Medicare and Employer-Sponsored Insurance (If You Have ESRD)
Because when you’re managing kidney care, it helps to know exactly who pays what.
How It Works
If you have End-Stage Renal Disease (ESRD) and are covered by both Medicare and an employer-sponsored health plan, there are special rules that determine who pays first.
- The plan that pays first is called the primary payer.
- The plan that pays second is the secondary payer.
The secondary payer may cover only part of what’s left after the primary payer processes your claim—or nothing at all, depending on the service and your plan.
The 30-Month Coordination Period
If you have health coverage through your employer or a family member’s employer, your employer plan pays first for the first 30 months after you become eligible for Medicare due to ESRD.
After those 30 months, Medicare becomes the primary payer, and your employer or union plan becomes the secondary payer.
Your employer plan may still help cover services Medicare doesn’t pay for, but coverage details vary. It’s best to check with your benefits administrator or HR department to confirm how your plan coordinates with Medicare once that 30-month period ends.
Before You Enroll
If you’re still working—or covered through a spouse’s employer plan—talk with your HR department or benefits manager before enrolling in Medicare.
They can help you confirm:
- Whether your coverage counts as creditable
- How your plan will coordinate payments with Medicare
- Whether your dependents can stay on your employer plan
Need Help Sorting It Out?
If you have questions about how your coverage works with Medicare, contact the Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627 (TTY: 1-855-797-2627). Hours: Monday – Friday, 8 a.m. – 8 p.m. ET (except holidays)
Keep Exploring
Managing ESRD often means balancing multiple types of coverage. Learn when Medicare starts, how long it lasts, and what happens if your treatment or transplant timeline changes.
Read: If I Have ESRD, When Will My Coverage Begin?
RO4983413
We work with multiple Medicare plan carriers including:
- Aetna Inc.
- Devoted Health, Inc.
- Humana Inc.
- Mutual of Omaha Insurance Company
Need help? Contact us(opens in a new tab)
Talk to a licensed insurance agent: (833) 748-5302 TTY: 711
Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you are in your Medicare Initial Enrollment Period. Enrollment depends on plan’s contract renewal with Medicare.
Your privacy is important to us. We won't share your contact information with anyone. By providing your email address, you agree that a sales representative may contact you and consent to receiving marketing messages. No obligation.
Medicare Advantage and Part D plans are insured by a Medicare Advantage HMO, PPO and PFFS organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment depends on plan’s contract renewal with Medicare.
We do not offer every plan available in your area. Currently we represent 4 organizations which offer 1056 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.
Not all carriers offer these benefits. Plans vary by region and state. Limitations and exclusions may apply.
Every year, Medicare evaluates Medicare Advantage and Part D plans based on a 5-star rating system.
Estimated annual costs are based on the usage you provided + yearly premiums. Medicare Advantage and Medicare Supplement plan calculations include the standard Part B premium + any Part B premium reductions. Actual annual costs depend on your usage, along with your Part B premium and the date you enroll.
Medicare Supplement insurance is generally available to individuals age 65 and older enrolled in Medicare Parts A and B. Availability for beneficiaries under age 65 who qualify for Medicare due to disability or End Stage Renal Disease varies by state. Benefits, eligibility, and premiums may vary by state.
Jellyvision does not discriminate based on race, color, national origin, age, disability, or sex. Calling this number will direct you to a licensed insurance agent. No obligation to enroll.
The Jellyvision Lab, Inc. All rights reserved. Jellyvision is not affiliated with or endorsed by any government entity. This is an advertisement for insurance.