End-Stage Renal Disease (ESRD), Amyotrophic Lateral Sclerosis (ALS) and Medicare Eligibility

People diagnosed with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig’s disease, may be eligible for Medicare coverage, even if they are younger than 65 years of age. 

How do I Become Eligible for Medicare if I Have ESRD?

You are eligible for Medicare if you have been diagnosed with ESRD and you have the minimum number of work credits to qualify for retirement benefits. 

If you are eligible for Medicare Part A, you also have the option to sign up for Medicare Part B to help pay for outpatient medical services. 

If you enroll in Part A and Part B, you are eligible to enroll in a Medicare Advantage plan to get Part A and Part B bundled together. Most Medicare Advantage plans also include prescription drug coverage and other health care benefits like hearing, vision and dental. 

When Do My Medicare Benefits for End-Stage Renal Disease Begin?

The day your Medicare coverage begins depends on your situation.

• If you are on dialysis, your eligibility will begin on the first day of the fourth month of dialysis treatment. 
• If you begin a self-dialysis training program, you can become eligible for Medicare right away. 
• If you are getting a kidney transplant, Medicare coverage will begin the month you are admitted to the hospital. Or, your Medicare coverage will begin two months before the date of your transplant if you have been admitted to the hospital for more than two months.

If you are younger than age 65, your Medicare coverage will end one year after you stop dialysis treatment or three years after you have a kidney transplant. If you need additional medical services because of ESRD, you may become eligible for Medicare again. 

How do I Become Eligible for Medicare if I Have ALS?

If you have been diagnosed with ALS you are eligible for Medicare as soon as you begin receiving Social Security Disability Insurance (SSDI) benefits. 

Individuals with ALS can get SSDI benefits sooner than some other younger people with disabilities. You will be eligible for SSDI five months after being declared disabled by a health care provider.

You can sign up for SSDI by contacting your local Social Security office. Or, if you are a railroad retiree, call your Railroad Retirement Board field office.

When Do My Medicare Benefits for ALS Begin?

You will be enrolled in Original Medicare as soon as you begin receiving your disability benefits. 

Once you are enrolled in Original Medicare, you are also eligible to enroll in a Medicare Advantage plan to get Part A and Part B bundled together. Most Medicare Advantage plans also include prescription drug coverage and other health care benefits like hearing, vision and dental. 

Have Questions? Learn More from Banner Health. 

Learn more about Banner Health’s Medicare Advantage plans.

Learn about Banner Health’s Medicare Part D plan.

Contact Banner Medicare so we can answer any questions you may have and even help you enroll. 

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