Centers for Medicare & Medicaid Services & Social Security Administration Form CMS-10798 (Application for Enrollment in Part B-ID) / Form SSA-10798 Consolidated Appropriations Act 2021 § 402 · Social Security Act § 1836(b) · 42 CFR § 407.1

Form CMS-10798 (Application for Enrollment in Part B-ID) / Form SSA-10798 Instructions: Medicare Part B Immunosuppressive Drug Benefit (Part B-ID): Lifetime Anti-Rejection Medicine for Kidney Recipients

“My Medicare expired 36 months after my kidney transplant, but my anti-rejection meds cost $2,000/month. How do I get lifetime immunosuppressive drug coverage?”

Official Procedural Summary & Rules

Kidney transplant recipients who lose full Medicare after 36 months can enroll in Part B-ID to receive lifetime anti-rejection drug coverage at a discounted premium.

Key Statutory Rules & Exceptions

Part B-ID covers immunosuppressive drugs indefinitely; you will never lose transplant drug coverage due to time limits. • The monthly premium is roughly one-third of the standard Medicare Part B premium. • Low-income individuals qualify to have the state pay the entire Part B-ID premium under Medicare Savings Programs.

Official Procedural Sequence

Confirm termination of 36-month full Medicare Complete Form CMS-10798 Mail to local Social Security office

⚠️ Administrative Traps & Rejection Triggers

Enrolling in Part B-ID if you already have active employer health insurance or full Medicaid (you are statutorily ineligible).

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Under Section 1836(b) of the Social Security Act and CMS regulations, detail Part B-ID coverage: (1) The permanent elimination of the 36-month Medicare cutoff for kidney transplant immunosuppressive medications; (2) The dedicated Part B-ID benefit (nominal monthly premium, ~1/3 of standard Part B, covering 80% of immunosuppressive drug costs for life); (3) Eligibility rules (individual does not have other comprehensive health coverage like employer group health, Medicaid, or TRICARE); (4) Enrolling via Form CMS-10798 with Social Security; (5) Coordination with Medicare Savings Programs for zero premium.

Related Federal Forms & Sibling Procedures

Form CMS-L564 & Form CMS-40B: Turning 65 While Still Working: Avoiding the Lifetime Medicare 10% Penalty → Form SSA-24 & Form SSA-8: Surviving Spouse Social Security: Claiming 100% Benefit & the $255 Lump-Sum Death Payment → Form CMS-10141 (Part D Late Enrollment Penalty Reconsideration): Medicare Part D Prescription Drug Penalty: Proving Creditable Coverage & Appeals → Form SSA-1 (Application for Retirement Insurance Benefits): Social Security 62 vs. 67 Break-Even Age: Statutory Penalty Math & Health Reality → State Institutional Medicaid Application: Medicaid Long-Term Care: Navigating the 5-Year Look-Back & Caregiver Child Exception → Form SSA-1020 (Application for Extra Help with Medicare Drug Plan Costs): Medicare Extra Help (LIS): Securing $0–$11 Co-Pays for Low-Income Seniors → Form SSA-2 (Application for Wife's/Husband's Insurance Benefits): Divorced Spouse Social Security: Claiming on Ex-Partner Without Affecting Their Benefit → Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount): Medicare IRMAA Surcharges: Slashing $1,000s in Part B & D Fees via Form SSA-44 →