Medicare Coverage of Kidney Dialysis & Transplant Services # 10128
Medicare Coverage of Kidney Dialysis & Transplant Services # 10128

I have been diagnosed with ESRD and will need a transplant.
I haven’t yet applied for Medicare.
Can I get a QHP- Qualified Health Plan – ObamaCare instead?

According to federal guidance, people with ESRD who have not applied for Medicare are eligible for premium tax credits if their income is between 100% and 400% of the federal poverty limit (FPL). This group can buy a Qualified Health Plan (QHP) instead of enrolling in Medicare. This federal guidance does not address the issue of someone with ESRD whose income is above 400% of the FPL and is ineligible for a premium tax credit and whether they can buy a QHP instead of Medicare. It also does not address the issue of whether a person in this situation whose income is between 100% and 250% of the FPL is eligible for any cost-sharing subsidy.

If you are considering a QHP instead of Medicare you should carefully compare all the costs and benefits associated with both a QHP and Medicare before making your decision. Please read the answer to #5 and 6. You should also know that if you do not enroll in Medicare Part A before you have a transplant, you will not be eligible for Medicare’s immunosuppressive medication benefit under Part B, even if you decide to enroll in Medicare later. In addition, you might be charged a late enrollment penalty and have a delay before benefits begin if you apply for Medicare in the future. For more help with this difficult decision, contact your local HICAP for assistance  Copied from ca health advocates.org/

Obamacare PROHIBITS discrimination or different rates based on health!   ‘‘§2701 Page 37  HR 3590 FAIR HEALTH INSURANCE PREMIUMS.

Related Pages in End Stage Renal  Section

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