What it is: This is a relatively new program from the Centers for Medicare and Medicaid Services (CMS). It is a comprehensive care plan, where one or more professionals are assigned to manage all the aspects of your chronic health case. For example, your health managers would assist in coordinating your health needs, such as listing your health problems and goals, other health care providers, medications, community services, and other information about your health. 

Who is it for: People with 2 or more serious chronic conditions that are expected to last at least 12 months and who are at significant risk of functional decline, deterioration, acute exacerbation, or death. A chronic condition is defined as any condition that lasts for at least a year and limits your daily activities or requires regular medical care.

What services does it include:

  • 20 minutes a month of telehealth services
  • Personalized assistance from a dedicated health care professional who will work with you to create a care plan
  • Help with medication management: review your medicines and how you take them
  • Coordination of care between your pharmacy, specialists, testing centers, hospitals etc.
  • 24/7 emergency access to a healthcare professional
  • Expert assistance with setting and meeting your health goals

What plans cover this service: Any Medicare or Medicare Advantage beneficiary that meets the medical necessity requirements for CCM is eligible to receive the CCM services as a covered benefit.

What you need to do: You will need to ask your health care professionals if they provide chronic care management services. If you qualify, your health care provider will ask you to sign an agreement to provide this service. 

For more information, visit Chronic Care Management Services at: https://www.medicare.gov/coverage/chronic-care-management-services

Pulmonary Fibrosis Now! hopes that this information helps to ensure a smoother enrollment process for you and your loved ones. Remember, you are your biggest advocate so make sure to do your research, ask questions, and choose a plan that covers all your individual anticipated pulmonary fibrosis healthcare needs. Together, we can #fightPFNOW!

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