Written by Ari Parker — Updated: Monday, August 15, 2022
Around 786,000 Americans suffer from End-Stage Renal Disease (ESRD), also known as End-Stage Kidney Disease (ESKD). Because the monthly cost of dialysis is too high for most Americans to manage, Medicare is available for ESRD patients to help make quality care more affordable.
Many people are unaware that Medicare provides coverage for younger Americans with certain disabilities and conditions. Options for patients with End-Stage Renal Disease were even expanded in 2021. The Cures Act now allows Medicare beneficiaries with ESRD to enroll in Medicare Advantage plans, regardless of their previous coverage.
You might be wondering if you’re eligible, when you can sign up, and what all of your options are. In this guide, we’ll go over just that to help you understand the ins and outs of Medicare for End-Stage Renal Disease patients.
While Medicare is generally meant for older Americans, younger ESRD patients can still be eligible if they meet the following conditions:
If you’re on Medicare only because of ESRD, then you’ll become ineligible once you no longer meet the above requirements. Your Medicare coverage will end 12 months after you stop dialysis treatments or 36 months after a kidney transplant.
If you’re eligible for Medicare because of ESRD, then late enrollment penalties and coverage start dates work differently. In fact, if you don’t sign up right away, your coverage could apply for services received up to 12 months prior to the month you sign up—this is known as retroactive coverage.
When you sign up for Medicare, you have two primary coverage options: Original Medicare or Medicare Advantage, and there are pros and cons to both.
As with any insurance, costs will vary depending on the plan(s) you choose and the services you need. Medicare greatly reduces the cost of dialysis, regardless of which coverage you choose. It’s best to work with a Chapter Advisor to compare the costs of monthly premiums, copayments, deductibles, and coinsurance to determine the best plan available for your needs. We’ll help you maximize your benefits while minimizing costs to ensure quality care at the most affordable price.
When we search and compare available plans, we go the extra mile to ensure your preferred doctors and prescriptions are covered. We’re also with you every step of the way after we find the right plan to help with:
Call one of our Advisors today to get your questions answered or enroll in Medicare.