Contents
Introduction
Section 1: Medicare Basics
What is Medicare?
What Medicare covers
What Medicare costs
Part A costs
Part B costs
Paying for Part B
Who’s eligible?
Medicare plan choices
How to sign up for Medicare
When Medicare coverage begins
When Medicare coverage ends
How Medicare works with employer or union group health plan coverage
When the 30-month coordination period starts
When the 30-month coordination period ends
How the 30-month coordination period works if you enroll in Medicare more than once
Do I have to get Medicare if I already have an employer or union group health plan?
For more information about how employer or union group health plan coverage works with Medicare
Medicare for children with ESRD
Section 2: Kidney Dialysis
What is dialysis?
Dialysis treatment options
Dialysis services and supplies covered by Medicare
Home dialysis services and supplies NOT covered by Medicare
Medicare payment system for dialysis services
What’s included in the new payment system
What YOU pay for dialysis services in a dialysis facility under the new payment system
Medicare payment for children with ESRD
Training for self-dialysis at home
Doctors’ self-dialysis training services
Home dialysis
Monthly doctor visits for home dialysis
How long will Medicare pay for home dialysis equipment?
Dialysis in a hospital
Inpatient doctors’ services
Outpatient doctors’ services
Where to get dialysis treatments
How to find a dialysis facility
“Dialysis Facility Compare”
Knowing how well your dialysis is working
Dialysis when you travel
Transportation to dialysis facilities
Section 3: Kidney Transplants
What is a kidney transplant?
Kidney transplant services covered by Medicare
Transplant drugs (cal ed immunosuppressive drugs)
What are immunosuppressive drugs?
What if I stop taking my transplant drugs?
How long will Medicare pay for transplant drugs?
What if I can’t pay for the transplant drugs?
Special information about pancreas transplants
What YOU pay for kidney transplant services
Do I have to pay for my kidney donor?
Hospital services
Doctors’ services
Clinical laboratory services
Section 4: How Medicare Pays for Blood
What YOU pay for blood
Having blood donated
Can I be charged for the blood that I have donated?
Section 5: Medicare Prescription Drug Coverage
What it costs
Extra Help for those who need it most
How do I apply for Extra Help?
When you can join
Section 6: Appeals & Grievances
Your Medicare rights
Appeals
Appeal rights in Original Medicare
Appeal rights in a Medicare health plan
Filing a grievance (complaint)
Section 7: Other Kinds of Health Insurance
Employee or retiree coverage from an employer or union
Medicare Supplement Insurance (Medigap) policies
Medicaid
Veterans’ benefits
Other ways to get help
Section 8: Where to Get More Information
Kidney organizations
End-Stage Renal Disease (ESRD) Networks
State Health Insurance Assistance Programs (SHIP)
State Survey Agency
Other Medicare products for kidney patients
Important phone numbers
Section 9: Definitions
Index