Medicare Part A and Part B (Original Medicare) extended benefits to those suffering from end-stage renal disease (ESRD) in 1972 to help cover the high cost of medical care for those with permanent kidney failure.
Medicare benefits are typically available to people under 65 who have been diagnosed with ESRD.
Original Medicare may cover a range of services to help treat kidney failure, including:
To qualify for Medicare coverage of ESRD, you must:
You can also qualify through the work history of your spouse or parent.
If you’re eligible for Medicare because you have ESRD, you can apply for Medicare benefits by visiting your local Social Security Office or by contacting Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
Medicare Advantage (Medicare Part C) plans are not typically available if you have ESRD unless you meet one or more of the following criteria:
If you do not qualify for a standard Medicare Advantage HMO or PPO plan, you may be eligible to enroll in a Medicare Special Needs Plan (SNP).
Medicare SNPs limit membership to people with specific diseases or financial circumstances.
Medicare Advantage SNPs tailor their benefits, provider choices and drug formularies to best meet the specific needs of the groups they serve, such as people living with ESRD.
A licensed insurance agent can help you better understand your coverage options and get you enrolled in a plan that works for you.
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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.
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Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
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