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Dialysis Medicare Advantage

Amani Posted Sun 27th of October, 2013 17:41:38 PM


Do you know what is the maximum number of treatments of dialysis Patients (or months) enrolled under MA before the benefits transfer under Straight Medicare?is there a limit? or the patient benefits for dialysis will continue to be under MA plan?

Thank you,

SuperCoder Answered Mon 28th of October, 2013 11:50:15 AM

We are working on this, please bear with us.

SuperCoder Answered Mon 28th of October, 2013 20:03:38 PM


I believe you are looking for the information mentioned in pages 13-15 of the following document.

Kindly go through this excellent article and please revert if this help you.

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Amani Posted Tue 29th of October, 2013 10:52:52 AM

So if the patient is enrolled under MA plan, the plan will continue to cover his dialysis. There is no such a time limit (example after 30 months) that Medicare will start covering the cost for dialysis? Thank you

SuperCoder Answered Tue 29th of October, 2013 18:29:13 PM

Renal Medicare can be available as soon as the first month of treatment for chronic renal failure. Coverage ends 3 yr after transplantation for recipients who have a functioning allograft at that time and who are not eligible for Medicare coverage by virtue of age or permanent disability.

If the patient first succeeds at one of the home-based dialysis modalities, then Medicare entitlement is available retroactively to the first day of the month in which dialysis took place. In-center dialysis patients have a waiting period before entitlement becomes available on the first day of the fourth month of treatment. A kidney transplant either before initiation of dialysis or during the waiting period brings Renal Medicare entitlement retroactive to the first day of the month of transplantation.

As it stands, Renal Medicare now provides lifetime coverage for patients who remain on dialysis. Transplant recipients who reach age 65 by the end of their Renal entitlement or who remain in the Social Security Disability program are also entitled to lifetime coverage for their medical care as well as their immunosuppression medications.

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