AHIP Practice Exam

If a person with end-stage renal disease (ESRD) begins dialysis, when does their Medicare coverage usually start?

1. On the first day of dialysis

2. The day they apply for Medicare

3. Three months after dialysis begins

4. The fourth month after dialysis treatments start

The correct answer is: The fourth month after dialysis treatments start

Medicare coverage for individuals with end-stage renal disease (ESRD) typically begins in the fourth month after they start dialysis treatments. This means that for the first three months of dialysis, Medicare coverage is not yet in effect. The purpose of this waiting period is to manage costs and ensure that Medicare resources are allocated efficiently. Individuals who undergo dialysis may apply for Medicare benefits while in the process, but the official coverage under Medicare begins as stipulated after the required waiting period. This helps to establish a framework for consistent care and ensures that those who require ongoing treatment due to ESRD have a structured process for receiving their benefits. In some cases, individuals may be eligible for Medicare coverage earlier than four months due to certain extenuating circumstances, but this is not the standard procedure for most patients starting dialysis. The other options presented do not align with this standard policy regarding the initiation of coverage, reinforcing why the fourth month is recognized as the typical start date for Medicare coverage in this context.