Chronic Care Management Coverage - Medicare

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Medicare Part B (Medical Insurance) may pay for a health care provider’s help to manage your care if you’re eligible.

• Covered by Part B

• After the Part B deductible , you pay 20% of the Medicare-approved amount

• Description
• Coverage details
• Who's eligible
• Costs

Description

Chronic care management includes:

• A comprehensive care plan that lists your health problems and goals, other providers, medications, community services you have and need, and other information about your health.
• 24/7 access to urgent care needs.
• Support when you go from one health care setting to another.
• Review your medicines and how you take them.
• Help you with other chronic care needs.

Coverage details

Your health care provider will ask you to sign an agreement for you to get this set of services on a monthly basis. If you agree to get these services, your provider will prepare a care plan for you or your caregiver that explains the care you need and how your providers will coordinate it.

To get started, ask your health care providers if they offer chronic care management services.

Who's eligible

If you have 2 or more serious chronic conditions (like arthritis and diabetes) that you expect to last at least a year, Medicare may pay for a health care provider’s help to manage your care for those conditions.

Costs

After you meet the Part B deductible , you pay coinsurance for these services.

Ask your doctor or healthcare provider how much your test, item, or service will cost.

Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.

Specific amounts you could owe depend on:

• Other insurance you may have

• How much your doctor charges

• If your doctor accepts assignment

• The type of facility

• Where you get your test, item, or service

Other related information

Related topics

• Caregiver training services
• Principal illness navigation services