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End-Stage Renal Disease (ESRD) Medicare Changes to Expect in 2021

A couple on their couch reads more information about the End-Stage Renal Disease Medicare changes to expect in 2021

Although eligible for Medicare, individuals with End-Stage Renal Disease (ESRD) have historically been restricted from enrolling in Medicare Advantage plans. The 21st Century Cures Act will lift that restriction beginning in 2021, which is a significant change for those with ESRD. The best time to learn more about Medicare options and Medicare Advantage plans is during the Medicare Annual Enrollment Period—also known as AEP—that runs every year from October 15-December 7. 

ESRD Medicare Changes in 2021

Individuals with ESRD, including those under age 65, have Medicare Eligibility to enroll in Original Medicare but prohibited from enrolling in Medicare Advantage plans unless they:

  • Developed ESRD after enrollment or
  • Were grandfathered in through employer-sponsored coverage

The change, effective January 1, 2021, will allow those with ESRD to enroll in Medicare Advantage plans, which increases their options for chronic-disease management and potentially more flexible or affordable payment opportunities. 

End-Stage Renal Disease (ESRD) Medicare Coverage

Medicare benefits were extended to individuals suffering from End-Stage Renal Disease in 1972, and to this day, kidney failure is one of only two medical conditions that qualifies individuals for Medicare without a two-year waiting period regardless of age. There are specific rules and eligibility for coverage, but Original Medicare covers most services for ESRD treatment. Costs can vary depending on the type of treatment and services. 

How to Prepare for End-Stage Renal Disease 2021 Medicare Enrollment with SelectQuote

Shopping around for Medicare coverage can seem intimidating, especially when there are new plans available, but we can help simplify the process and answer any questions you might have about Medicare eligibility, enrollment, or coverage for treatment of End-Stage Renal Disease (ESRD). The service is free, there’s no obligation to enroll, and we can help ensure you’re getting all of the available Medicare benefits you’re entitled to.

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