Understanding SSDI, SSI, and Medicare for Kidney Failure
Kidney failure can affect your ability to work and to pay for care. Several government programs may help, but none of them is automatic. Each program has its own rules, and only the agency that runs it can decide whether you qualify.
Social Security Disability Insurance (SSDI)
SSDI pays monthly benefits to people whose health condition stops or limits their ability to work and who have enough work history in jobs covered by Social Security. The monthly amount depends on your earnings before your disability began.
Supplemental Security Income (SSI)
SSI makes monthly payments to people who have a disability, are blind, or are age 65 or older, and who have little or no income and resources. It is based on financial need.
How Social Security Looks at Kidney Disease
Social Security’s medical listings for kidney disease include:
- Chronic kidney disease treated with ongoing hemodialysis or peritoneal dialysis that has lasted, or is expected to last, at least 12 months in a row
- Chronic kidney disease with a kidney transplant, which Social Security considers disabling for one year from the transplant date before it reviews how you are doing
Meeting a medical listing is only one part of the decision. Social Security also looks at your work, your income, and other program rules.
Medicare for Kidney Failure (ESRD)
You can get Medicare at any age if your kidneys no longer work, you need regular dialysis or have had a kidney transplant, and one of these is true:
- You have worked the required amount of time under Social Security, the Railroad Retirement Board, or as a government employee.
- You already get, or qualify for, Social Security or Railroad Retirement benefits.
- You are the spouse or dependent child of someone who meets one of the requirements above.
When coverage starts and ends
- Coverage usually starts on the first day of the fourth month of dialysis.
- It can start in the first month if you train for home dialysis during your first three months of dialysis and meet the other conditions.
- For a transplant, coverage can start the month you are admitted to a Medicare-certified hospital for the transplant, if the transplant happens that month or within the next two months.
- Medicare based only on kidney failure usually ends 12 months after the month dialysis stops, or 36 months after the month of a kidney transplant.
Learn more on Medicare’s End-Stage Renal Disease page.
Medicaid
Florida Medicaid may help pay for care for people who meet income and other rules. Medicaid eligibility in Florida is handled by the Department of Children and Families at 1-866-762-2237.
Before You Apply
- Gather your medical records, including the date you started dialysis or had a transplant.
- List your doctors, dialysis center, and hospitals, with addresses and phone numbers.
- Have your work history, income, and bank information ready.
- Keep copies of every application, letter, and confirmation number.
- If you are denied, ask about the appeal process and the deadline right away.
- Ask your dialysis or hospital social worker, or a benefits counselor, for help.
For a wider look at income, housing, food, and other programs, see Government and Disability Resource Navigation.
Where to Verify
- Social Security: Disability (SSDI): Learn about SSDI and how to apply.
- Social Security: SSI: Learn about SSI and how to apply. Social Security phone: 1-800-772-1213. TTY: 1-800-325-0778.
- Medicare: End-Stage Renal Disease: Medicare eligibility and coverage dates for kidney failure.
- Florida Division of Vocational Rehabilitation: Help for people with disabilities who want to work. Phone: 800-451-4327.
Before You Use This Information
This page is for general education only. It is not legal, medical, or benefits advice, and it does not decide whether you qualify for any program. Rules and phone numbers can change, so confirm details directly with the agency or organization. Please read our Medical Disclaimer.
Organizations listed on this page are outside resources. Marshall Kidney Foundation is not affiliated with them, and a listing here is not an endorsement.
Do you have a question about this topic? Contact us and let us know.
