Medicare

[Ihavethreekids]

My son was born with a kidney disease. He's 33. He recently had a transplant. We are having issues with the hospital social worker and Medicare. The hospital says he needs to apply for Part A within one year of transplant. Medicare is saying not to do this. My son has a full time job and has good insurance. He has never been on dialysis. I need guidance. Has anyone experienced this?

[Bassetmommer]

I would look to an insurance broker. They charge nothing for helping people with insurance issues like yours. I do not know where you live, but I have one that can help people in NY or Florida.

[maddux320]

Hello! I recently had a transplant and my hospital social worker told me not to apply for Medicare if you are already covered medical insurance. Medicare will require a monthly premium payment if you go ahead and apply for it, hence you are now having to pay for two medical insurance.

[Oceansideup]

I had my transplant 3 years ago and already had health insurance as well.

The reason I was told by the hospital to apply for the 3 year ESRD Medicare was, if I didn’t, I would have trouble getting immunosuppressant drug coverage once I lost my private insurance later due to retiring.

That said, policies and laws change all the time, especially with regard to drug coverage, so it’s best to do your homework. I do not know if this is still the case now, especially since Medicare is advising you not to apply?

Won’t hurt to ask Medicare this question tho…and if there are any penalties later if you do not sign up for this benefit now.

[Rupmh]

We were told to, and did, sign up for part A effective date of transplant. There is no charge for this. Part B is required 30-36 months after transplant as your son’s private insurance becomes secondary after 30 months “the coordination period.” If we did not sign up for part B, the understanding was that immunosuppression medication and visits for post transplant care would not be covered by the private insurance for these six months.

[LavenderRabbit]

I think it all depends on whether your son was ever on dialysis or not. You get Medicare automatically when you go on dialysis. Of course you do have to pay for it, but believe me it’s worth it if you’re on dialysis. You then get to keep it for three years after transplant. You should ask somebody in the know about it.

[EmTexas in reply to LavenderRabbit]

I think once you have a transplant, you’re deemed to be eligible. If you have dialysis it’s earlier. The premium for the 3yrs coverage of Medicare is relative to annual income. It may not make sense for him to apply based on that. However if he does, it’s a good fall back if he loses his job. The premium can be steep though.

[maximina]

My son is now 40 years old......he has never worked because of his FSGS condition. He is now on dialysis and waiting for a kidney transplant.....he has private insurance and I pay for everything. I am 81 years old and still working since I have to cover the expenses....Could someone out there inform if he could apply for Medicare? I was told that he would not qualify since he never worked.....we live in California and I don't want for him to apply for Medical...what other resources are there. Would appreciate any recommendations.

[CKD2-4]

Hi: NKF just did a webinar on this topic. If you review it on their website you might get some direction. I thought it was informative and they did review situations like your sons.