Principal Care Management

Specialized Medicare-Covered Care for Complex Chronic Conditions

Principal Care Management (PCM) is a Medicare-covered Part B benefit designed for patients with a single, complex chronic condition that requires significant care coordination and management. When one serious health challenge dominates your medical care, PCM provides more intensive support than standard chronic care management, with focused attention on your primary condition.

What Makes PCM Different?

PCM offers a higher level of support than Chronic Care Management. While CCM addresses multiple conditions, PCM provides intensive, condition-specific care for one serious chronic condition. You'll receive more frequent check-ins (typically weekly or more often), deeper engagement with your care team, and specialized monitoring focused specifically on managing your principal condition and preventing complications.

Who Qualifies for Principal Care Management?

You may be eligible if you have Medicare Part B or Medicare Advantage and one serious, complex chronic condition expected to last at least 12 months that places you at significant risk of death, hospitalization, or functional decline. Common qualifying conditions include advanced heart failure or complex heart disease, advanced COPD requiring oxygen or frequent exacerbations, complex diabetes with multiple complications, advanced kidney disease (Stage 4 or 5 CKD), cancer requiring ongoing treatment management, severe arthritis significantly limiting function, advanced dementia or Alzheimer's disease, Parkinson's disease, multiple sclerosis, and stroke recovery with ongoing complications.

Comprehensive PCM Services

Your PCM program includes intensive care coordination with more frequent touchpoints and deeper engagement than standard care management, all laser-focused on your principal condition. We create a condition-specific care plan designed around managing your primary condition, preventing complications, and maintaining the best possible quality of life.

You'll receive enhanced monitoring and support with weekly or more frequent check-ins, close monitoring of condition-specific symptoms, early intervention when warning signs appear, and active coordination with specialists managing your condition. Our team provides detailed medication management specific to your condition, including medication reviews, side effect monitoring, and coordination with your providers for adjustments.

We handle comprehensive symptom tracking with regular monitoring of key symptoms related to your condition and proactive adjustments to your care plan when needed. Our team actively coordinates between your primary care provider, specialists, and care team to ensure seamless, focused care. You have 24/7 access to your care team for urgent questions or concerning symptoms, plus family support and education to help your loved ones understand your condition, recognize warning signs, and effectively support your care plan.

Cost and Coverage

PCM is a Medicare Part B covered benefit. After your deductible, Medicare pays 80% and you pay 20% coinsurance. With Medigap, you often pay $0 (coinsurance covered). With Medicare Advantage, you often pay $0 to minimal cost. Most patients pay little or nothing for this intensive level of support.

Benefits of Principal Care Management

PCM provides focused expertise on your most critical condition, reduced risk of hospitalization, better symptom control, coordinated specialist care, early identification of complications, improved quality of life, and peace of mind for you and your family. You keep your same doctors and specialists—we coordinate with them but don't replace them. We ensure everyone is working together toward your health goals.