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Medicare Coverage and ESRD

You may get Medicare benefits at any age if you have ESRD and one of the following applies:

• You are eligible for Medicare based on your work record.
• You are already getting Social Security or Railroad Retirement Board benefits, or you are eligible for benefits.
• Your spouse or parent meets one of the above requirements.

Medicare coverage starts the fourth month you receive dialysis treatments. For example, your Medicare coverage would start on October 1 if you start getting your dialysis treatments in July.

Medicare coverage could start the first month you receive treatments if all of these apply:

• You attend a home dialysis training program provided by a Medicare-certified training facility.
• Your doctor expects you to complete the training and be able to do your own dialysis treatments.
• You maintain regular dialysis treatments throughout the usual required waiting period.

You must enroll in Original Medicare Parts A and B yourself. Once you have both Part A and Part B, you may make other Medicare coverage choices, such as adding Medicare Part D prescription drug coverage or choosing a Medicare Advantage plan.

If you are 65 or older, or disabled, and are already enrolled in Part A, you may enroll in Part B without penalty if you are approved for Medicare based on ESRD. You may also have an existing Part B late enrollment penalty removed.