You can get Medicare no matter how old you are if your kidneys no longer work, you need regular dialysis or have had a kidney transplant, and one of these applies to you:
- You've worked the required amount of time under Social Security, the Railroad Retirement Board (RRB), or as a government employee.
- You’re already getting or are eligible for Social Security or Railroad Retirement benefits.
- You’re the spouse or dependent child of a person who meets either of the requirements listed above.
Contact Social Security for more information about the amount of time required to be eligible for Medicare. If you get benefits from the Railroad Retirement Board (RRB), contact the Railroad Retirement Board.
If you’re eligible for Medicare because of ESRD, you can enroll in Part A and Part B by visiting your local Social Security office or by contacting Social Security.
If you qualify for Part A, you can also get Part B. Enrolling in Medicare is your choice, but you’ll need both Part A and Part B to get the full benefits available under Medicare to cover certain dialysis and kidney transplant services.
When you enroll in Medicare based on End-Stage Renal Disease (ESRD) and you’re on dialysis, Medicare coverage usually starts on the first day of the fourth month of your dialysis treatments. This waiting period will start even if you haven’t signed up for Medicare. For example, if you don’t sign up until after you’ve met all the requirements, your coverage could begin up to 12 months before the month you apply.
If you're covered by an employer group health plan, your Medicare coverage will still start the fourth month of dialysis treatments. Your employer group may pay the first 3 months of dialysis.
Medicare coverage can start as early as the first month of dialysis if you meet all of these conditions:
- You take part in a home dialysis training program offered by a Medicare-certified training facility to teach you how to give yourself dialysis treatments at home.
- Your doctor expects you to finish training and be able to do your own dialysis treatments.
- The regular course of dialysis is maintained throughout the waiting period that would otherwise apply.
If you have Medicare only because of permanent kidney failure, Medicare coverage will end:
- 12 months after the month you stop dialysis treatments.
- 36 months after the month you have a kidney transplant.
Your Medicare coverage will be extended if:
- You start dialysis again, or you get a kidney transplant within 12 months after the month you stopped getting dialysis.
- You start dialysis or get another kidney transplant within 36 months after the month you get a kidney transplant.
If you qualify for Part A, you can also get Part B. Enrolling in Part B is your choice, but you’ll need both Part A and Part B to get the full benefits available under Medicare to cover certain dialysis and kidney transplant services.
If you’re already enrolled in Medicare based on age or disability, and you’re already paying a higher Part B premium, because you didn’t enroll in Part B when you were first eligible, the penalty will stop when you become eligible for Medicare based on ESRD. Call your local Social Security office to make an appointment to re-enroll in Medicare based on ESRD.