People with End Stage Renal Disease (ESRD, or kidney failure) can get Medicare regardless of age.
Medicare coverage for people with ESRD typically begins in the fourth month they receive kidney dialysis.
How Medicare covers immunosuppressant drugs after a kidney transplant depends on the individual's circumstances.
A person with End Stage Renal Disease (ESRD) has irreversible kidney damage that requires dialysis or a kidney transplant. Individuals with ESRD can get Medicare coverage regardless of their age. In addition to providing a range of services that treat kidney failure, ESRD Medicare also covers the typical services and items provided under Medicare to those without kidney disease.
Signing up for Medicare with ESRD
Eligibility for ESRD Medicare works differently than other types of Medicare eligibility based on age or disability. For those receiving dialysis at an inpatient or outpatient facility, coverage begins on the first day of the fourth month of dialysis. For those receiving home dialysis or a kidney transplant, coverage depends on when they start treatment or enter the hospital. People with ESRD can sign up for Medicare online at the Social Security website or by visiting their local Social Security office.
Help people navigating Medicare and ESRD
In partnership with the Medicare Rights Center, NCOA has developed this toolkit to help Medicare counselors navigate Medicare coverage for the ESRD population. This toolkit includes information about:
- When and how someone with ESRD can enroll in Medicare
- The costs of receiving inpatient, outpatient, and home dialysis under ESRD Medicare
- How Medicare covers immunosuppressant drugs following a kidney transplant
- How ESRD Medicare coordinates with other health coverage
This toolkit contains five resources to use with training your staff/volunteers and working with clients:
- Frequently asked questions about Medicare and ESRD
- A professional slide deck you can download and tailor for your training needs
- A handout explaining the 30-month coordination period for people who also have job-based insurance
- An ESRD Medicare basics fact sheet for consumers
- A handout outlining how immunosuppressants and vitamins are covered for people with ESRD Medicare