If you manage two or more ongoing health conditions, Medicare may already pay for a nurse or care team to help coordinate it all every single month. The benefit is called Chronic Care Management, and a lot of the people who qualify have never heard of it. This guide walks through who qualifies, what the service actually includes, what it costs, and how to say yes (or no) so you can decide whether it fits your situation.
What chronic care management is
Here's the idea. When you live with more than one serious chronic condition, the hard part often is not any single appointment. It's everything between the appointments: keeping medications straight, remembering which specialist said what, knowing who to call when something feels off. Chronic Care Management, or CCM, is a Medicare Part B benefit built for exactly that gap.
Under CCM, a doctor or other health care professional provides at least 20 minutes a month of care coordination outside your regular in-person office visits. That can look like a phone check-in to see how you're doing and whether your medications are working. It is care that happens between visits, not during them.
The service comes with a comprehensive care plan, which is a written document that lists your health problems and goals, your medications, your other providers, and the community services you use. You and your care team build it together, and you get access to it through a secure electronic record. CCM also includes help managing your conditions and medications between visits, plus 24/7 access to a health professional for urgent needs, so there's someone to reach when a question comes up at an inconvenient hour. If you've used Medicare's free preventive services to stay ahead of problems, think of CCM as the ongoing support that picks up once a chronic condition is already part of your life.
Who qualifies
CCM is for people who have two or more serious chronic conditions that are expected to last at least a year, or until the end of life, and that place them at significant risk of getting worse, losing function, or worse outcomes. The "two or more" part is the key threshold. One condition on its own does not qualify.
The conditions that count are common ones. Medicare lists examples including arthritis, asthma, cancer, depression, diabetes, high blood pressure, heart disease, and osteoporosis. So someone managing, say, diabetes and high blood pressure together would generally meet the bar. Your provider makes the formal determination, but if two or more long-term conditions describe your situation, it's worth asking.
The benefit at a glance
Here's how the pieces fit together.
| What to know | |
|---|---|
| Who qualifies | People with two or more serious chronic conditions expected to last at least a year |
| What you get | At least 20 minutes a month of care coordination, a comprehensive care plan, and 24/7 access for urgent needs |
| Where it happens | Outside regular in-person office visits, such as by phone, between appointments |
| Your consent | Voluntary; you give written or verbal consent once before services begin |
| What it costs | Usual Part B cost-sharing: 20% after the $283 deductible (2026), unless you have supplemental coverage |
What it costs
This is the part worth slowing down on, because the cost depends on the rest of your coverage. CCM follows the usual Medicare Part B cost-sharing rules. That means after you meet the annual Part B deductible, which is $283 in 2026, you generally pay 20% of the Medicare-approved amount for the monthly service. The remaining 80% is covered by Part B.
The 20% is not the end of the story for most people, though. If you carry supplemental or wraparound coverage, that coverage may pick up the cost-sharing. A Medigap policy or other supplemental insurance can cover the 20% you would otherwise owe. And most people who are dually eligible for both Medicare and Medicaid are not responsible for the cost-sharing at all, so for them CCM typically costs nothing out of pocket. Before you enroll, it's reasonable to ask your provider what the monthly charge will be for your specific coverage.
Saying yes, or no
CCM is voluntary. Nobody is enrolled automatically, and you are free to decline. Before the service begins, your provider has to get your consent, which can be written or verbal, and you only have to give it once unless you switch to a new provider. That consent step exists partly to confirm you understand any cost-sharing involved, so it doubles as your chance to ask the cost question up front.
You can also stop at any time. If you try CCM and decide the monthly coordination isn't adding enough value for you, you can opt out. The benefit is meant to help, not to lock you in.
Frequently asked questions
You qualify if you have two or more serious chronic conditions that are expected to last at least a year, or until the end of life, and that put you at significant risk of getting worse or losing function. Example conditions include arthritis, asthma, cancer, depression, diabetes, high blood pressure, heart disease, and osteoporosis. One condition alone does not meet the threshold; you need at least two, and your provider makes the determination.
CCM gives you at least 20 minutes a month of care coordination from a doctor or other health professional, provided outside your regular in-person office visits, such as by phone. It also includes a comprehensive care plan that lists your conditions, goals, medications, providers, and community services, help managing your conditions and medications between visits, and 24/7 access to a health professional for urgent needs along with a secure electronic copy of your care plan.
CCM uses the usual Medicare Part B cost-sharing. After you meet the $283 Part B deductible in 2026, you generally pay 20% of the Medicare-approved amount for the monthly service, unless you have supplemental coverage. A Medigap policy or other supplemental insurance may cover that 20%, and most people dually eligible for Medicare and Medicaid pay nothing. Ask your provider what your specific monthly cost will be before you enroll.
No, you do not have to sign up. CCM is entirely voluntary. Your provider must get your consent, written or verbal, before services begin, and you only give that consent once unless you change providers. The consent step confirms you understand any cost-sharing. You can also stop participating at any time if you decide it isn't right for you.
Learn More
- What Is Medicare? Parts A, B, C, and D explained
- Principal care management (for one complex condition)
- Medicare preventive services you can get for free
- How Medigap supplemental coverage works
- Being dually eligible for Medicare and Medicaid
If you're managing two or more conditions and want help figuring out whether chronic care management fits your situation, start at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.