A New Way to Get Support Between Doctor Visits
Managing a chronic condition often means long stretches between appointments where you are on your own. A new blood pressure reading, a missed dose, or a worrying symptom can leave you wondering whether to call the doctor's office or just wait it out.
Starting July 5, 2026, Medicare launched a program designed to fill that gap. It is called the ACCESS Model, and it connects eligible people on Original Medicare with approved organizations that offer ongoing, technology-supported help for certain chronic conditions.
This program does not replace your doctor or change your existing Medicare benefits. It adds an extra layer of support, and whether it makes sense for you depends on your health condition, where you live, and which organizations serve your area.
What ACCESS Stands For
ACCESS stands for Advancing Chronic Care with Effective, Scalable Solutions. It is a 10-year Medicare Innovation Center model that began July 5, 2026, and ties payments to health outcomes rather than individual visits.
Key Takeaways
- ACCESS is a 10-year Medicare Innovation Center model that began July 5, 2026, paying organizations based on health outcomes rather than individual visits
- Eligibility requires having Original Medicare and at least one qualifying chronic condition included in an ACCESS clinical track
- Participation is voluntary and does not reduce Medicare benefits, limit provider choice, or require leaving your current doctor
- No referral is needed; beneficiaries can contact ACCESS organizations directly, though each confirms eligibility based on condition and location
- CMS announced an expansion on September 15, 2026, adding new conditions starting April 1, 2027, with availability varying by organization
What Is the Medicare ACCESS Model
ACCESS gives participating healthcare organizations a new way to provide technology-supported care for chronic conditions. Instead of billing Medicare only for individual services or appointments, these organizations are paid based on measurable health outcomes across the patients they serve.
For you, the practical benefit is support between appointments. Depending on the organization you choose, that might include help tracking blood pressure, managing medications, adjusting daily habits, or monitoring symptoms from home.
Joining ACCESS is entirely voluntary. It does not reduce your Medicare benefits, limit your choice of providers, or require you to leave your primary care doctor or specialists. You can review full program details on the <a href="https://www.cms.gov/priorities/innovation/innovation-models/access">CMS ACCESS Model page</a>.
Who Qualifies for the ACCESS Model
You may qualify when two things are true: you have Original Medicare, and you have at least one health condition included in an ACCESS clinical track. Having a qualifying condition does not guarantee that every organization can serve you, since each one supports specific conditions and geographic areas.
You do not need a doctor's referral to reach out to an ACCESS organization directly. Your doctor, pharmacist, or another provider can also help you find one that fits your needs.
Check Before You Commit
Each participating organization confirms eligibility before care begins. Ask specifically whether it supports your condition and your zip code before assuming you qualify.
Conditions Included Today
ACCESS currently includes four broad clinical tracks covering a range of common chronic conditions. CMS may expand this list over time, so it's worth checking back periodically.
| Clinical Track | Included Conditions |
|---|---|
| Early cardio kidney metabolic conditions | High blood pressure, high cholesterol, obesity, overweight with central obesity marker, prediabetes |
| Cardio kidney metabolic conditions | Diabetes, chronic kidney disease, atherosclerotic cardiovascular disease |
| Musculoskeletal conditions | Ongoing muscle or joint pain |
| Behavioral health conditions | Depression and anxiety |
Not every participating organization offers every track. Check each organization's listing before signing up.
Conditions Being Added April 1, 2027
CMS announced an expansion of ACCESS on September 15, 2026, adding several new conditions starting April 1, 2027. These additions do not mean every organization will offer the new tracks right away.
Heart failure
Chronic obstructive pulmonary disease (COPD)
Substance use disorders, including opioid and alcohol use disorders
Tobacco cessation
Extended support for certain chronic musculoskeletal conditions after the initial care period
You can review the details in Medicare's <a href="https://www.cms.gov/priorities/innovation/innovation-models/access">ACCESS expansion announcement</a>. Checking the participant directory closer to the launch date will tell you which organizations near you plan to offer these new tracks.
What Services Can ACCESS Organizations Provide
The support you receive depends on your condition and the organization you choose. Services can vary quite a bit from one organization to another, so comparing options matters.
Virtual visits with members of your care team
Nutrition, exercise, and lifestyle coaching
Apps that track symptoms or health goals
Connected devices or wearables
Medication management
Behavioral health support
Patient education and care coordination
Support for more than one chronic condition
Some organizations may lend equipment related to your condition, such as a blood pressure monitor or continuous glucose monitor. Medicare states you will not pay to use this equipment, though you may need to return it if you leave the program.
More Than Telehealth
ACCESS can include virtual visits, but it goes beyond standard Medicare telehealth coverage. Organizations may combine virtual care with monitoring, coaching, devices, medication support, and coordination with your regular doctors.
How Much Does the ACCESS Model Cost
Cost is often the first question people ask, and understandably so. Most participating organizations charge between $0 and $7 per month for ACCESS support.
If a single organization helps you manage more than one qualifying condition, it cannot charge more than $13 per month total. If you use separate organizations for different conditions, ask each one to explain its own monthly charge before enrolling.
This Fee Is Separate From Your Other Medicare Costs
Your ACCESS monthly fee pays only for that organization's support. It does not replace your Part B premium, deductible, or cost-sharing for other Medicare-covered services.
The monthly amount you will owe
Which services and devices are included
Whether equipment must be returned
How the organization will coordinate with your doctors
Whether you will have any costs outside the monthly ACCESS charge
I always tell clients to ask an ACCESS organization for its fee structure in writing before enrolling, not just a verbal quote over the phone. Some organizations waive their monthly charge entirely for certain conditions, and you won't know that unless you ask directly. I've also seen people assume a $0 fee means no strings attached, so always confirm whether loaned equipment needs to be returned and what happens to your data if you cancel.
How to Find and Join an ACCESS Organization
Enrolling in ACCESS does not require a referral. You can reach out to a participating organization directly whenever you're ready.
Visit the Medicare ACCESS directory and search for participating organizations
Confirm the organization supports your condition and serves your location
Review its services, technology requirements, monthly cost, and equipment policies
Ask how it will communicate with your primary care doctor and specialists
Contact the organization directly to enroll
Your doctor, pharmacist, or another healthcare provider can help you compare organizations if you manage several qualifying conditions. Before signing up, think about whether you're comfortable using the required app, devices, or virtual-care platform, and whether you'll need a smartphone or internet connection to participate.
ACCESS Compared With Chronic Care Management
ACCESS and Medicare Chronic Care Management both help with ongoing health conditions, but they are separate programs with different rules. Understanding the distinction can help you decide whether one, both, or neither fits your situation.
| Feature | ACCESS Model | Chronic Care Management |
|---|---|---|
| Who may qualify | Original Medicare with at least one condition in an ACCESS track | Two or more chronic conditions expected to last 12+ months with significant health risk |
| Who provides the service | A Medicare-approved ACCESS organization | A physician or other qualified healthcare professional |
| Type of support | Coaching, monitoring, apps, devices, virtual care | Care planning and coordination outside office visits |
| Enrollment | Contact an organization directly, no referral needed | Your provider obtains consent and enrolls you |
| Typical cost | $0 to $7 per month, subject to program limits | Part B deductible and coinsurance may apply |
| Medicare Advantage | Not available through ACCESS | Covered, though plan rules and costs vary |
You may qualify for both programs. Ask your provider and the ACCESS organization how they will coordinate care.
Can Medicare Advantage Members Use ACCESS
ACCESS is currently limited to people with Original Medicare. If you have a Medicare Advantage plan, you cannot enroll in this particular program.
That doesn't necessarily mean you're missing out entirely. Your Medicare Advantage plan may offer a similar chronic-condition program, virtual-care service, or remote monitoring benefit worth exploring.
Whether it offers support for your condition
Which providers or vendors participate
Whether referrals or prior authorization are required
What copayments or other costs apply
Whether devices or monitoring equipment are included
Think Before Switching Coverage
Do not leave a Medicare Advantage plan solely to access ACCESS without reviewing the full consequences. Changing coverage can affect your provider network, prescription coverage, out-of-pocket costs, and your ability to purchase a Medicare Supplement policy later.
Is the ACCESS Model Right for You
ACCESS may be worth considering if you have Original Medicare, qualify through a clinical track, and want more consistent support between appointments. For example, someone managing type 2 diabetes and high blood pressure might appreciate having a coach checking in weekly rather than waiting three months for the next office visit.
Another example: someone recovering from ongoing joint pain might value an organization that combines coaching with a connected device to track mobility progress over time. The right fit depends entirely on your goals and what's available in your area.
Condition support: Confirm the organization serves your specific condition
Services: Ask what coaching, monitoring, appointments, or devices you'll actually receive
Technology: Make sure you can use the required technology or get setup help
Care coordination: Find out how often the organization contacts your doctors
Cost: Confirm the monthly charge and any other potential costs
Privacy: Ask how your health information will be collected and shared
Cancellation: Review the 90-day commitment and equipment-return process
Is ACCESS a New Medicare Plan?
Do You Need a Referral for ACCESS?
Can You Keep Your Doctors After Joining ACCESS?
Can You Use More Than One ACCESS Organization?
Can You Cancel ACCESS?
Does ACCESS Cover Heart Failure and COPD?
I'm worried about signing up and getting stuck with something I don't want. Is that a risk here?
Will joining ACCESS require me to talk to an insurance agent?
How to Take the Next Step
Start by checking Medicare's ACCESS directory for an organization that supports your condition and serves your location. Compare services, technology requirements, costs, and how each one coordinates with your doctors before enrolling.
If you can't find an appropriate organization or need help understanding the program, call 1-800-MEDICARE. If your bigger question involves choosing between Original Medicare and Medicare Advantage, a <a href="/medicare-supplement-plans/plan-g/">licensed Medicare agent</a> can help you compare coverage available in your area, though joining ACCESS itself does not require working with an agent.
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