2 minute read
Helping Seniors Remain at Home With PACE
PACE (Program of All-Inclusive Care for the Elderly) provides home and community-based care and services to people age 55 or older who meet level-of-care requirements, but wish to continue living at home. Care and services are approved through the PACE interdisciplinary team based on medical necessity and the individual’s goals. PACE provides coverage for primary and specialty healthcare, prescription drugs, transportation, home care, checkups, hospital visits and nursing home stays when necessary.
Who Can Join PACE?
You can join PACE if: • You are age 55 or older; • You live in the service area of a PACE organization; • You meet level-of-care criteria from an assessment completed by a registered nurse; and • Receiving PACE services would enable you to live safely in the community.
PACE Provides Comprehensive and Preventive Care
With PACE, you have a interdisciplinary team of experienced healthcare professionals overseeing your care. Since your team cares for a small number of people, they get to know you, your living situation and your care preferences. You and your family work with your team to set personal goals and develop and update your plan of care.
When you enroll in PACE, you may be required to use a PACE-preferred physician. These physicians are best suited to help you make healthcare decisions. PACE organizations also support family members and other caregivers with training, support groups and respite care.
PACE Provides Services in the Community
PACE organizations provide care and services in the home, the community and at the PACE center. They have contracts with specialists and other providers in the community to ensure you get the care you need. PACE participants often get most of their care from staff employed by the PACE organization in the PACE center. PACE centers meet state health and federal safety requirements and include adult day health programs, primary care from physicians and nurses, medications, home care, activities and occupational and physical therapy services.
PACE Provides Transportation
PACE organizations provide transportation to the PACE center for activities and medical appointments. PACE also transports to medically necessary appointments in the community on an as-needed basis.
What You Pay Depends on Your Financial Situation
PACE uses Medicare and Medicaid funds to cover your care and services that have been approved by your team. You can have either Medicare or Medicaid or both to join PACE. If you have Medicaid, you will not have to pay a monthly premium for the PACE benefit. If you have Medicare, but don’t qualify for Medicaid, you will be charged a monthly fee to cover the PACE benefit and will continue paying the premium for your existing Medicare Part D coverage for prescriptions. In PACE, however, there is never a deductible or copayment for any drug, service or care approved by the PACE team. If you do not have Medicare or Medicaid, you can also pay for PACE privately. If you currently don’t have Medicaid, PACE staff can help you determine eligibility and complete the Medicaid application process.
