Few individuals know that Medicare does provide some level of coverage for some younger patients who have End-Stage Renal Disease (ESRD), a terminal disease and will need a transplant or dialysis. If you or someone you know is diagnosed with ESRD, understanding Medicare and ESRD will make financial issues easier and provide the greatest benefits in the quality of care.

Who Can Qualify for Medicare under ESRD?

Compared to the regular age-based Medicare eligibility, ESRD patients are eligible at any age if they meet the following conditions:

• They have chronic kidney failure that necessitates multiple dialysis or kidney transplant.
• They have earned (or are a beneficiary of someone who has earned) enough Social Security or Railroad Retirement benefits.
• They are getting dialysis at a Medicare-certified facility or are on home dialysis treatment.
• This unique pathway to Medicare coverage is significant to these patients who are undergoing expensive treatments.

What Medicare Covers for ESRD Patients

Once a patient enrolls in Medicare due to End-Stage Renal Disease, he or she is eligible for full benefits in connection with the treatment of the kidneys such as:

Inpatient and outpatient dialysis treatments

Home dialysis training and management

Dialysis drugs

Kidney transplant surgery

Post-transplant immunosuppressive drugs

But Medicare does not cover trips to dialysis facilities or other non-medical home care.

How many months is Medicare to ESRD patients?

The coverage period depends on the treatment:

Dialysis Patients: Medicare begins on the first day of the fourth month of receiving treatment with dialysis and lasts until the patient's continued dialysis treatment.

Kidney Transplant Recipients: Medicare coverage is maintained for 36 months following surgery if a transplant is undertaken unless the patient is covered on the basis of age or disability. Preventing Delay and Increasing Coverage

To receive immediate Medicare benefits:

Use as soon as possible after diagnosis in an effort to avoid surprise gaps in coverage. Enroll in Medicare Part A (hospital) and Part B (doctor) to pay for necessary care. Discuss Medicare Advantage or Medigap coverage for supplemental insurance to help pay out-of-pocket costs. Medicare's End-Stage Renal Disease (ESRD) special rules are intimidating, but professional guidance can simplify them. If you're looking at plan options or eligibility requirements, a licensed Medicare broker can guide you through your benefits and coverage options. Medicare's specialized treatment for ESRD patients is a precious medical and financial assistance program, but few individuals know about these benefits. If you or a loved one is experiencing kidney failure, taking the time to learn about Medicare options can make a big difference in treatment and finances. Take the time to investigate all options and speak with a licensed Medicare broker to make informed decisions regarding your healthcare coverage.