How the CHRONIC Care Act Changes Medicare for the Chronically Ill

Despite all the good Medicare does in the hospital, Medicare is known for leaving home needs unfilled.

Older adults who live with chronic illnesses – such as arthritis, diabetes, and cancer – are challenged by these non-medical needs on a daily basis. Doctors gained new tools to address chronic but non-medical needs when the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act took effect, and several of its provisions have kept evolving in the years since.

The CHRONIC Care Act addresses daily health needs by increasing the range of support your Medicare can provide. The law particularly expands care for Medicare beneficiaries living with long-term health issues.

What’s In the CHRONIC Care Act?

The law includes multiple solutions to improve integrated care for people with Medicare, or both Medicare and Medicaid. We’ve highlighted the main parts of the legislation, and where each one stands today, to give you a better understanding of the act:

Coverage for Non-Medical Costs

For individuals with chronic illnesses, non-medical equipment can be just as effective as prescription medications and other health treatments. Since 2020, Medicare Advantage plans have been able to choose to cover costs for certain items, such as wheelchair ramps and bathroom grab bars, that prevent future accidents and help you manage daily tasks — a category CMS calls Special Supplemental Benefits for the Chronically Ill (SSBCI).

Under the CHRONIC Care Act, Medicare Advantage plans can also cover additional targeted expenses for those with specific illnesses, including alternative therapies such as fitness programs and counseling, and non-medical extras like healthy food and non-medical transportation. This benefit category has grown substantially since it launched — special needs plans in particular now put a large and growing share of their rebate dollars toward these non-traditional benefits. For 2026, CMS also tightened the rules around what qualifies, spelling out a list of items that don’t count (like general groceries, alcohol, tobacco, or life insurance) after some plans had stretched the benefit further than intended. If you’re chronically ill and shopping Medicare Advantage plans, it’s worth asking specifically what SSBCI-type benefits a plan offers, since they vary a lot by plan.

Expansion of Telehealth

Folks with chronic disorders may have more care questions compared to the average patient. Telehealth services – programs that give help over the phone, video, and emerging technologies – are a tool for Medicare enrollees to get personalized attention faster.

The CHRONIC Care Act’s own telehealth provisions were narrower than people often assume: they gave Medicare Advantage plans more flexibility to design their own telehealth programs starting in 2020, and separately removed originating-site restrictions for acute stroke evaluation and monthly ESRD home dialysis check-ins under traditional Medicare. Those specific changes are permanent and remain in effect today.

The much broader telehealth access most people associate with Medicare now — seeing any provider from home, audio-only visits, and similar flexibilities — actually came later, as part of the COVID-era telehealth waivers, and those have never been made permanent. Congress has kept extending them in short stretches; the most recent extension runs through December 31, 2027, so this remains something to watch rather than a settled, permanent benefit. One piece has been made permanent, though: telehealth for behavioral and mental health care, which you can now access from home indefinitely.

Support From Accountable Care Organizations (ACOs)

Chronically ill patients are often burdened by the financial costs of doctor’s visits, creating more barriers to health resources.

Since 2019, certain ACOs have been able to offer monetary incentives – up to $20 per qualifying primary care visit – to encourage patients to receive primary care. By law, that $20 cap adjusts each year for inflation, though CMS hasn’t published one clear updated figure, so ask your ACO what the current amount is if this applies to you. ACOs include doctors and hospitals that offer Medicare patients high-quality, coordinated services. This kind of incentive, which is already common in some health insurance plans for younger people, is meant to make it easier to seek professional help when needed.

Looking ahead, the ACO REACH model — a separate CMS program relevant to how some ACOs are paid — is scheduled to end December 31, 2026. CMS has announced a replacement, the ACO LEAD model, launching in 2027 with a 10-year design aimed at long-term, high-needs patients.

What Happened to the Independence at Home (IAH) Program

The Independence at Home program provided primary care in the homes of Medicare beneficiaries with chronic disorders, with medical professionals visiting patients directly. The CHRONIC Care Act extended it, and Congress extended it again after that — but the program’s final extension ran out, and IAH concluded on December 31, 2023. There’s no direct successor program carrying the “Independence at Home” name.

Home-based primary care for people with complex, chronic needs hasn’t disappeared, though — it’s mostly shifted into other CMS models, including the GUIDE model for dementia care (launched 2024) and home-based initiatives run through ACOs. If home-based primary care is something you’re looking for, ask your doctor or Medicare plan what’s currently available in your area, since it now varies more by program and region than it did under the old nationwide IAH structure.

The Politics of the CHRONIC Care Act

The CHRONIC Care Act was introduced in December 2016. The bill came to fruition from the help of patients, doctors, healthcare professionals, and advocacy groups, convincing politicians to make changes to the sensitive Medicare program. Later, the bill was unanimously passed by both Republicans and Democrats in the Senate. On February 9, 2018, the final bill was enacted and signed by the President as a part of the Bipartisan Budget Act of 2018.

The act won support from across the ideological spectrum in the Senate – an example of public health concern trumping politics. Congress has acknowledged the difficulties and barriers of those with special requirements due to chronic disorders. Washington has a general awareness of how important it is to keep Medicare standards up-to-date.

By improving the efficiency of professional medical care, legislators hoped to see better health for the chronically ill older generations — and years later, several of the law’s provisions (Medicare Advantage’s non-medical chronic-illness benefits especially) have grown well beyond their original scope.

Taking the Next Steps

Once you turn 65, you’re able to apply for Medicare online. You can enroll in Medicare Advantage during your Initial Enrollment Period or during Medicare’s Open Enrollment Period, which runs from October 15 through December 7 every year. The CHRONIC Care Act’s core changes to Medicare Advantage have been in effect for several years now, but the benefits built on top of them — especially the non-medical supplemental benefits for chronic illness — keep changing from year to year, so it’s worth checking what a plan currently offers each time you shop rather than assuming it matches what you remember.

By learning about the different parts of Medicare, you can choose the best plan to fit your needs. Chronic illnesses can limit your day-to-day activities. The CHRONIC Care Act remains a meaningful source of holistic support and care for people managing chronic conditions, even as individual pieces of it — like Independence at Home — have come and gone.