Over 65, Working, and Diagnosed With ESRD: The 30-Month Coordination Period
Yes. If you are over 65, still working, and have active employer group health coverage when ESRD eligibility begins, the 30-month coordination period applies. Your employer 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 coverage and just diagnosed with ESRD — which plan pays first?
- Your employer 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 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.