Basic (03-86)

DI 45001.089 Acknowledgement of Report of Kidney Transplant

This notice acknowledges receipt of your report that you have received a kidney transplant. Under the law, Medicare coverage will end the last day of the 36th month after the month in which an individual receives a kidney transplant unless by that time a regular course of dialysis is begun or a new kidney transplant is received. We will contact you shortly before the 36th month for information about your condition at that time.

If you have any questions about your claim, you may contact any social security office. Most questions can be handled by telephone or mail. However, if you visit an office, please take this notice with you.