How much does it cost to use a Medicare broker?

Nothing. A licensed Medicare broker like Anthony Orner is paid by insurance carriers, not by you. There's no fee for plan reviews, comparisons, or enrollment help for dialysis patients with ESRD.

How do I apply for Medicare if I'm on dialysis?

You apply through Social Security. If you have ESRD requiring regular dialysis, you can qualify for Medicare regardless of age. Coverage typically starts the fourth month of dialysis, though it can begin sooner if you train for home dialysis.

Can dialysis patients enroll in Medicare Advantage plans?

Yes. Since 2021, people with ESRD can enroll in Medicare Advantage during the annual Open Enrollment Period (October 15 through December 7). Before that change, ESRD patients were largely locked out of Advantage plans.

Who pays the 20% that Medicare doesn't cover for dialysis?

Under Original Medicare, you're responsible for 20% of the Medicare-approved amount after meeting the Part B deductible ($283 in 2026). A Medigap policy, Medicaid, or employer coverage can pick up that cost share. Without secondary coverage, those bills add up fast at three sessions per week.

Medicare Broker for Dialysis Patients — Navigating ESRD Coverage and Plan Options

A Medicare broker for dialysis patients can save you from the confusion that hits when kidney failure forces you into the insurance system earlier than expected. Three sessions a week, bills arriving from directions you didn't anticipate, coverage timelines that don't line up with when you actually need treatment.

I'm Anthony Orner, a licensed Medicare broker. I help ESRD patients across New Jersey and beyond sort through eligibility rules, plan options, and the cost gaps nobody warned them about. No cost to you, ever.

Call for Free Advice — 855-559-1700

How Medicare eligibility works with end-stage renal disease

ESRD gives you Medicare eligibility at any age. You don't have to be 65. According to Medicare.gov, you qualify if your kidneys have permanently failed, you need regular dialysis or have had a transplant, and you (or a spouse or parent) have enough work credits under Social Security.

Coverage generally starts the fourth month after dialysis begins. If you start home dialysis training, it can kick in as early as month one. That gap between starting treatment and gaining coverage catches people off guard.

Original Medicare vs. Advantage for dialysis: key differences

Original Medicare (Parts A + B): Covers inpatient dialysis under Part A and outpatient sessions under Part B. You pay 20% of the approved amount after the $283 Part B deductible (2026). You can pair it with a Medigap plan to cover that 20%.
Medicare Advantage (Part C): Since 2021, ESRD patients can enroll during Open Enrollment (October 15 through December 7). Some plans offer $0 premiums and extra benefits like transportation. But network restrictions matter when you rely on a specific dialysis center.

Neither option is automatically better. It depends on your dialysis center's network status, your other medications, and whether you have secondary coverage already.

Coordinating employer coverage with Medicare during ESRD

If you're under 65 and still working when you start dialysis, your employer plan typically pays first for 30 months. Medicare acts as secondary. After that 30-month coordination period, Medicare becomes primary.

This transition is where costly mistakes happen. Miss a deadline and you risk a coverage gap or a Part B late enrollment penalty of 10% for every 12-month period you delayed. I walk my clients through the exact timeline so nothing falls through.

What the 20% cost share really looks like

Dialysis three times a week can run $6,000 or more per month at the Medicare-approved rate. That 20% cost share adds up to over $1,200 monthly if you have no secondary insurance. Over a year, that's more than $14,000 out of pocket.

A Medigap plan, Medicaid, or certain Advantage plans can absorb that cost. If you're not sure what's covering the 20% right now, that's exactly the kind of thing I review for free.

Avoiding coverage gaps when aging off a parent's plan

Younger dialysis patients often lose a parent's insurance at 26. The waiting period for Medicare or Medicaid approval can leave you exposed for weeks. Planning ahead matters here.

If you're approaching that birthday, call me before your coverage ends. We can map out interim options and make sure your Medicare application is already in motion at Social Security.

Request a free ESRD plan review with Anthony Orner

You shouldn't have to figure out coordination periods, cost shares, and network restrictions while managing dialysis three days a week. I review your current coverage, identify what you're actually paying, and show you whether a different setup saves money or protects you better.

There's no fee, no obligation, and no pressure.

Talk to a broker who understands ESRD coverage.

Call 855-559-1700 or get a free quote online.