If I start dialysis, how does that change my Medicare eligibility or coverage?

Question

Melonie Wood · Accepted Answer

Most people on dialysys are covered on their plan.  A member on Medicaid-Medicare, all cost would be covered, depending on their plan & cost share

Andrew Zurbuch, MBA · Answer

For both Original Medicare Part A & Part B for eligibility it doesn't. It does not change your eligibility status. If your entitled to Original Medicare, like working 40 quarters in the U.S., then you are entitled to it. It starts the Month of your 65th birth Month or the month after receiving 24 Months of Disability payments. This is just 2 of the ways to be eligible.  

As for coverage if your already on Medicare Part A & Part B at the time of your diagnosis then dialysis does not affect your status on Original Medicare. 

Claims regarding dialysis are a different question or questions & therefore not addressed herein. Thank you.

Andrew J. Zurbuch, MBA
Licensed Broker
Integrated Financial
azurbuch@i-f-s-in.com

Yasmery Vargas · Answer

It does not change your eligibility or coverage.  Depending on the plan will ultimately decide out of pocket expense.

Bruce Kern · Answer

Definitely not as you are guarantee issue when you first turn 65. either with a Medicare Supplement or a Medicare Advantage Plan

Tony Hardwick · Answer

You would become eligible for a Chronic Special Needs plan. There are plans that are built specifically for individuals with diabetes, heart conditions, and ESRD.

Calvin Fritz · Answer

If you're under 65 and have end-stage renal disease (ESRD), which requires dialysis or a kidney transplant, you’ll become eligible for Medicare when you begin dialysis. This applies regardless of age, and you don’t need to wait until you're 65 to apply.

If you're over 65 and already on Medicare, there’s no change to your eligibility for Medicare; your coverage will continue as normal. However, starting dialysis might mean that you’ll need to adjust your plan choices to accommodate the new medical needs.

Joseph Lombardo · Answer

Thank you for your question. If you are under 65 and have ESRD (End Stage Renal Disease), eligibility for Medicare would start on the 4th month of dialysis, however, if you're 65 and over and already qualify for Medicare, your eligibility for coverage for dialysis would start immediately. I hope this helps.

Answered by Joseph Lombardo on April 21, 2025

Agent Licensed in NY, CT, NJ & PA

Answered by Joseph Lombardo Medicare Insurance Agent

If I start dialysis, how does that change my Medicare eligibility or coverage?

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If I start dialysis, how does that change my Medicare eligibility or coverage?

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