TN 67 (02-24)

HI 00801.215 ESRD Medicare Date of Entitlement - General Policy

Subject to the dialysis or transplant requirements in HI 00801.216 and HI 00801.221, entitlement to R-HI for an individual who meets the eligibility requirements in HI 00801.191 C. begins with the earliest of the following:

  • the third month after the month a regular course of renal dialysis begins (this period of non-coverage is called the qualifying or waiting period); or

  • the first month during which a regular course of renal dialysis begins if self-care dialysis training is begun before the qualifying period ends; or

  • the month of kidney transplant; or

  • the month of hospitalization as an inpatient in a Medicare-approved facility for procedures preliminary to a transplant, provided that the transplant occurs during one of the following two months; or

  • the second month prior to the month of kidney transplant if the inpatient procedures preliminary to the transplant took placemore than 2 months prior to the transplant; or

  • the first month during which a regular period of renal dialysis begins if the individual has had a previous period of R-HI entitlement.

Entitlement can never begin before the insured status requirement is met.

NOTE: R-HI may begin later in cases where the individual delays filing their application because of GHP coverage or the individual restricts the retroactivity of their application, see HI 00801.196.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600801215
HI 00801.215 - ESRD Medicare Date of Entitlement - General Policy - 02/27/2024
Batch run: 02/27/2024
Rev:02/27/2024