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I have end-stage renal disease, what are my Medicare options?
If you have end-stage renal disease (ESRD) and are currently enrolled in a Medicare Advantage plan, you may be eligible to enroll in Original Medicare (Part A and Part B) and/or a Medicare Supplement (Medigap) plan outside of the typical enrollment periods. Here are some options to consider:
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1. Enroll in either Medicare Advantage or Original Medicare:
If you have ESRD, you are eligible for Medicare coverage, regardless of your age. You can enroll in either Medicare Advantage or Original Medicare (Part A and Part B) during the Initial Enrollment Period (IEP) or during a Special Enrollment Period (SEP).
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If you are currently enrolled in the Original Medicare plan, you may want to consider enrolling in a Medicare Advantage Plan because it may provide specific coverage for dialysis services and other treatments related to ESRD. Starting in 2021, Medicare Advantage plans are required to accept individuals with ESRD.
If you are enrolled in Original Medicare Parts A and B, you may also want to consider enrolling in a Medicare Supplement (Medigap) plan.
Medigap plans help pay for some of the costs that Original Medicare does not cover, such as copayments, coinsurance, and deductibles.
If you enroll in a Medigap plan during your Open Enrollment Period, you will have guaranteed issue rights, which means that you cannot be denied coverage or charged more because of your ESRD.
If you enroll in Original Medicare, you may also want to consider enrolling in a Medicare Prescription Drug Plan (Part D) to help pay for the cost of your prescription medications. Enroll in a Medicare Part D:
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If you prefer to stay in a Medicare Advantage plan, you may want to consider enrolling in a Medicare Advantage plan that specializes in ESRD. These plans are designed to provide comprehensive care for individuals with ESRD, including dialysis, transplant services, and other treatments related to ESRD.Enroll in a Medicare Advantage Part C for ESRD: It is important to note that your options may depend on whether you're enrolled in Original Medicare or the specific Medicare Advantage plan you are enrolled in. It's recommended to review your plan's benefits and speak with either a Medicare representative or a licensed and qualified insurance agent to understand your options and make an informed decision.
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