Medicare 2026

Medicare's ACCESS Model: Tech-Supported Care for Chronic Conditions Explained

Chronic conditions like high blood pressure, diabetes, and ongoing joint pain are among the most common reasons people with Medicare see a doctor. They are also the kinds of conditions where day-to-day habits, monitoring, and follow-up matter as much as any single office visit. That is the thinking behind a newer Medicare initiative called the ACCESS Model, short for Advancing Chronic Care with Effective, Scalable Solutions. Here is a plain-English look at what it is, who can use it, and what to think about before signing up.

What the ACCESS Model is

ACCESS is a voluntary model from the Centers for Medicare & Medicaid Services (CMS) that launched July 5, 2026 and is scheduled to run for 10 years. It works inside Original Medicare (Part A and Part B), not Medicare Advantage. The idea is to pay participating care organizations recurring payments for actively managing a patient's chronic conditions using technology-supported care — things like remote monitoring, coaching, medication support, and digital check-ins. Importantly, full payment to the organization is tied to measurable health outcomes, such as actually lowering a patient's blood pressure. In other words, the organization gets paid in full when the care works.

Who can join

According to Medicare.gov, anyone with Original Medicare who has one or more of these conditions can join an ACCESS organization:

• High blood pressure
• High cholesterol
• Obesity
• Prediabetes or diabetes
• Chronic kidney disease
• Heart disease
• Depression or anxiety
• Ongoing muscle or joint pain

Starting April 1, 2027, ACCESS will add tracks for heart failure, chronic obstructive pulmonary disease (COPD), substance use disorder, and tobacco cessation.

If you are enrolled in a Medicare Advantage plan, Medicare.gov says you cannot use ACCESS. CMS has noted that Medicare Advantage organizations may independently set up similar arrangements with their contracted providers, so if you are in a Medicare Advantage plan and interested in tech-supported chronic care management, check with your plan.

How you sign up

You enroll directly with a participating ACCESS organization. You can do that on your own or after a referral from your provider — Medicare.gov is clear that a referral is not required. CMS maintains a directory of participating organizations that shows which conditions each one treats and their risk-adjusted outcomes, so you can compare how organizations are performing before you decide.

What it costs

Medicare.gov says most ACCESS organizations will charge between $0 and $7 per month. If one organization helps you with multiple conditions, the total cannot exceed $13 per month. Some ACCESS organizations may also choose to waive standard Medicare cost-sharing. Beyond that, participating does not change your Medicare benefits, coverage, or rights, and you can continue to see any Medicare provider you choose.

If after enrolling you decide ACCESS is not for you, you can cancel or switch to a different organization after the first 90 days.

How ACCESS fits with the rest of Medicare

ACCESS is an add-on care arrangement, not a replacement for any part of Medicare. You still have your Part A, Part B, and (if you choose) Part D drug coverage and any supplemental coverage you've selected. For 2027, program-wide, the Part D out-of-pocket cap rises to $2,400 (up from $2,100 in 2026), the most any Part D plan may charge as a deductible is $700, and the Part D base beneficiary premium (a national figure used in the late-enrollment penalty) is $41.33. Actual plan premiums are set plan by plan. The 2027 Part B standard premium and deductible and the 2027 IRMAA income brackets and surcharges have not yet been announced; CMS typically announces those in the fall. Social Security announced on October 14, 2026 a 3.6 percent cost-of-living adjustment for benefits payable beginning January 2027.

If you want to make broader changes to your coverage for 2027, Medicare's Annual Enrollment Period runs October 15 – December 7, 2026, with choices taking effect January 1, 2027.

A note on coverage choices

ACCESS only works with Original Medicare, so some readers may be weighing Original Medicare (often paired with a stand-alone Part D plan and sometimes a Medigap policy) against Medicare Advantage. Both paths have trade-offs: Original Medicare generally lets you see any provider who accepts Medicare and can be paired with Medigap for predictable out-of-pocket costs, while Medicare Advantage plans often bundle drug coverage and extras but use provider networks and plan rules. Neither is "better" in the abstract — it depends on your providers, medications, budget, and preferences.

Special enrollment for people with Medicaid or Extra Help

If you have Medicaid or qualify for Extra Help with Part D costs, since 2025 you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. People who are full-benefit dual-eligible can also join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month. This flexibility can be useful if you want to move to Original Medicare so you can participate in ACCESS.

Where to learn more

For official details on the ACCESS Model, the directory of participating organizations, enrollment windows, and your coverage options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week.