Advanced Primary Care Management services
now pays for Advanced Primary Care Management services to help your doctor and other health care providers coordinate and tailor care to your needs each month.
Your costs in Original Medicare
After you meet the Part B deductible, you pay 20% of the Medicare-approved amount. Many people who have both Medicare and Medicaid won’t pay anything for these services. If you have a Medicare Advantage Plan, your costs for these services might be different. Contact your plan for specific cost information.
What it is
Depending on the primary care services you're currently getting, you may get the same or more services through Advanced Primary Care Management. Providers that offer these services must provide you with:
- 24/7 access to your care team or provider through the phone, an online portal, email, and virtual check-ins
- Chronic care management
- A personalized care plan that lists your current conditions and treatments
- Comprehensive care coordination to quickly connect you with specialists and other providers
- Transitional care between health care settings (like follow-up are after you're discharged from a hospital)
- Medication management
Things to know
- Check with your primary care provider to make sure they offer these services. Then, give your provider verbal or written consent to be your main point of care for all your health needs. They’ll document your consent on your medical record. You also need to have an initial visit with your provider unless:
- You've gone to the provider or another provider in the same practice within the last 3 years.
- You got another type of care management (like chronic care management) from the provider or another provider in the same practice within the last year.
- You can stop getting services at any time. Talk to your provider to stop participating.