Is a Child Eligible for Medicare?

Medicare is the nation's largest health care coverage plan. It covers more than 40 million Americans and typically covers adults 65 years or older who qualify. However, if you have a child that has been diagnosed with end-stage renal disease (ESRD) and needs a kidney transplant or even dialysis, Medicare may help pay for some of the health costs.

Child's Eligibility

• Medicare benefits may apply if you have a child that is age 22 or younger and you either gave birth to, legally adopted or have been a stepparent to this child for at least one year. Grandchildren or step-grandchildren may also qualify.

Other Eligibility Requirements

• Additional eligibility requirements for Medicare coverage on your child would include Social Security credits. You or your spouse would need to have earned a minimum of six credits within the last three years by working and paying out Social Security taxes. Also, your child may qualify for Medicare if you or your spouse is eligible for Social Security or Railroad Retirement Benefits. If you are not sure if you meet the requirements, you can speak with a Social Security representative.

Kidney Dialysis

• If your child is in a hospital, Medicare may cover dialysis, kidney

  treatments and even doctor services. If your child isn't in a hospital, the coverage may still include outpatient dialysis treatments (in a Medicare-approved

  dialysis facility) and home dialysis equipment. The supplies, home support services, drugs, doctors' services and laboratory tests may also be provided.

Kidney Transplant

• If your child needs a kidney transplant Medicare may cover inpatient services at a hospital. Items in this coverage may include the registration fees for the kidney, laboratory tests, the cost of locating a kidney for transplant, surgery and blood transfusions. Medicare may also cover all of the medical costs associated with the donor.

Enrolling Your child

• To enroll your child into the Medicare program, you'll need to call or visit your local Social Security office. Have available your child's birth certificate, your identification, your child's and your own Social Security card, and form CMS 2728, which is a chronic medical evidence report that a doctor would provide. You can also visit the official Medicare website to see if you qualify (see Resources).

Medicaid

• If your child doesn't qualify for Medicare and you are a low-income family you might qualify for Medicaid, which also provides medical and long-term care coverage. This program is called the Children's Health Insurance Program (CHIP) and you can apply directly through your county's social services website.