Medicare can help patients manage chronic illnesses
Caring for yourself when you have a chronic illness like diabetes or heart disease is hard work. When you have more than one such illness, it can sometimes seem overwhelming.
Seventy percent of Louisiana residents with Medicare have at least two chronic conditions. They often must juggle visits to several doctors, as well as the separate trips for follow-up tests. Then they must make sure they’re taking the right medications at the right times.
Managing a number of chronic illnesses all at once can quickly become a full-time job. Unless it’s done right, you can compromise your quality of life and possibly increase your risk of a long-term disability or an earlier-than-expected death.
That’s why Medicare is encouraging your health care providers to work together more closely to coordinate the treatment of your chronic conditions, so that you can spend less time sitting in medical offices and more time doing whatever you enjoy.
To keep you healthy, Medicare has expanded a benefit called chronic care management. It provides higher payments to doctors and other providers to help you live with chronic disease.
Through this benefit, your health care practitioner will assist you in keeping track of your medical history, your medications and all of the other health care providers you see. You’ll receive a comprehensive care plan that outlines your treatments and goals.
You’ll also have 24-hour-a-day, 7-day-a-week access to health care professionals for urgent needs from the comfort of your home. Does that sound like something that might interest you?
To qualify for chronic care management services, you must be enrolled in Medicare’s traditional fee-for-service program, or you must be in the Medicaid program and receiving Medicare benefits. You also must have at least two chronic illnesses that pose a serious threat.
The list of eligible diseases includes asthma, chronic kidney disease, chronic obstructive pulmonary disease, depression, hepatitis, heart failure, high blood pressure, HIV/AIDS, osteoporosis, schizophrenia and stroke, among others.
If you think you might benefit, ask your doctor to explain the various services you’d receive, such as:
- At least 20 minutes a month of chronic care management services
- Personalized assistance from a dedicated health care professional who will work with you to create your care plan
- Coordination of care between your pharmacy, specialists, testing centers, hospitals and more
- Phone check-ins between visits to keep you on track
- 24/7 emergency access to a health care professional
- Expert assistance with setting and meeting your health goals
Your out-of-pocket cost for chronic care management will be the same as your share for other Medicare Part B services, so you may have a deductible or co-payment. But if you have Medigap or retiree supplemental health insurance, you may not have to pay those out-of-pocket expenses.
Also, chronic care management can help you avoid the need for more costly services. By acting now and managing your health, you may be able to head off hospitalization and more serious treatment in the future.
Chronic care management means having a continuous relationship with a dedicated health care professional who knows you and your history, provides personal attention and helps you make the best choices for your health. For more about the program, call Medicare at 1-800-633-4227 or visit http://go.cms.gov/ccm.
Navigating your way through the health care system can often be bewildering and time-consuming. Medicare’s chronic care benefit gives you and your loved ones the assistance you need to manage your medical conditions so that you can focus on the things you love.
If that sounds right for you, talk with your doctor or nurse about the program.
By Bob Moos
Southwest public affairs officer for the U.S. Centers for Medicare and Medicaid Services