Assisting a friend, who has ESRD and is on dialysis, navigate Medicare and private insurance benefits.
Some info:
- Began dialysis in December 2023
- SSDI Benefits began in June 2025
- Medicare premium deductions from SSDI benefits began in November 2025
- Currently on spouse's employer plan as a dependent
- Current age: 60
Questions:
When (what date) does the 30-month coordination period end, where Medicare is primary and the employer health plan is secondary? Some confusing responses by case/social worker at the dialysis center.
Now the twist: spouse has been informed that she and others will be laid off in November 2026. Spouse is looking for another position in the next few months and will hopefully land another position and will be on that employer's family health plan. Friend will be enrolled in that plan.
- If, for some reason, a new position is not found by November 2026, plan is to go on COBRA for family plan and/or find insurance in the marketplace (with similar great current coverage for family; understanding premiums/deductibles will be high).
- Does this make sense?
- OR, my friend can keep with current health insurance, but pay as a medicare gap/supplemental insurance plan for the other 20% coverage since Medicare will pay 80%. Friend has reached out to current insurance plan to walk through how this would work.
Any insight and/or suggestions would be greatly appreciated.