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Program of All-Inclusive Care for the Elderly (PACE)

PACE

Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility.

If you join PACE, a team of health care professionals will work with you to help coordinate your care.

How does PACE work?

PACE covers all Medicare- and Medicaid-covered care and services, and anything else the health care professionals in your PACE team decide you need to improve and maintain your health. This includes prescription drugs and any medically necessary care.

Here are some of the services PACE may cover:

  • Adult day primary care (including doctor and recreational therapy nursing services)
  • Dentistry
  • Emergency services
  • Home care
  • Hospital care
  • Laboratory/x-ray services
  • Meals
  • Nursing home care
  • Nutritional counseling
  • Occupational therapy
  • Physical therapy
  • Preventive care
  • Social work counseling
  • Transportation to the PACE center for activities or medical appointments

You’ll get your Part-D covered drugs and all other necessary medication from the PACE program. If you join a separate Medicare drug plan while you’re in the PACE program, you’ll be disenrolled from PACE.

Who can get PACE?

The PACE program is only available in some states that offer PACE under Medicaid.

You can join PACE, even if you don’t have Medicare or Medicaid, if you:

  • Are at least 55
  • Live in the service area of a PACE organization
  • Need a nursing home-level of care (as certified by your state)
  • Are able to live safely in the community with help from PACE

What does PACE cost?

If you have Medicaid, you won't pay a monthly premium for the long-term care portion of the PACE benefit.

If you don't qualify for Medicaid but you have Medicare, you'll pay:

  • A monthly premium to cover the long-term care portion of the PACE benefit
  • A premium for Medicare Part D drugs

There's no deductible or copayment for any drug, service, or care approved by your health care team. If you don't have Medicare or Medicaid, you can pay for PACE yourself.

How do I apply for PACE?

To find out if you’re eligible and if there’s a PACE program near you, search for PACE plans in your area, or call your Medicaid office.


Article Source
Centers for Medicare & Medicaid Services
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