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Can I get Medicare if I have advanced kidney disease?

Yes, you can receive kidney-care benefits if you’re 65 or older and enrolled in Medicare. You also may be eligible for Medicare coverage before age 65 based on your kidney condition if you, your spouse or your parent (for dependent children) has earned enough work credits.

For Medicare purposes, permanent kidney failure is known as chronic kidney disease stage 5, or end-stage renal disease (ESRD). It means your kidneys have stopped working properly and you need regular dialysis or a kidney transplant to stay alive.

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If you’ve been diagnosed with kidney failure, Medicare may waive its usual two-year waiting period required for people who qualify based on receiving Social Security Disability Insurance (SSDI). About 8 in 10 Americans with kidney failure have Medicare coverage, according to the National Kidney Foundation.

End-stage renal disease is one of two conditions that allow people to receive Medicare quickly before age 65. The other is amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease.

To qualify, you generally need to earn 40 work credits toward Social Security by age 65. Workers who pay FICA taxes receive one benefit credit for every $1,730 in earnings in 2024 (the amount changes annually), earning a maximum of four credits a year. However, younger people diagnosed with kidney failure may not need 40 quarters to be eligible for Medicare benefits, according to the National Kidney Foundation:

  • Younger than 24: Six credits earned three years before kidney failure​​.
  • Ages 24 to 30: Half the work credits earned from age 21 until kidney failure.​​
  • Ages 31 to 43: 20 credits earned 10 years before kidney failure​​.
  • Ages 44 to 61: 20 credits earned 10 years before kidney failure, plus two credits for every two years starting at age 44​​.
  • 62 and older: 40 credits earned before kidney failure.

Call Social Security at 800-772-1213 or sign up for a My Social Security account to find out how many work credits you have. Medicare’s Eligibility Tool can also offer guidance.

Another option: You can qualify as the spouse or dependent child of a person who has earned enough work credits. Your State Health Insurance Assistance Program (SHIP) can help with Medicare enrollment and coverage questions.

People with ESRD aren’t required to sign up for SSDI to receive Medicare coverage, but they need to take steps to enroll. You can contact the Social Security Administration to start the Medicare application process.


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When does Medicare coverage for kidney disease take effect?

If you’re 65 or older, you can receive kidney-related benefits from Medicare anytime after you enroll.

For new enrollees younger than 65, Medicare coverage begins based on the dialysis or kidney transplant you need:

  • If you’re using a dialysis center, Medicare coverage can start the first day of the fourth month of dialysis treatment and continues for up to 12 months after you stop dialysis.
  • If you’re in a home dialysis program, your coverage can begin the first month of dialysis and continue for up to 12 months after you stop dialysis. 
  • If you’re getting a kidney transplant, you can generally receive Medicare benefits the month you’re admitted to the hospital. Coverage usually continues for 36 months after you’ve had the transplant and no longer need dialysis.
  • If you need to resume dialysis or have another transplant, coverage will begin again without a waiting period. If you’re also eligible for Medicare because of another disability or because you’re 65 or older, your coverage won’t end.
  • If you’re a transplant recipient and have met your 36-month coverage limit, you can now sign up for the Medicare Part B immunosuppressive drug benefit, which became available on Jan. 1, 2023. With this coverage, Medicare Part B continues to cover your transplant immunosuppressive drugs at 80 percent if you have no other insurance coverage that contains a benefit for anti-rejection drugs. The standard monthly premium for this benefit is $103 in 2024; high earners pay more. This program only covers immunosuppressive drugs, not other Part B coverage.
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New rules for Medicare Advantage and kidney disease

People with end-stage renal disease can now receive coverage through either original Medicare or a private Medicare Advantage plan. Before the 21st Century Cures Act of 2016 opened the door to coverage beginning Jan. 1, 2021, people with kidney failure couldn’t enroll in Medicare Advantage.

At age 65, you can sign up for Medicare Advantage when you first enroll in Medicare parts A and B. You can also sign up or switch plans during open enrollment from Oct. 15 to Dec. 7, with new coverage starting Jan. 1.

If you’re younger than 65, you can enroll in Medicare Advantage when you first become eligible for Medicare under ESRD rules after signing up for parts A and B. You can also sign up for Medicare Advantage or switch plans during open enrollment each year. 

Before choosing a Medicare Advantage plan, make sure your care team, including your primary care physicians, dialysis provider, nephrologist, transplant center and other specialists like cardiologists and endocrinologists, is part of the plan’s network. If you’re pursuing a kidney transplant, find out how the plan will cover Part B medications, such as those to prevent rejection of the transplant.

Some Medicare Advantage special needs plans offer coverage for people with ESRD. These plans provide services to support dialysis, help manage care for kidney patients, and may include a dedicated kidney care team.

For more information about coverage for ESRD under original Medicare and Medicare Advantage, see’s Medicare Coverage of Kidney Dialysis & Kidney Transplant Services.

Keep in mind

If you’re younger than 65 and qualify for Medicare because of ESRD, find out about your state’s rules on Medicare supplement policies, also called Medigap, before deciding between original Medicare and Medicare Advantage. These rules may be a deciding factor in your choice.

Even though you can buy a Medigap policy within six months of signing up for Medicare Part B at age 65, regardless of preexisting conditions, rules for younger people vary by state. These plans can help pay out-of-pocket costs for parts A and B of original Medicare.

Some states don’t have guaranteed issue rights for Medigap if a Medicare beneficiary is younger than 65, which makes it difficult to qualify for coverage with a preexisting condition such as ESRD. Contact the SHIP program in your area to learn more about your state’s rules.

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