ESRD Over 65 and Working: 30-Month Coordination
Yes. If you are over 65, still working, and have active employer or union group health coverage when ESRD eligibility begins, the 30-month coordination period applies. Your employer or union plan pays first and Medicare pays second for the first 30 months. After 30 months, Medicare becomes the primary payer.
Frequently Asked Questions
- I'm over 65 with employer or union coverage and just diagnosed with ESRD — which plan pays first?
- Your employer or union group health plan pays first for the first 30 months of ESRD Medicare eligibility, regardless of your age. After 30 months, Medicare becomes the primary payer.
- Do the standard age-65 employer size rules (20-employee threshold) apply with ESRD?
- The ESRD 30-month coordination rules are separate from the standard age-65 employer-size rules. With ESRD, the 30-month coordination period is driven by ESRD eligibility date.
- Should I enroll in Part B if my employer or union plan is paying first with ESRD?
- Yes. Enroll in both Part A and Part B when ESRD eligibility begins. After the 30-month period ends, Medicare becomes primary — if you delayed Part B, you could face a gap in coverage.