Four in 10 adults have two or more chronic conditions, and managing those conditions isn’t always easy.1 There are medications to take, specialists to see and various other treatment regimens to follow.
The good news is that Medicare covers a service called chronic care management (CCM) that’s designed to help you succeed. Learning about this important benefit can keep you healthy and out of the hospital.
Chronic care management is a service designed to help you manage your chronic conditions through frequent communication with your doctor and the creation of a personalized care plan that takes your unique physical, mental, cognitive, psychosocial, functional and environmental challenges into consideration.
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Examples of chronic conditions include, but aren’t limited to:
Medicare may pay for chronic care management if you have two or more chronic conditions that your doctor expects will last at least 12 months and that place you at significant risk of death, acute exacerbation/decompensation or functional decline.
If you’re not sure whether you’re eligible, be sure to ask your doctor.
When you consent to receive CCM, you may receive on or a few of a whole host of services that Medicare covers.
With CCM, you’ll also receive help with care transitions, care coordination with home- and community-based providers and 24/7 access to your provider for urgent care needs. All in all, it’s at least 20 minutes of services each month designed to help you get the connected care you need.
For many patients, CCM provides an extra boost of support beyond the face-to-face encounter. Through ongoing communications with your doctor, you’ll be able to take better control over your health and manage your chronic conditions more effectively.
If you want to become more engaged in your health, but you need a little help, CCM may be right for you.
No. It’s optional. You must consent to this service, and you have the right to stop it at any time (effective at the end of the calendar month).
If you consent to receive CCM services, you’ll pay a monthly fee, and the Part B deductible and coinsurance will apply.
Simply ask your doctor. Not every physician provides CCM services, but many do – particularly primary care physicians and internists. They can explain the process in greater detail and determine whether you’re eligible.
If you’re not satisfied with Original Medicare (Medicare Part A and Part B) and would like an insurance plan that provides more coverage, call to speak with a licensed agent at today. There may be Medicare Advantage plans (Medicare Part C) available near you that cover prescription drugs, transportation to your doctor's office and more.
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1 National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). (Jan. 12, 2021). About Chronic Diseases. https://www.cdc.gov/chronicdisease/about/index.htm.
Lisa Eramo is an independent health care writer whose work appears in the Journal of the American Health Information Management Association, Healthcare Financial Management Association, For The Record Magazine, Medical Economics, Medscape and more.
Lisa studied creative writing at Hamilton College and obtained a master’s degree in journalism from Northeastern University. She is a member of the American Health Information Management Association, American Academy of Professional Coders, Society of Professional Journalists, Association of Health Care Journalists and the American Society of Journalists and Authors.
Lisa currently resides in Cranston, Rhode Island with her wife and two-year-old twin boys.
LinkedIn: Lisa Eramo