Wondering if Medicare is going to catch up with me...

[Sax-O-Trix]

My transplant will be 30 months young at the end of September.  I am wondering if I will be automatically enrolled in Medicare (never been on it)  and sent a bill.  I still don't get how I can be forced into Medicare payments at 30 months for 6 months when I already pay for private insurance through my employer.  Ugh.  Has anyone here dealt with this?

[amanda100wilson]

Yes, although I was on dialysis.  My insurance co. said that I had to see if I was eligible for Medicare coverage.  I didn't think I was but the Social Security office said I was.  So still have to pay private insurance premiums so that they pay the difference.

[jeannea]

For my first transplant, I worked except for 8 weeks off. I did not do dialysis. I used only my work insurance and never signed for Medicare. Eleven years later when that transplant failed I went on dialysis and signed up for Medicare. I would say don't worry about it. No one at Medicare wants to sign up up almost 3 years after a transplant.

[Bill Peckham]

My transplant will be 30 months young at the end of September.  I am wondering if I will be automatically enrolled in Medicare (never been on it)  and sent a bill.  I still don't get how I can be forced into Medicare payments at 30 months for 6 months when I already pay for private insurance through my employer.  Ugh.  Has anyone here dealt with this?

A transplant doesn't count, only dialysis.

Medicare kicks in if you start dialysis, a 30 month clock starts 3 months after your first dialysis treatment, after 33 months Medicare becomes your primary insurer, so long as you or your spouse or your parent if you're a dependent have enough work quarters paying FICA.

Once you are using dialysis and Medicare Primary, if you then get a transplant a 36 month clock starts, after 36 months with a successful transplant you loose your Medicare eligibility due to ESRD (you could still qualify due to age or disability).

[cattlekid]

I have the opposite problem.  I signed up for Medicare in 2012 because I thought that transplant was around the corner.  Prior to that, my employer insurance was happily paying for everything related to dialysis and my yearly OOP maximum was very reasonable. 

So I signed up for Medicare because I thought I had to.  Turns out I shoveled them over $1200 over the course of a year and they didn't pay out squat because my primary insurance was paying 100% of everything already when I signed up. 

I received my transplant in 2013 and my employer insurance again paid 100%.  Nothing went to Medicare. 

My transplant meds average a total of $30 per month for everything because I am on all generics.  I never bothered telling the pharmacy to switch it to Medicare because I can swing a dollar a day for my meds.

I haven't bothered paying Medicare their last premium and now I got the next premium notice saying that I will be dropped from Medicare Part B at the end of August unless I pay up.  Well, I am not planning on it because it's a complete waste of money. 

I still can't get a straight answer from anyone as to the drawbacks of dropping Medicare but I know that I will be damned if I will continue to shell out this money for absolutely nothing.

[Sax-O-Trix]

Somehow I was under the impression that I will be automatically signed up for Medicare for the 30-36 month period post-transplant and my primary insurance will become secondary to Mecicare for those 6 months.  It doesn't make sense to me, but then again anything to do with the government doesn't make sense to me most of the time anyway, lol.  I was never on dialysis, worked full-time right up to the Friday prior to my Tuesday transplant and then took 6 or 7 weeks off to recover. 

I hope Bill is correct because I'd really rather not deal with the temporary switch, extra payments and hassles.  Thank you for your thoughtful responses!  I'll post if I receive a bill in the next month or so

[appleface]

My transplant will be 30 months young at the end of September.  I am wondering if I will be automatically enrolled in Medicare (never been on it)  and sent a bill.  I still don't get how I can be forced into Medicare payments at 30 months for 6 months when I already pay for private insurance through my employer.  Ugh.  Has anyone here dealt with this?

A transplant doesn't count, only dialysis.

Medicare kicks in if you start dialysis, a 30 month clock starts 3 months after your first dialysis treatment, after 33 months Medicare becomes your primary insurer, so long as you or your spouse or your parent if you're a dependent have enough work quarters paying FICA.

Once you are using dialysis and Medicare Primary, if you then get a transplant a 36 month clock starts, after 36 months with a successful transplant you loose your Medicare eligibility due to ESRD (you could still qualify due to age or disability).

This is good to know. I am near the end of the 36 months after transplant. Can I just terminate the Medicare coverage without penalty?
I am 55 years old and  Medicare is primary before I got the transplant. My company has good plan. Thanks

[cattlekid]

Do not mess with this.  I tried cancelling Medicare and once the end of my 30 month coordination period rolled around, my insurance company stopped paying my claims because they said I was eligible for Medicare and didn't take it.  So now I am straightening that out.  No real financial issue but too much paperwork headache.

[appleface]

Do not mess with this.  I tried cancelling Medicare and once the end of my 30 month coordination period rolled around, my insurance company stopped paying my claims because they said I was eligible for Medicare and didn't take it.  So now I am straightening that out.  No real financial issue but too much paperwork headache.

Thank you very much for the information. Hope Everything  is ok with you. I know the pain of paperwork.  Now I am trying to find out if the saa knows That I had transplant . Although Medicare paid the transplant fee as primary, It does not mean SAA  knows I had transplant. Thought Medicare  is part of SAA! 2 years ago, when I went to the Saa  office, the saa guy told me that they were contractors and they just collected paper. But they did not know what paper I should turn in. So I get no answer from SAA office. By the way, did your social work let you turn in Cms 2728 form to saa after the transplant? I found out from the internet that saa use this as a report to establish that You had transplant if you had dialysis prior to the transplant.
 Best regards