Going back to work


I have been on dialysis, first PD and now Home Hemodialysis. I’ve been doing home hemo for about 3 years and I feel great on it. My blood work is good, and I’ve felt healthy enough to re-enter the workforce. Currently on SSD and Medicare + Private insurance (Emblem Health). My nephrologist once told me “Look out that window at the people walking around. You’re healthier than half of those people, some of whom aren’t even aware of what condition they have.”

Recently a Real Estate Director of Career Development for a large Real Estate Broker suggested I become a Real Estate Salesperson. I would be an independent contractor. This means I would be financially responsible for my own health insurance.

Is this something I should pursue? If so what are my options as far as health insurance that covers home hemo?

Would the Affordable Care Act be a useful option? Is that insurance in the place of the Emblem Health private insurance?

How long will Medicare still cover me after I start work full time?

Thanks so much for taking the time to read my post and helping us renal disease patients!

It’s great to hear that you’re feeling well and want to return to work. I encourage anyone who feels well enough to work as much as they are able.

So far as health insurance, as long as you’re on dialysis and pay your Medicare Part B premium, you can keep Medicare. It doesn’t matter if you work or not. If you get a transplant, you can keep Medicare for 36 months post-transplant. If you have another disability that makes you eligible for Medicare besides kidney failure, you can keep Medicare for several years even if you work enough that your Social Security Disability checks stop. Is your Emblem Health a Medigap (Medicare supplement) plan or individual plan? If it’s a Medigap plan, it should stay in effect as long as you have Medicare and pay the premiums. If it’s an individual plan, you should be able to keep it if Medicare ends post-transplant as long as you can afford the premiums. If you lose Medicare down the road, you should be able to get health insurance through the health insurance marketplace. There may be help to pay premiums if your income is limited. If you have Medicare, you can’t buy a plan through the health insurance marketplace.

There’s a great book from Social Security that describes various Social Security work incentive programs that help people on SSDI or SSI return to work and even keep getting checks while they work during a “trial work period.” If you have “impairment-related work expenses” (defined in the book), Social Security can deduct those expenses from your gross income before determining if you make enough that you don’t need disability checks (called “substantial gainful activity”). You can find that book here:

The Emblem Health plan is a Medicare supplement plan. It’s encouraging that I’ll be able to keep the insurance as I have it now.

Thank you Beth!