Chronic Care Management Program Enrollment Form

This program is covered by Medicare and could be covered-in-full if you have a secondary insurance. Full coverage depends on your secondary insurance carrier or Medicare Replacement Plan Coverage.

Although Medicare developed this program, you do not need to be a Medicare beneficiary to take advantage of these valuable services. Most commercial and Medicare Advantage plans also cover this benefit.

Like all other healthcare services, Care Management is subject to your annual insurance deductible, coinsurance, and copay. Depending on your specific benefits there may be a minimal fee associated with the program.

The program provides you with a dedicated care coordinator to work with you and your care team to create your care plan.

• Coordination of care between your pharmacy, specialists, testing centers, hospitals, and more.
• Phone check-ins between visits to keep you on track.
• Expert assistance with setting and meeting your health goals.

A care team consists of many participants who support you in your network of care (e.g. providers, nurses, office staff, caregivers/family members, and more).

You are eligible if you have conditions that your provider would like to continue monitoring between visits.

Absolutely! This service does not replace your doctor visits. You will still need to see your doctor as scheduled.

Absolutely not! However, it is recommended that all eligible patients give Care Management a try. If you do not find value in this service, you may easily opt out by notifying your Care Specialist or calling us at the office.