Medicare for kidney failure (ESRD)

People with End-Stage Renal Disease (ESRD), permanent kidney failure that needs regular dialysis or a transplant, can get Medicare at any age.

Who qualifies

You need dialysis or a kidney transplant, and one of these:

• You've worked long enough under Social Security, the Railroad Retirement Board or as a government employee.
• You already get, or qualify for, Social Security or Railroad Retirement benefits.
• You're the spouse or dependent child of someone who meets either of those.

You apply through Social Security; coverage isn't automatic.

When coverage starts

• Dialysis at a center: usually the first day of the fourth month of dialysis.
• Home dialysis training: as early as the first month of dialysis, if you take part in a Medicare-certified home training program during the first 3 months and keep up your treatments.
• Kidney transplant: the month you're admitted to a Medicare-certified hospital for the transplant or care before it, if the transplant happens that month or within the next 2 months.

Original Medicare or Medicare Advantage

Since 2021, people with ESRD can join Medicare Advantage plans. Before you choose one, make sure your dialysis center, kidney doctor and transplant center are in the plan's network. Medigap for people under 65 with ESRD depends on your state; see Medigap under 65.

When ESRD coverage ends

If you have Medicare only because of ESRD, it ends 12 months after the month you stop dialysis, or 36 months after the month of a kidney transplant. It can start again if you need dialysis or another transplant.