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Chronic Conditions and Medicare

Chronic conditions are long-term health problems that require ongoing care and management. They are the leading cause of death and disability in the United States, and they account for more than 75% of Medicare spending.

The most common chronic conditions among Medicare beneficiaries include:

  • Arthritis
  • Cancer
  • Chronic kidney disease
  • Chronic obstructive pulmonary disease (COPD)
  • Diabetes
  • Heart disease
  • Hypertension (high blood pressure)
  • Mental health conditions
  • Osteoporosis
  • Stroke

Medicare provides coverage for a wide range of services and treatments related to chronic conditions. This includes preventive care, such as screenings and vaccinations; diagnostic tests; prescription drugs; and inpatient and outpatient care.

Medicare also offers a number of programs and services specifically designed to help people with chronic conditions manage their care and improve their quality of life. These include:

  • Chronic care management (CCM): CCM is a program that provides coordinated care for people with two or more chronic conditions. CCM services can include developing a personalized care plan, coordinating care with other providers, and providing education and support.
  • Medicare Advantage special needs plans (C-SNPs): C-SNPs are Medicare Advantage plans that are designed for people with specific chronic conditions or disabilities. C-SNPs can offer additional benefits and services that are tailored to the needs of their members.
  • Home health care: Home health care provides skilled nursing care, physical therapy, and other services in the home for people with chronic conditions who are unable to leave their homes.
  • Hospice care: Hospice care provides palliative care for people who are terminally ill. Hospice care can be provided in the home, in a nursing home, or in a hospice facility.

If you have a chronic condition and are enrolled in Medicare, there are a number of things you can do to manage your care and improve your quality of life. These include:

  • Talk to your doctor about your care plan. Your doctor can help you develop a personalized care plan that includes preventive care, diagnostic tests, medications, and other treatments.
  • Consider enrolling in a C-SNP. If you have a specific chronic condition or disability, you may be eligible to enroll in a C-SNP. C-SNPs can offer additional benefits and services that are tailored to the needs of their members.
  • Take advantage of Medicare’s preventive care benefits. Medicare covers a wide range of preventive care services, such as screenings and vaccinations. These services can help you stay healthy and prevent complications from your chronic condition.
  • Adhere to your medications and treatment plan. It is important to take your medications as prescribed and to follow your doctor’s treatment plan. This will help you control your chronic condition and improve your quality of life.

If you have any questions about Medicare coverage for chronic conditions, you can contact Medicare Customer Service at 1-800-MEDICARE (1-800-633-4227).