A significant portion of Medicare beneficiaries have two or more chronic conditions, making up more than two-thirds of beneficiaries. Managing chronic conditions takes additional time, energy, and care. Chronic care services offered by Medicare help these Americans access the care they need and stay on top of their medications with the coordination of a health care provider.
Additionally, if you have two or more chronic conditions, you will likely qualify for a Chronic Condition Special Needs Plan, a type of Medicare Advantage plan. These plans are designed specifically for people with your condition(s) and connect you with providers and specialists who can care for your particular needs.
Chronic Care Management Services
You are eligible for Medicare Chronic Care Management Services if you have two or more chronic conditions expected to last at least 12 months. These benefits are covered by your Medicare Part B benefits if you qualify.
With Chronic Care Management Services, your coverage can include frequent check-ins with your doctor, emergency access to health care providers, at least 20 minutes of care management health services each month, and a plan of care created by your doctor. You can also get help with medication management and support when you go from one health care office to another.
If you think you qualify for these services, you can meet with your doctor. They will have you fill out forms and consents for these services, then you will work together to create a plan of care going forward.
Chronic Condition Special Needs Plans
Special Needs Plans exist to help people with advanced requirements find the care they need. There are plans for those dual-enrolled in Medicare and Medicaid, people who live in institutions, and people who suffer from chronic health conditions. As with any other Medicare Advantage plan, you must first be enrolled in Medicare Part A and Part B and live within the plan’s coverage area to apply for coverage.
Chronic Condition Special Needs Plans have been created for 15 specific chronic conditions by the Center for Medicare and Medicaid Services (CMS). You can find a plan for:
- Chronic alcohol and other drug dependence
- Autoimmune disorders
- Cancer
- Cardiovascular disorders
- Chronic heart failure
- Dementia
- Diabetes mellitus
- End-stage liver disease
- End-stage renal disease
- Severe hematologic disorders
- HIV/AIDS
- Chronic lung disorders
- Chronic and disabling mental health conditions
- Neurologic disorders
- Stroke
For more about which conditions have Special Needs Plans, visit the CMS website.
Do you need help coordinating your care for chronic conditions? Magellan Healthcare can help you find the assistance programs that connect you with the services you need to help you gain better health. Contact us today to schedule an appointment with one of our licensed agents.
