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Modality
ESRD
Age
Disability
Initial
Medicare
Entitlement
Due to:
Hemodialysis / Nocturnal
Hemo – 3-month wait for
Medicare entitlement
PD/Home Hemo/Self Care
– 3-month waiting period
waived
The CMS 2728 form must
indicate training started
within the first 3 months
of the RCDB / FDODE
start date
First reason patient would be entitled to Medicare if they
had applied timely
Patient covered by
EGHP & policy holder
must be currently
employed & group
must have 20 or more
employees at the time
patient is entitled for
Medicare due to ESRD
Patient has an EGHP
30-month COB
If Medicare
entitlement due to
Age and ESRD occur in
the same month, ESRD
takes precedence
Patient covered by EGHP
& policy holder must be
currently employed &
group must have 100 or
more employees at the
time patient is entitled
for Medicare due to
ESRD
If Medicare entitlement
due to Disability & ESRD
occur in the same
month, ESRD takes
precedence
If patient was initially entitled
to Medicare due to Disability,
and turns 65 before ESRD
entitlement, initial
entitlement becomes Age
Words of Wisdom from
COB Experts
Throughout our Neighborhoods