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Author Topic: medicare and employer insurance after transplant  (Read 3574 times)
sullidog
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« on: May 14, 2013, 05:36:30 PM »

After my transplant since I'm not on dialysis anymore I noticed medicare switched back to secondary and my employers insurance went back to primary again. Is this common? Any idea why this happened? I thought medicare would at least be primary until I was no longer elgible for it. I also get it do to my blindness so maybe that's it?
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
JaeCie
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« Reply #1 on: January 23, 2014, 06:19:20 PM »

THis is common. You get forced Medicare for I believe it's 18 or 24 months post-transplant and then back to primary insurance - which is a good thing since you pay for it anyway. If you go back on dialysis - certainly hope you don't - then the old Medicare stuff kicks in again.
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smcd23
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The patient, the baby and the donor - October 2010

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« Reply #2 on: January 23, 2014, 07:39:33 PM »

How long has it been post transplant?

When you are on Medicare and also have employer insurance through current employment, Medicare is typically secondary. HOWEVER when you have Medicare for ESRD this is only true for the first 30 months. Then after 30 months,  Medicare switches to primary and the employer insurance is secondary. Things would continue like this so long as you are on Medicare for ESRD. So for example, my husband became eligible in 2/2010. Medicare was secondary for 30 months, and now that period is over, so Medicare is primary and my insurance is secondary.

You continue to get Medicare under the ESRD rules for 36 months post transplant. If you are past that point, but still qualify for Medicare based on disability or age, it would revert to the regular Medicare rules, which is Medicare is secondary to employer health insurance through current work.
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Caregiver to Husband with ESRD.

1995 - Diagnosed with vesicoureteral reflux and had surgery to repair at age 11. Post surgery left side still had Stage I VUR, right side was okay. Both sides were underdeveloped.
2005 - Discovered renal function was declining, causing HBP. Regular monitoring began.

March 2008 - Started transplant evaluation for preemptive transplant due to declining function.

September 16, 2008 - Transplanted with my kidney.
September 18, 2008 - Kidney was removed due to thrombosis in the vessels in and leading to the kidney.

October 2008 - Listed in Region I

May 2009 - Started in Center Hemo
January 2010 - Started CCPD on Liberty Cycler

June 15, 2012 - Kidney transplant from a 43 year old deceased donor
June 22, 2012 - Major acute rejection episode and hospitalization began
June 27, 2012 - Nephrectomy to remove kidney after complete HLA antibody rejection. Possibly not eligible for another transplant, ever again.

Now what?
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