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What if I have End-Stage Renal Disease (ESRD)?

If you have ESRD, you'll usually get your health care through Original Medicare. You can only join a Medicare Advantage Plan (Part C) in certain situations:

  • If you're already in a Medicare Advantage Plan when you develop ESRD, you may be able to stay in your plan or join another plan offered by the same company.
  • If you’re already getting your health benefits (for example, through an employer health plan) through the same organization that offers the Medicare Advantage Plan.
  • If you had ESRD, but have had a successful kidney transplant, and you still qualify for Medicare benefits (based on your age or a disability), you can stay in Original Medicare, or join a Medicare Advantage Plan.
  • You may be able to join a Medicare Special Needs Plan (SNP) for people with ESRD if one is available in your area.

If you have ESRD and are in a Medicare Advantage Plan, and the plan leaves Medicare or no longer provides coverage in your area, you have a one-time right to join another plan. You don't have to use your one-time right to join a new plan immediately.

If you go directly to Original Medicare after your plan leaves or stops providing coverage, you'll still have a one-time right to join a Medicare Advantage Plan later.