Re: Medicare enrollment after transplant

[Guest guest]

,

I have copied and pasted

an answer I received from Santana back in 2010 on a Medicare eligibility

question. I believe based on this information, it sounds like your

patient can sign up for Medicare now with a retroactive effective date of

8/1/2011. Of course Part B premiums will have to be back paid upon enrollment.

The patient would then have a Medicare covered transplant with coverage under

Part B for immunosuppressants.

Maddox

Transplant Financial Coordinator

Via Christi Hospital

Transplant Institute

929 N St Francis, Suite M157

Wichita KS 67214

PH

FX

shannon.maddox@...

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,

I

have a question in regards to a patient that has been on dialysis since 2003,

but never signed up for Medicare. I have read through our TFCA list serve

and the Medicare 2010 & You 2010 booklet and cannot find anything

specifically related to my situation. I am familiar with the 30 month COB

period and how the patient can sign up during that time frame.

What

if the 30 months has long passed and the patient comes in for a

transplant? Does the transplant event open up another opportunity in

which they can enroll? Or are they only allowed to sign up during that 30

month time frame?

Thank

you for your assistance.

Maddox

Transplant

Financial Coordinator

Hi ,

Good to hear from you, I

always enjoy your conference and I hope I can assist this year too!

Here are the answer

to your questions:

Q- What if the 30 months

has long passed and the patient comes in for a transplant?

A-

If the individual meet

the eligibility requirements for Medicare based on ESRD i.e.

·

entitled to a monthly

benefit under title II (Social Security retirement benefits)or an annuity under

the Railroad Retirement Act; or

·

fully or currently

insured; or

·

the spouse or dependent

child of a person who is entitled to a monthly benefit or fully or currently

insured, as described above.

The individual can apply for Medicare at any time he/she

meets the above requirements.

Q- Does the transplant event open up another

opportunity in which they can enroll?

A-

No, the transplant do not

open another opportunity, but if the individual meets all the eligibility requirements mentioned on

the previews response he/she can apply for Medicare at any time. Eligibility

for Medicare can begin with the earliest of the preceding 12 months from the

date the application was filed, provided all other conditions of eligibility

were met.

Note:

This is in the case an individual postponed enrollment in Medicare, meaning

Part A and Part B.

A person entitled to Medicare Part A on the basis of

ESRD is also entitled to Medicare Part B effective with the same month (except

if the person enrolled in Part A and declined Part .

If there will be 6 or more months' premium arrearage,

Medicare Part B can be elected as of:

·

The first month of Medicare Part A entitlement; or

·

The month of filing; or

·

The month of processing

Q- Or are they only allowed to sign up during

that 30 month time frame?

A- Same

as above.

Conclusion,

since this individual postponed enrollment in both, Medicare Part A and Part B,

he/she can apply for Medicare at any time and enrollment can be retroactive up

to 12 months, keeping in mind that if he/she wants Part B retroactive he/she

would have to pay all the premiums due upon enrollment.

I hope this is helpful, should you need

additional information or have a follow up questions, please do not hesitate to

ask.

Santana

Office

of External Affairs

200

Independence Ave S.W

Washington,

DC 20201

Mail

Stop 303D-01

Phone#

david.santana@...