SEKTC

I applied for Medicare, when will my Medicare coverage begin? 

• The effective date of Medicare based on ESRD is dependent upon the type of treatment you choose: 
• For hemodialysis patients, Medicare is effective in the 4th month of treatment 
  For example, if hemodialysis is begun in May, Medicare becomes effective on August 1. 
• For home dialysis patients Medicare is effective during the first month of treatment. 
• For trans
  • the month you’re admitted to the hospital for a kidney transplant or for health care needed prior to a transplant if the transplant takes place that same month or within the following two months
  • OR
  • Two months prior to transplant if the transplant is delayed more than two months after you are admitted to the hospital in anticipation of transplant or related health services 

I have insurance through my employer – do I need to apply for Medicare too? 

• If you have health insurance through your employer, you will be subjected to the Medicare Coordination of Benefits (COB) period. This means that your employee group health plan will pay for your dialysis treatment for 30 months and then Medicare will automatically become your primary insurance. If you choose to continue to keep your employee group health plan it would then become secondary to Medicare and could help pay the extra 20% not covered by Medicare part B. 

I have Medicare only. Can I sign up for supplemental insurance through the Affordable Care Act Marketplace? 

• No, the Affordable Care Act Marketplace only provides primary insurance to people without any health insurance coverage. You may want to see if you are eligible for Medicaid in your state or contact your State Health Insurance Assistance Programs (SHIPs) to see if there are supplemental insurance policies available for you in your state. If you would like personal help understanding Medicare A, B, D, and Medigap supplement plans, plus how to enroll in a suitable plan, contact your state’s SHIP. These trained volunteers are experts in Medicare resources and provide unbiased insurance counseling.