If I Have ESRD, When Will My Coverage Begin?
Because when you’re managing dialysis or a transplant, your coverage timeline shouldn’t be confusing.
If You’re on Dialysis
Your Medicare coverage begins the first day of the fourth month of your regular dialysis treatments.
If you have employer or group health insurance, your plan may pay for the first three months before Medicare starts.
However, your Medicare can start sooner—as early as the first month of dialysis—if all of these apply:
✅ You join a home dialysis training program through a Medicare-certified facility during your first 3 months of dialysis
✅ Your doctor expects you’ll complete the training and perform dialysis at home
✅ You continue a regular course of dialysis during the typical waiting period
If You’re Preparing for Dialysis
Medicare rules differ depending on whether you already have coverage:
- If you already have Medicare: It covers services needed to prepare for dialysis, such as surgery for access placement.
- If you don’t have Medicare yet: Medicare may still cover preparation costs if you complete a home dialysis training program as described above.
- If neither applies: Medicare won’t pay for dialysis preparation until your coverage officially begins.
If You’re Getting a Kidney Transplant
If you’re admitted to a Medicare-certified hospital for a kidney transplant, your coverage can start as early as the month you’re admitted—as long as your transplant takes place that month or within the next two months.
Example:
If you’re admitted for transplant on February 15, your Medicare coverage starts February 1.
If the transplant is delayed to March or April, your coverage still starts in February.
If the transplant is delayed more than two months, coverage begins two months before the actual transplant.
If You Sign Up Late
If you wait to apply for Medicare after you’re already eligible because of ESRD, your coverage can start retroactively for up to 12 months before the month you apply.
This can help cover dialysis or transplant-related costs you paid out of pocket before you enrolled.
When ESRD Coverage Ends
If you have Medicare only because of ESRD, your coverage will end:
- 12 months after you stop dialysis, or
- 36 months after you receive a kidney transplant.
Coverage can restart if:
- You begin dialysis again within 12 months of stopping, or
- You receive another kidney transplant within 36 months of your last one.
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We work with multiple Medicare plan carriers including:
- Aetna Inc.
- Devoted Health, Inc.
- Humana Inc.
- Mutual of Omaha Insurance Company
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