How can you manage a chronic condition on Medicare Advantage?

A chronic condition is defined as an illness lasting one year or longer that requires ongoing medical attention and/or has a negative impact on your daily life. Of Medicare beneficiaries aged 65 and older, 90% have at least 1 chronic condition.

The 10 most common chronic conditions for older adults are:

1. High blood pressure (hypertension)
2. High cholesterol
3. Arthritis
4. Obesity
5. Diabetes
6. Cancer
7. Heart disease
8. Depression
9. COPD
10. Asthma

Having a chronic condition may raise your risk for higher healthcare costs, disability and death. A single chronic condition may negatively impact the quality of your life, including your physical mobility, social connections and mental health.

The time and energy to manage your condition and care for yourself can add up. Some people may feel stressed navigating everything on their own. Managing a condition may feel more complex as you age into Medicare and need to decide which plan type is right for you.

Some risk factors are within your control (tobacco use, inactivity, poor nutrition), while others aren’t (family history, income, access to care).

Having multiple chronic conditions can make things more complex. Learn why here.

Why does your Medicare Advantage plan and primary care provider matter to your chronic condition?

When you have a Medicare Advantage plan and provider who work together to support you and your health goals, you have partners in your health.

Why your Medicare Advantage plan matters

A Medicare Advantage plan may give you access to a network of primary care providers focused on giving you proactive, preventive and personalized care close to your home. It may also have benefits you value and provide you with the support you need to manage your chronic condition with confidence.

That could be finding a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) or Dual-Eligible Special Needs Plan (D-SNP) if you are eligible. C-SNPs are tailored for people with certain chronic conditions, while D-SNPs are designed to coordinate care between Medicare and Medicaid for people who have both types of coverage.

Why your primary care provider matters

Once you are eligible for Medicare, “you want to find a doctor who is comfortable taking care of adults with a lot of medical issues and medications,” said Dr. Ryan Dickert with Meadowcrest Family Physicians in Florida. His brother and fellow provider, Dr. Alex Dickert, added, “The medical complexity jumps significantly.”

When you’re younger, a cough may be an allergy or acid reflux. But at 70, a cough could be a sign of something more serious. Having a provider who is experienced in caring for Medicare beneficiaries can make a difference with your healthcare experience.

How does a Humana Medicare Advantage plan support you with your chronic condition?

Humana designs its Medicare Advantage plans to be stable and affordable from year to year. With a variety of plans to meet different needs, you can prioritize what matters most to you, whether that’s having maximum provider choice, balancing costs and benefits or wanting more robust benefits in exchange for staying in network for care.

While benefits vary by plan and location, the following are some of the benefits that may be included on a Humana Medicare Advantage plan. Not all benefits are included on all plans. Be sure to check each plan’s evidence of coverage to confirm which benefits are offered.

• $0 or low-cost monthly premiums
• $0 or low-cost copays for primary care
• Over-the-counter benefits for vitamins, supplements and first-aid supplies
• If your plan includes the Humana Healthy Options Allowance* and you’re eligible for it, it could help pay for things like groceries, rent, utilities
• Go365 rewards† for eligible preventive-health activities like screenings
• SilverSneakers so you can stay active at home or in the community stay active at home or in the community
• Dental, vision and hearing coverage for total body health since certain conditions can first be detected by either a dental or vision exam
• If you’re eligible, you may qualify for care management to help you get support over-the-phone support from a variety of health and wellness professionals at Humana like registered nurses or certified pharmacists.

How can a primary care provider in Humana’s network help you manage a chronic condition?

Every human body is different. How your chronic condition affects your life may differ from another person. That’s why finding a primary care provider who gets to know what’s going on in your chart and your life is so important.

You’ll want to be sure they take time to listen and understand you and your health goals. “As simple as it sounds, a lot of primary care is paying attention—spending the time to organize notes, make plans and talk to patients,” said Dr. Ryan.

They should also take time to review all that with you and make a plan of action for how to move forward. “Primary care is about developing relationships with patients to know what quality of life means to them,” said Dr. Alex. You can better work together to manage your chronic condition.

Your primary care provider is the quarterback of your care

Without a primary care provider who can coordinate with specialists, you must do that on your own. “When you play your own health navigator, care is siloed, where it feels like one provider isn’t talking to the others,” said Dr. Alex.

But when you have a primary care provider overseeing your healthcare, they can better connect the dots and coordinate with everyone—they can see the whole picture. As Dr. Alex said, “Here I am to put it all together. I can say, ‘Let’s simplify your drug regimen and your treatment regimen.’ It reinforces that relationship of total-person care.”

Counterintuitively, going to the primary care provider more often throughout the year could help you avoid more costly urgent care, emergency department or hospital visits later. “You want a clinician who understands where things could go wrong and what to keep a close eye on. That’s why we see our patients, on average, 6 times a year,” said Dr. Alex.

How your care team help you manage a chronic condition

Each provider team may look different, but here are examples of people who might support you.

• Nurses who can answer questions about your treatment plan or help you with remote monitoring devices.
• Social workers connect you to local community resources for arranging transportation, getting food assistance or other non-medical needs.
• Health coaches make starting and maintaining healthy habits easy by helping you identify and overcome barriers.
• Behavioral specialists can support you with mental health concerns like depression or anxiety as well as substance misuse.
• Acute-care transition specialists help you as you leave the hospital, whether that’s going to a rehab facility, a skilled nursing facility or back home.
• Care-quality specialists ensure your quality of care is high and that preventable risks are spotted and addressed.
• A dietician or nutritionist can help you adjust your eating habits based on your chronic condition and your food preferences to help you make changes that stick.

“It’s usually a major health event that changes people,” Dr. Ryan said. With a team beside you, you can make those changes before it’s too late.

Committed to your health

If you’re turning 65 and ready to have a Medicare Advantage plan and a provider network you can count on, connect with a licensed Humana sales agent for no extra cost to you and without any obligation. Call now or schedule a meeting.