If you are only eligible for Medicare because you have End-Stage Renal Disease (ESRD) and your condition improves, your Medicare coverage may end. Your ESRD Medicare coverage will end if:

  • You no longer need dialysis. Your Medicare coverage will end 12 months after the month of your last dialysis treatment.
  • You had a successful kidney transplant. A transplant is considered successful if it lasts for 36 months without rejection. If your transplant was successful, your Medicare coverage will end 36 months after the month of the transplant.

Your ESRD Medicare coverage can resume if, within 12 months of stopping dialysis, you start dialysis again or have a transplant. Coverage also continues if, within 36 months of having a transplant, you start dialysis or have another transplant.

If you become eligible for ESRD Medicare again after your previous coverage ends, you can start receiving ESRD Medicare without a waiting period. Your Medicare coverage will either resume the first of the month that you start dialysis again or the first of the month you have a kidney transplant. There is also a separate 30-month coordination period each time you become eligible for ESRD Medicare.

Note: If you receive a kidney transplant and want Part B to cover your immunosuppressant drug costs, you must have Medicare Part A at the time of your transplant. If you do not have Medicare when you receive a transplant, your immunosuppressant drugs will be covered by Part D after your transplant. Part D coverage for this type of drug typically means higher costs and additional restrictions, such as having to go to specific in-network pharmacies for your drugs.

If you have Medicare due to age or disability, your Medicare coverage will continue regardless of your ESRD Medicare status.

Return to: Medicare In-depth

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