To enroll in Medicare if you have End-Stage Renal Disease (ESRD), go to your local Social Security office. Even if you are a railroad worker, you should enroll in Medicare by contacting Social Security (Only those railroad workers who get Medicare based on age or disability enroll through the Railroad Retirement Board.)

Your doctor and dialysis center will have to send documentation to Social Security verifying that you have ESRD and stating what kind of treatment you need. Call the National Social Security Hotline at 1-800-772-1213 for the office nearest you. If you are unable to enroll yourself due to illness, a family member or other responsible party can enroll for you.

When your Medicare begins depends on your treatment plan:

  • If you need dialysis and start a self-dialysis training program, Medicare begins the first day of the first month of the program. You must start the training program before your third month of dialysis. However, your doctor must also state that he or she expects that you can complete the training program and will continue self-dialysis after the program ends. 
  • If you have been receiving dialysis, Medicare eligibility starts on the first day of the fourth month you get renal dialysis. For example, if you begin receiving dialysis on May 10, your Medicare eligibility will start on August 1.
  • If you receive a kidney transplant, Medicare begins with the month you are admitted to a Medicare-approved hospital for the transplant or for health care services that you need before getting the kidney transplant. 
    • You must receive the transplant that same month or within the two following months. If the transplant is delayed, Medicare coverage begins two months before the month of your transplant.