-profit organisations. Fees are usually lower because they are supported by donations and, for eligible patients, government subsidies. Some NGO centres have waiting lists.
Private centres usually offer more choice of locations and shift times, but fees are higher and vary from one centre to the next. Many private centres are also PERKESO panel centres.
Tip: Ask for a written quote that breaks down every charge: session fee, consumables, EPO, blood tests, doctor's fees and any registration deposit. It makes comparing centres and applying for aid much easier.
Help from PERKESO (SOCSO)
PERKESO (SOCSO) provides dialysis facilities for insured persons with end-stage kidney failure, as part of the rehabilitation benefits under its Invalidity Scheme. According to PERKESO, this covers:
- haemodialysis free of charge at PERKESO panel dialysis centres, and reimbursement, subject to PERKESO's terms, for treatment at non-panel centres and government hospitals;
- peritoneal dialysis (CAPD);
- subsidised EPO injections;
- subsidised immunosuppressant medicines for patients who have had a kidney transplant;
- payment for arteriovenous fistula (AVF) surgery.
Eligibility depends on your contribution record under the Invalidity Scheme and PERKESO's assessment, and payments follow the rates and conditions PERKESO sets. If you have worked and contributed, ask early, even if you have already stopped working because of your illness.
Take your MyKad and a medical report from your doctor to the nearest PERKESO office, or ask a panel dialysis centre, as they are familiar with the process. If you choose a non-panel centre, also ask whether there is any balance you would need to pay yourself. The official details are on PERKESO's dialysis page, and you can browse the list of PERKESO panel centres on this site.
Government and NKF subsidies
MOH subsidy at NGO centres
The Ministry of Health (MOH, or KKM) subsidises haemodialysis and EPO injections for citizens who are poor or on a low income, for treatment at NGO haemodialysis centres registered with the ministry. Eligibility is assessed by a medical social worker at a government hospital. For eligible patients, the amount left to pay can be very low.
The medical social worker can also tell you about the MOH Medical Assistance Fund (Tabung Bantuan Perubatan), which helps patients who cannot afford it with part or all of the cost of certain treatments.
National Kidney Foundation (NKF)
NKF runs its own dialysis centres with subsidised fees and assesses applications based on the patient's financial situation. It also offers help such as transport subsidies and vascular access subsidies for patients in greatest need. Applications go through the staff at NKF dialysis centres, usually with copies of your MyKad, payslips and relevant bills. See NKF's patient welfare page.
Zakat, JKM and other sources
- Zakat: Muslim patients who qualify as asnaf can apply for medical or dialysis assistance from their state zakat body or state Islamic religious council. Each state sets its own criteria and process, so contact the zakat office in the state where you live.
- Department of Social Welfare (JKM): JKM provides monthly financial assistance to eligible low-income households, including older people. It is not specific to dialysis, but it can ease the pressure on the family. Apply at your district JKM office or online through eBantuanJKM, linked from the JKM portal.
- Civil servants and government pensioners: Civil servants, pensioners and their eligible dependants have dialysis benefits under the public service medical rules, subject to conditions such as referral by a government hospital nephrologist. Ask your department or the hospital's nephrology unit.
- Employers and insurance: Check your employer's group medical cover and any personal policy. Some policies cover dialysis; others exclude pre-existing conditions or limit outpatient treatment. Get confirmation in writing.
- Charities and community groups: Religious organisations, community associations and elected representatives' service centres sometimes give one-off help, for example with transport or access surgery.
Tips for managing the cost
- See a medical social worker as early as possible, as soon as your doctor mentions dialysis.
- Apply for more than one type of help if you qualify, and ask whether they can be combined.
- Keep every receipt, quote and approval letter together in one file.
- Ask whether the centre can bill PERKESO, zakat or your insurer directly so you don't have to pay upfront.
Remember: Never stop or cut down your dialysis sessions because of money without talking to your dialysis team first. Missing sessions can be life-threatening. Tell them early so they can help you find a way.
Next steps
- Find a dialysis centre near you and compare government, NGO and private options.
- See the list of PERKESO panel dialysis centres.
- Read how to choose a dialysis centre for a checklist before you register.
- Get ready for your first dialysis session.