What is care management?
Care management is a Medicare Advantage (MA) program that helps you get the care you need.
A care manager will work with you and your doctors to:
- Make sure your doctors and other services work together
- Help you make a plan and stick to it (visits, treatment and medicines)
- Connect you to help in your community (support programs, benefits help and learning)
- Check in with you over time to help prevent problems and avoid extra ER visits or hospital stays
Which Aetna Medicare plans have care management?
Getting a plan with care management can help you get the support you need. These Aetna Medicare plans may offer care management services:
Medicare Advantage (MA) plans
Some MA plans may give you a care team to help you. This team works with you and your doctors to make sure you get the care you need. They help you keep track of long-term health problems.
Chronic Condition Special Needs Plans (C-SNPs)
A C-SNP is a type of MA plan for people with chronic conditions, like diabetes or heart disease. You will get a care manager with this plan. A care team helps you keep track of your medicines and doctor visits.
Dual-Eligible Special Needs Plans (D-SNPs)
A D-SNP is a type of MA plan for people who have both Medicare and Medicaid. You will get a care manager with this plan. A care team helps you use both programs and connects your care and benefits.
Common questions about care management
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If you have Medicare Part B, you may be able to get added help from your doctor’s office through care management programs. Principal Care Management (PCM) can help if you have a serious health condition that is expected to last at least three months. Medicare Part B also offers Chronic Care Management (CCM), which provides ongoing support for people with two or more chronic conditions.
With CCM, your provider’s team may:
- Make a plan for your care
- Check in to see how you are doing
- Help you keep track of your medications, appointments and more
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Care management helps you take care of your health if you have more than one health condition. This support helps make sure nothing gets missed and makes it easier to take care of your health.
A care manager works with you to understand your needs and help you follow your care plan. They can help you with things like:
- Scheduling doctor visits
- Managing your medications
- Answering questions about your health
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If you have a Chronic Condition Special Needs Plan (C-SNP) or a Dual Eligible Special Needs Plan (D-SNP), you'll automatically get a care manager.
If you have an MA plan, you may get a care manager who coordinates your care. But it depends on your health condition. Care management helps people who:
- Have a chronic condition, like diabetes or heart disease
- Take many medications
- Need help planning and keeping track of doctor appointments, tests or other needs
- Have recently been in the hospital or had an urgent care visit
How care management can help with your health
Care management can help make your health care easier to manage. It brings your providers, medications and support together, so nothing gets missed. The kind of help you get depends on your Medicare plan and your health needs.
If you want extra support, talk with your doctor or call your plan to find out what help you can get.
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Disclaimer
The Aetna C-SNP is available to Medicare members who have at least one of the qualifying chronic conditions. To ensure a successful enrollment process, we’ll confirm with your healthcare provider that you have one of these eligible conditions. If verification of eligible condition is not received, involuntary disenrollment will occur.
This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to our website.
