The moments that shape your kidney coverage

What happens

Medicare for kidney failure usually starts in your fourth month of dialysis. If you train for home dialysis in your first three months, it can start in your first month.

Your dialysis center and your doctor complete a form that shows your kidney failure. You then sign up for Medicare through Social Security.

To decide

Whether to take Part A and Part B, and how to fill the gaps: a Medicare Advantage plan, or Original Medicare with a Medigap policy and a drug plan.

How we help

We explain the dates, give you a checklist for the form and the sign-up, and show both paths with the same care.

What happens

If you have health coverage through your job or your spouse’s job, it pays first for 30 months. Medicare pays second during that time.

To decide

When to start Part B, and what to do when the 30 months end.

How we help

We help you mark the dates and plan the change before it comes.

What happens

Medicare can help pay for a kidney transplant and for the drugs you take after it.

If you have Medicare only because of kidney failure, it ends 36 months after a successful transplant. A separate Part B benefit may keep paying for your transplant drugs after that.

To decide

A plan that keeps your transplant center and your doctors in reach. Many transplant centers ask for a dental exam before you can be listed.

How we help

We check that your choices fit your transplant plans, including dental coverage.

What happens

Medicare covers people with kidney failure at any age.

Medicare Advantage plans can enroll people with kidney failure. Each plan has a yearly limit on what you pay for covered care in its network.

Medigap rules for people under 65 are different in each state. In some states, companies must sell you a policy. In others, they do not have to.

To decide

Which path protects you more in your state: Medicare Advantage, or Original Medicare with Medigap.

How we help

We explain the rules where you live and compare both paths.

What happens

When you turn 65 and have Part B, a six-month Medigap open enrollment period starts. In that time, a company cannot refuse to sell you a Medigap policy or charge you more because of your health.

To decide

Whether to keep your current coverage or change it.

How we help

We remind you before your birthday and review your options with you.

What happens

From October 15 to December 7, you can change your Medicare Advantage plan or your drug plan.

From January 1 to March 31, people in a Medicare Advantage plan can switch to another Medicare Advantage plan or go back to Original Medicare.

To decide

Whether your plan still fits your dialysis center, your doctors, your drugs and your budget.

How we help

We review your coverage with you each autumn.

What happens

If you have both Medicare and Medicaid, some plans are built to coordinate both. Medicaid or a state program may also help pay your premiums and costs.

To decide

Whether a plan for people with both kinds of coverage fits you better.

How we help

We explain how your Medicaid and your Medicare work together.

What happens

Original Medicare pays for dialysis at Medicare-certified facilities across the United States.

Medicare Advantage plans must cover dialysis when you are briefly away from the plan's service area. Call your plan before you go.

If you move, you may get a chance to change plans.

To decide

How to keep your dialysis on track while you are away, or after you move.

How we help

We help you plan ahead and review your choices after a move.