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Waiting period for Medicare coverage

Credentialing Resource Center Connection, July 28, 2005

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Q: Is there a waiting period to be covered for benefits for dialysis for Medicare? I was told there is a 90-day waiting period. What about Medicaid and coordination of benefits between Medicare and Medicaid?

A: The waiting period is called the test of permanence. The client may receive his or her Medicare card, but the start date is after 90 days.

You cannot bill Medicare for the 90-day waiting period; that is where Medicaid or other insurers come in. Even though the patient has Medicare after 90 days, Medicare is the supplemental payer until 18 months have lapsed.

If the first insurance is private, that is the primary payer until the 18 months have expired. If the first insurance is Medicaid, then Medicare will become primary and the start date will be on the card.

This question was answered by Karen Basinger, MS, LN, renal dietitian at Wheaton (MD) Dialysis Center.

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