Medicare Part B Part B, also known as medical insurance, is the part of Medicare that covers most medically necessary doctors’ services, preventive care, hospital outpatient care, durable medical equipment (DME), laboratory tests, x-rays, mental health services, and some home health care and ambulance services. covers care management for chronic conditions. The goal of care management is to provide you with high-quality, coordinated care to better maintain your health and functioning.
Eligibility
You are eligible for Medicare coverage of care management if you have two or more chronic health conditions. A chronic health condition is a health issue that may last at least 12 months, and which places you at significant risk of functional decline or death. Examples include arthritis, asthma, diabetes, and heart disease.
Chronic care management services may include:
- Development of a plan of care A plan of care is a doctor’s written plan describing the type and frequency of health services a particular patient needs. by a health care professional or team of professionals
- At least 20 minutes per month of care management services
- Increased care coordination among your providers, pharmacies, and other facilities
- Regular check-ins with you between doctor’s office visits
- Continuous emergency access to a health care professional
Note: This benefit is separate from the care coordination you can receive after an inpatient An inpatient is a patient who has been formally admitted into the hospital by a doctor. Most inpatient care is covered under Medicare Part A (hospital insurance). hospital or skilled nursing facility (SNF) Skilled nursing facilities (SNFs) are Medicare-approved facilities that provide short-term post-hospital extended care services. stay.
Costs
You may pay a monthly fee for care management services. Original Medicare Original Medicare, also known as Traditional Medicare, is the fee-for-service health insurance program offered through the federal government, which pays providers directly for the services you receive. Almost all doctors and hospitals in the U.S. accept Original Medicare. cost-sharing (deductibles, copayments/coinsurances) also applies.