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If you have End-Stage Renal Disease (ESRD)

If you have ESRD, you'll usually get your health care through Original Medicare. You can only join a Medicare Advantage Plan in certain situations:

  • If you're already in a Medicare Advantage Plan when you develop ESRD, you may be able to stay in your plan or join another plan offered by the same company.
  • If you have an employer or union health plan or other health coverage through a company that offers Medicare Advantage Plans, you may be able to join one of its Medicare Advantage Plans.
  • If you've had a successful kidney transplant, you may be able to join a Medicare Advantage Plan.
  • You may be able to join a Medicare Special Needs Plan (SNP) for people with ESRD if one is available in your area.

If you have ESRD and are in a Medicare Advantage Plan, and the plan leaves Medicare or no longer provides coverage in your area, you have a one-time right to join another plan. You don't have to use your one-time right to join a new plan immediately.

If you go directly to Original Medicare after your plan leaves or stops providing coverage, you'll still have a one-time right to join a Medicare Advantage Plan later.

 

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