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ESRD Medicare Timeline

  • Medicare starts on first day of fourth month of Hemodialysis
  • Medicare goes back to 1st day of month that Peritoneal Dialysis began
  • Medicare goes back to 1st day of month that kidney transplant is received
  • Medicare pays after your insurance does, it pays deductibles and copays
  • Medicare Part B covers outpatient dialysis, you may pay a late penalty if you wait to enroll

*30 month coordination begins whether or not you sign up for Medicare

  • Medicare starts paying before your group/employer based insurance plans
  • Patients need to make sure Medicare knows about their group coverage and that group plan knows the patient has Medicare as the first payer
  • Medicare always pays first before Medicaid, Children’s Special Health Care Services and TRICARE
  • Medicare will stop paying 36 months after the month you have a kidney transplant (If the patient is not getting Medicare because of age or another disability)
  • If patient recovers kidney function and is no longer on dialysis or stops getting treatment, Medicare will end 12 months after the month you stop dialysis

Medicare will be extended if:

  • You start dialysis again or get a kidney transplant within 12 months after the month you stopped dialysis; or
  • You start dialysis or get another kidney transplant within 36 months after the month you get a kidney transplant
Medicare Entitlement and 30 Month Coordination Period Begins
  • Medicare starts on first day of fourth month of Hemodialysis
  • Medicare goes back to 1st day of month that Peritoneal Dialysis began
  • Medicare goes back to 1st day of month that kidney transplant is received
  • Medicare pays after your insurance does, it pays deductibles and copays
  • Medicare Part B covers outpatient dialysis, you may pay a late penalty if you wait to enroll

*30 month coordination begins whether or not you sign up for Medicare

30 Month Coordination Period Ends
  • Medicare starts paying before your group/employer based insurance plans
  • Patients need to make sure Medicare knows about their group coverage and that group plan knows the patient has Medicare as the first payer
  • Medicare always pays first before Medicaid, Children’s Special Health Care Services and TRICARE
End of ESRD Medicare
  • Medicare will stop paying 36 months after the month you have a kidney transplant (If the patient is not getting Medicare because of age or another disability)
  • If patient recovers kidney function and is no longer on dialysis or stops getting treatment, Medicare will end 12 months after the month you stop dialysis

Medicare will be extended if:

  • You start dialysis again or get a kidney transplant within 12 months after the month you stopped dialysis; or
  • You start dialysis or get another kidney transplant within 36 months after the month you get a kidney transplant