Medicare Eligibility For Those With Kidney Failure

According to Dear Marci, a weekly e-newsletter distributed by the Medicare Rights Center, persons with lupus that are diagnosed with end-stage renal disease (ESRD) may be eligible for Medicare regardless of age. In this instance, Medicare will assist in covering the cost of dialysis treatments and medications and/or a kidney transplant. Additionally, the length of time to receive the Medicare coverage depends on why a person qualifies and where they receive their dialysis treatment:

• If treatments are received at a dialysis center, then Medicare eligibility begins the fourth month of dialysis.
• If dialysis occurs at home through a Medicare-approved home dialysis training program, then Medicare eligibility begins the first month of the program.
• If a kidney transplant is received before starting dialysis, then Medicare eligibility coverage begins the month of the transplant or up to two months before the transplant, if pre-transplant testing has begun.

Additionally, those that have employer or retiree insurance and are eligible for Medicare because of ESRD have a 30-month coordination period in which the group health plan pays first and Medicare pays second. At the end of this period, Medicare will pay first for all Medicare-covered services and the employer group health plan will pay second. Additionally, a group health plan may also pay for services not covered by Medicare.

Visit the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) http://kidney.niddk.nih.gov/ to learn more about different types of treatment and at-home treatment options. In this guide, there is also information about the pros and cons of in-center versus at-home treatment plus online resources for even more information.

Furthermore, American Kidney Fund has an online list of patient aid programs to cover some expenses before Medicare begins, along with more information about kidney failure and a helpful glossary of commonly used terms.

For more information on Medicare benefits, rights, and options contact your State Health Insurance Assistance Program. Call Social Security (800-772-1213) for questions about enrolling in Medicare.im