Medicare will cover treatment for End-Stage Renal Disease. Treatment can include in-home dialysis, outpatient dialysis, and more. Yet, there are a few additional things to know about ESRD and Medicare, including the waiting period, eligibility, and plan options. For example, there are some plans for which you may not qualify due to ESRD, and other plans are made just for you.
Can You Get Medicare With End-Stage Renal Disease?
Does Medicare Cover End-Stage Renal Disease?
Yes, Medicare covers the treatment of End-Stage Renal Disease, including dialysis and a kidney transplant. You must have permanent kidney failure requiring a kidney transplant or dialysis.
When Does a Person Become Eligible for Medicare Due to End-Stage Renal Disease?
People who are eligible for Medicare solely due to their End-Stage Renal Disease diagnosis do not face a waiting period before they can sign up. Instead, eligibility begins when a physician prescribes a regular course of dialysis or a kidney transplant necessary for the patient to stay alive at their stage of kidney failure.
Yet, once the patient enrolls, they may face a waiting period before their Medicare coverage begins. Typically, Medicare coverage for an eligible ESRD patient will begin on the first day of the third month following the month when they start their regular dialysis.
However, Medicare sometimes waives the three-month waiting period. ESRD patients eligible for Medicare may receive their coverage sooner if they:
- Have a kidney transplant that falls within those three months
- Parttake in a self-dialysis training program
Do You Have to Sign Up For Medicare if You Have End-Stage Renal Disease?
If you get your insurance through the Marketplace, you sign up for Medicare if you want it. You can’t have both Medicare and Marketplace insurance. Those who don’t enroll in Medicare when their kidneys fail will have penalties when they do enroll.
What is the 30-month Coordination Period with Medicare?
The 30-month coordination period begins on the first date you become entitled to enroll in Medicare due to End-Stage Renal Disease. During this time Medicare can be the secondary payer for 30-months.
Can I Enroll in Part C When I Have End-Stage Renal Disease?
Can I Enroll in Medigap With End-Stage Renal Disease?
Either way, you’ll need to sign up during your Medigap Open Enrollment Period, or during a time when you have guaranteed issue rights, to avoid underwriting eligibility questions.
How to Find a Medicare Plan When You Have End-Stage Renal Disease
Finding a Medicare plan when you have a chronic condition can be a challenge. We can look at your plan options and make a recommendation based on your needs.
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