ESRD and PPO Plan Coverage

People with End-Stage Renal Disease (ESRD) are not allowed to join PPO Plans. However, if a person gets ESRD while they are on the plan they can remain within the plan and use these insurance services. PPO Plans can end and when this happens these people find themselves in a strange predicament. They have a one-time right to rejoin another PPO Plan. This right does not need to be used immediately and there may be another exception that the ESRD patient can use instead of taking advantage of their one time right to rejoin a PPO plan.

Exceptions to the ESRD Rule

In some cases when a Medicare PPO ends ESRD patients will be allowed to join another PPO plan rather than returning to Original Medicare. For example if your plan ends you are allowed to join another plan that is offered through the same insurance company. Similarly, if your benefits plan or employment offers Medicare PPO Plans you may be able to use one of their plans if your current coverage ends. ESRD patients that have undergone a successful kidney transplant are also able to join another PPO plan. ESRD patients could also look into joining a Medicare Special Needs Plan. These plans are designed for people with Special needs and are organized to deal with the special situations that surround the lives of ESRD patients.

ESRD patients have very unique needs and they should contact Medicare if their plan sends them a notice telling them that it is planning on ending. Changing insurance with ESRD is a serious decision. Within Medicare there are specialists that help ESRD patients navigate their way through the various plans so that the patient is able to choose the best option for their health care if their current plan ends.