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If you’re managing multiple chronic conditions like diabetes and high blood pressure, or heart disease and arthritis, you might feel like you’re coordinating a lot on your own. Here’s something many people don’t know: you may already have access to a team of healthcare professionals who can help coordinate your care, and it’s likely covered by Medicare or your health plan.
It’s called Chronic Care Management (CCM), and it’s designed to give you exactly the kind of ongoing support that makes managing multiple conditions feel less overwhelming.
What Chronic Care Management Actually Does
Think of CCM as having a healthcare advocate in your corner. This isn’t about adding more appointments to your schedule. Instead, it’s about getting personalized support between your regular doctor visits.
Here’s What You Get:
• A dedicated care coordinator (often a registered nurse) who gets to know your specific health situation
• 24/7 access to healthcare professionals for urgent questions or concerns
• A comprehensive care plan that brings all your conditions and treatments together in one place
• Medication reviews to make sure everything works well together and you’re taking things correctly
• Coordination between all your doctors so everyone’s on the same page
• Help navigating transitions between hospital, home, or other care settings
The program focuses on keeping you healthy and out of the hospital by catching potential problems early and making sure you have the support you need to manage your conditions effectively.
Who Qualifies for These Services
You might be eligible if you have two or more chronic conditions that are expected to last at least 12 months. These don’t have to be life-threatening conditions, just ongoing health issues that require regular attention.
Common Qualifying Conditions Include:
• Diabetes (Type 1 or 2) • High blood pressure (hypertension) • Heart disease or heart failure • Arthritis • Chronic kidney disease • Depression or anxiety • Asthma or COPD • High cholesterol • Osteoporosis
Your doctor can help determine if you meet the specific criteria for your plan’s CCM program.
How Medicare Covers Chronic Care Management
Medicare Part B covers chronic care management services for eligible beneficiaries. After you meet your Part B deductible, you’ll typically pay 20% coinsurance for these services, but many supplemental insurance plans help cover this cost.
For 2025, the Medicare Part B monthly premium is $164.90 for most people, with a $226 annual deductible. Once you meet the deductible, your 20% share for CCM services usually comes to about $8-15 per month, depending on the level of service you receive.
If You Have Medicare Advantage:
Medicare Advantage plans must cover everything Original Medicare covers, including CCM services. However, your costs may be different, and some plans offer enhanced care management services at no additional cost.
Getting Started Is Simple
The process begins with a conversation with your healthcare provider during a regular visit. This could be during your annual wellness visit, a routine appointment, or even a visit specifically to discuss care management.
Here’s How It Works:
- Initial discussion: Your doctor explains the program and how it could help your specific situation
- Consent: You’ll sign an agreement to participate (you can withdraw at any time)
- Care plan development: Your care team creates a comprehensive plan that includes all your conditions, medications, and health goals
- Monthly check-ins: You’ll have regular contact with your care coordinator, usually by phone
- Ongoing coordination: Your team manages communication between all your healthcare providers
What Your Monthly Support Looks Like
Once you’re enrolled, you can expect at least 20 minutes of meaningful contact each month with your care coordinator. This might involve reviewing how you’re feeling, discussing any concerns about your medications, helping you prepare for upcoming appointments, or connecting you with community resources.
You Might Receive:
• Medication reminders and reviews • Help scheduling and preparing for specialist appointments • Education about your conditions and self-management strategies • Support during transitions between different levels of care • Connections to community resources and support services • Assistance understanding test results or treatment changes
Private Insurance Plans Often Offer Similar Programs
Many private health insurance plans, including those offered through employers, provide their own versions of chronic care management. These might be called wellness coaching, disease management, or care coordination programs.
Examples Include:
• Cigna’s Your Health First program for 16 common chronic conditions including asthma, heart disease, diabetes, depression, anxiety, and COPD • Health coaching through major insurers for conditions like diabetes, heart disease, and depression • Telephonic support programs that provide regular check-ins with registered nurses • Care management services for complex health situations
Check with your insurance plan to see what programs they offer. Many people don’t realize these services are included in their benefits at no extra cost.
Making the Most of Your Care Management
The key to getting the most from CCM is being open and honest with your care coordinator. They’re there to help, not judge, and the more they know about your challenges, the better they can support you.
Be upfront about: medication side effects, financial concerns, transportation issues, or any other barriers that make managing your health difficult.
Ask questions: Your care coordinator can help you understand your conditions better and teach you warning signs to watch for.
Use the 24/7 access: If you’re unsure whether a symptom warrants an emergency room visit, call your care management team first. They can often help you determine the appropriate level of care.
The Bottom Line
Research consistently shows that chronic care management programs reduce healthcare costs and improve patient outcomes. A study from the Center for Medicare & Medicaid Innovation found that CCM programs reduced costs by $74 per beneficiary per month, primarily by preventing hospitalizations and emergency room visits.
More importantly, people enrolled in CCM programs report feeling more confident about managing their health and less isolated in dealing with their conditions. Having a dedicated person who knows your health story and can help coordinate your care makes a real difference in both your health outcomes and your peace of mind.
If you have multiple chronic conditions, ask your healthcare provider about chronic care management during your next visit. This support might already be covered by your plan, and it could be exactly what you need to feel more in control of your health.
