Medicare Plans and Kidney Disease: Get Covered for ESRD
If you have End-Stage Renal Disease (ESRD), can you sign up for Medicare? Yes. You can get your healthcare coverage through Original Medicare Parts A & B when you turn 65 or if you have been on Social Security Disability for 24 months. If you want to sign up for a Medicare Insurance plan in addition to having Original Medicare, there are a few more things you need to be aware of.
Can I sign up for a Medicare Advantage Plan (MAPD)?
As of 2020, Medicare members with ESRD can only have a Medicare Advantage Plan if the following are true:
1. You were already on an MAPD when you developed ESRD.
2. You currently have an MAPD, but that plan leaves Medicare or stops providing coverage in your area.
*Quick heads up: In 2021, the rules for MAPD plans and those with ESRD will be changing and more Medicare Beneficiaries with ESRD will be able to sign up for MAPDs.
What if I want to sign up with a Medicare Supplement Plan (Medigap Plan)?
If you take out your Medicare Parts A & B when you turn 65, you will be able to join a Medigap plan. There are also few instances when a Medicare member can sign up for a Medigap plan and receive a guarantee issue without having to answer underwriting questions about their health. The rules for these guarantee issues vary from state and insurance carrier, so it’s best to discuss this option with a local insurance agent who knows the plans in your area.
What if I no longer have ESRD because I’ve had a successful kidney transplant? Can I still get Medicare?
Yes, you still qualify for Medicare (given you’re at least 65 years old or have a disability that qualifies you for Medicare). You can use Original Medicare as your insurance or enroll in a MAPD. In order to enroll in a Medigap plan, talk to an agent to find out if you qualify for a guarantee issue.
Signing up for a Medicare Plan when you first turn 65 is a more straightforward process because you have a guarantee issue called your initial enrollment period. However, we know ESRD doesn’t show up when it’s convenient for you to enroll in an insurance plan. So if you have ESRD and want to sign up for a Medicare Insurance Plan, talk to a local agent to find out what plans in your area are available to you.
Caress Insurance Agency, Inc has local agents who are ready to help you find a plan. We work with Scripps Affiliated Medical Groups to help answer your Medicare questions.