Three different things
A model is a test run by the CMS Innovation Center. You can add it only if you meet that model’s rules. It does not replace Part A and Part B. A service is something Original Medicare already pays a doctor to do, such as care management between visits. A plan is the coverage you choose: Original Medicare, Medicare Advantage, Part D, or a Supplement. Annual Enrollment is about Advantage and Part D. It is not how you join a model.
ACCESS is a model
ACCESS, Advancing Chronic Care with Effective, Scalable Solutions, tests a new way to pay organizations for technology-supported help with certain chronic conditions. It started July 5, 2026, and it is for people with Original Medicare. You sign up with an approved organization. You keep your doctors. The conditions, the monthly amounts, and the difference between a model and a plan are on the ACCESS page. People in a Medicare Advantage plan cannot use it.
GUIDE is a different model
GUIDE, Guiding an Improved Dementia Experience, is a separate model for people with dementia and their unpaid caregivers. Medicare says the person must have Original Medicare, not a Medicare Advantage plan and not PACE, and a clinician working with a participating organization confirms the dementia. It is not ACCESS, and it is not a plan you choose in the fall. Respite and memory-care rules are specific. Confirm them on Medicare.gov before you assume a service is included.
Chronic Care Management is a service
Chronic Care Management is a Part B service, not a model and not a plan. It is for people with two or more chronic conditions that are expected to last at least 12 months and that put them at real risk. Principal Care Management is the related service aimed at one serious chronic condition. The doctor’s office explains the service and should get your consent before it bills Medicare. You may owe the usual Part B coinsurance unless other coverage pays it. Consenting is not joining ACCESS, and it is not enrolling in a plan.
An ACO is a payment arrangement
An Accountable Care Organization is how Medicare pays a group of providers for the cost and quality of care, including care for chronic illness. If you have Original Medicare, Medicare may attribute you because of the primary doctor you already see. You do not enroll. Your card and your right to see any doctor who accepts Medicare stay the same. The details are on the ACO page.
A plan is still a plan
A Chronic Condition Special Needs Plan is a Medicare Advantage plan with an enrollment limit. SSBCI is an optional extra inside some Medicare Advantage plans. Neither one is a CMS model. A postcard about meals, a ride, or a coach may be a plan extra, a Part B service, or a model. The name on the letter is the first check. If the letter does not say which it is, Talk with Alan. That conversation does not enroll you.
Common questions
- Is Chronic Care Management the same as ACCESS?
- No. Chronic Care Management is a Part B service your doctor’s office can bill. ACCESS is a CMS model you sign up for with an approved organization. You can hear about both and still have neither.
- Does joining a model replace my Medicare plan?
- No. ACCESS and GUIDE are add-ons for some people with Original Medicare. They do not replace Part A and Part B, and they are not a choice you make instead of Medicare Advantage during Annual Enrollment.
- What should I ask when I get a letter?
- Ask whether it is a model, a doctor’s service, a plan, or PACE. Then ask what you would pay, whether you keep your current doctors, and whether it requires Original Medicare.
My Medicare Checkup
Use My Medicare Checkup for your own doctors, prescriptions, and costs.
Start My Medicare CheckupThen get your summary, or talk with Alan.
For the other pages on this topic, open the Lowering Medicare costs guide.