Children & End-Stage Renal Disease

Learning that your child has End-Stage Renal Disease (ESRD) can be one of the hardest things you have to face as a parent. There are many important questions such as:

  • What kind of treatment is available for ESRD?
  • What is the best treatment for ESRD?
  • How will I cover the costs of treatment for ESRD?

When you think of Original Medicare, you generally think the coverage is for individuals over the age of 65. However, there are cases where Original Medicare will cover a person under the age of 65, one of which is children who have been diagnosed with ESRD. Original Medicare can help cover most costs for ESRD even if you currently have other health coverage and provide consistent protection.

The first step is to determine whether your child qualifies for Medicare coverage. Below is a chart of eligibility requirements:

Please note: A child is defined as a person that is younger than 22 years of age, and unmarried. They must be your biological child, stepchild for at least one year, legally adopted child, or grandchild/step-grandchild.

To receive Medicare benefits, your child must first be enrolled and satisfy the waiting period. You or your child (if 18 years or older) can contact your local Social Security office to enroll or obtain more information. You can call Social Security at 800-772-1213 to make an appointment. At your visit, you will want to bring the following information:

  • Your child’s birth certificate and Social Security Card
  • Your Social Security Card
  • CMS FORM 2728 (End-Stage Renal Disease Medical Evident report Medicare Entitlement and/or Patient Registration). You can download the form by clicking here, or from your doctor’s office, dialysis unit, or by visiting Medicare.gov

When it comes to treatment for ESRD there are always new discoveries and clinical breakthroughs. Do your own research and don’t be afraid to speak with doctors about options covered by Medicare. For more information on Children with ESRD, you can visit Medicare.gov

If you have any additional questions regarding coverage options, please contact Medicare Pathways and speak with a licensed sales agent at 866-466-9118.