Frequently Asked Questions
AND PACE PROGRAM QUICK FACTS
Quick Facts about Programs of
All-inclusive Care for the Elderly (PACE)
What are Programs of All-inclusive Care for the Elderly (PACE)?
PACE is a Medicare program for older adults and people over age 55 living with disabilities. This program provides community-based care and services to people who otherwise need nursing home level of care. PACE was created as a way to provide you, your family, caregivers, and professional health care providers flexibility to meet your health care needs and to help you continue living in the community.
An interdisciplinary team of professionals will give you the coordinated care you need. These professionals are also experts in working with older people. They will work together with you and your family (if appropriate) to develop your most effective plan of care.
PACE provides all the care and services covered by Medicare and Medicaid, as authorized by the interdisciplinary team, as well as additional medically-necessary care and services not covered by Medicare and Medicaid. PACE provides coverage for prescription drugs, doctor care, transportation, home care, check ups, hospital visits, and even nursing home stays whenever necessary. With PACE, your ability to pay will never keep you from getting the care you need.
You should know this about PACE:
PACE Provides Comprehensive Care
PACE uses Medicare and Medicaid funds to cover all of your medically-necessary care and services. You can have either Medicare or Medicaid or both ; Or for a Flat Monthly fee you can also join PACE
The Focus is on You
You have a team of health care professionals to help you make health care decisions. Your team is experienced in caring for people like you. They usually care for a small number of people. That way, they get to know you, what kind of living situation you are in, and what your preferences are. You and your family participate as the team develops and updates your plan of care and your goals in the program.
PACE Covers Prescription Drugs
PACE organizations offer Medicare Part D prescription drug coverage. If you join a PACE program, you’ll get your Part D-covered drugs and all other necessary medication from the PACE program. Note: If you are in a PACE program, you don’t need to join a separate Medicare drug plan. If you do, you will lose your PACE health and prescription drug benefits.
PACE Supports Family Caregivers
PACE organizations support your family members and other caregivers with caregiving training, support groups, and respite care to help families keep their loved ones in the community.
PACE Provides Services in the Community
PACE organizations provide care and services in the home, the community, and the PACE center. They have contracts with many specialists and other providers in the community to make sure that you get the care you need. Many PACE participants get most of their care from staff employed by the PACE organization in the PACE center. PACE centers meet state and Federal safety requirements and include adult day programs, medical clinics, activities, and occupational and physical therapy facilities.
PACE is Sponsored by the Health Care Professionals Who Treat You
PACE programs are provider sponsored health plans. This means your PACE doctor and other care providers are also the people who work with you to make decisions about your care. No higher authorities will overrule what you, your doctor, and other care providers agree is best for you. If you disagree with the interdisciplinary team about your care plan, you have the right to file an appeal.
Preventive Care is Covered and Encouraged
The focus of every PACE organization is to help you live in the community for as long as possible. To meet this goal, PACE organizations focus on preventive care. Although all people enrolled in PACE are eligible for nursing home care, only 7% live in nursing homes.
PACE Provides Medical Transportation
PACE organizations provide all medically-necessary transportation to the PACE center for activities or medical appointments. You can also get transportation to appointments in the community.
What You Pay for PACE Depends on Your Financial Situation
If you qualify for Medicare, all Medicare-covered services are paid for by Medicare. If you also qualify for your State’s Medicaid program, you will either have a small monthly payment or pay nothing for the long-term care portion of the PACE benefit. If you don’t qualify for Medicaid you will be charged a monthly premium to cover the long-term care portion the PACE benefit and a premium for Medicare Part D drugs. However, in PACE there is never a deductible or copayment for any drug, service, or care approved by the PACE team.
PACE uses Medicare and Medicaid funds to cover all of your medically-necessary care and services. You can have either Medicare or Medicaid or both ; Or for a Flat Monthly fee you can also join PACE
The Focus is on You
You have a team of health care professionals to help you make health care decisions. Your team is experienced in caring for people like you. They usually care for a small number of people. That way, they get to know you, what kind of living situation you are in, and what your preferences are. You and your family participate as the team develops and updates your plan of care and your goals in the program.
PACE Covers Prescription Drugs
PACE organizations offer Medicare Part D prescription drug coverage. If you join a PACE program, you’ll get your Part D-covered drugs and all other necessary medication from the PACE program. Note: If you are in a PACE program, you don’t need to join a separate Medicare drug plan. If you do, you will lose your PACE health and prescription drug benefits.
PACE Supports Family Caregivers
PACE organizations support your family members and other caregivers with caregiving training, support groups, and respite care to help families keep their loved ones in the community.
PACE Provides Services in the Community
PACE organizations provide care and services in the home, the community, and the PACE center. They have contracts with many specialists and other providers in the community to make sure that you get the care you need. Many PACE participants get most of their care from staff employed by the PACE organization in the PACE center. PACE centers meet state and Federal safety requirements and include adult day programs, medical clinics, activities, and occupational and physical therapy facilities.
PACE is Sponsored by the Health Care Professionals Who Treat You
PACE programs are provider sponsored health plans. This means your PACE doctor and other care providers are also the people who work with you to make decisions about your care. No higher authorities will overrule what you, your doctor, and other care providers agree is best for you. If you disagree with the interdisciplinary team about your care plan, you have the right to file an appeal.
Preventive Care is Covered and Encouraged
The focus of every PACE organization is to help you live in the community for as long as possible. To meet this goal, PACE organizations focus on preventive care. Although all people enrolled in PACE are eligible for nursing home care, only 7% live in nursing homes.
PACE Provides Medical Transportation
PACE organizations provide all medically-necessary transportation to the PACE center for activities or medical appointments. You can also get transportation to appointments in the community.
What You Pay for PACE Depends on Your Financial Situation
If you qualify for Medicare, all Medicare-covered services are paid for by Medicare. If you also qualify for your State’s Medicaid program, you will either have a small monthly payment or pay nothing for the long-term care portion of the PACE benefit. If you don’t qualify for Medicaid you will be charged a monthly premium to cover the long-term care portion the PACE benefit and a premium for Medicare Part D drugs. However, in PACE there is never a deductible or copayment for any drug, service, or care approved by the PACE team.
PACE Your LIFE: Frequently Asked Questions
PACE Your LIFE is the Program of All-Inclusive Care for the Elderly. Located in the Milford Wellness Village, we are an alternative to nursing facilities for people 55 and better that provides customized health care and social engagement to older adults to help them stay independent and in their homes.
PACE Your LIFE is not a nursing home. The goal of the PACE Your LIFE is to keep seniors living safely at home and in the community for as long as possible with our services in place. Many of our members live in their own homes, senior housing complexes, apartments, or with family. PACE Your LIFE Day Center is more than a Senior Center, it’s the driving force behind successful participant care. At the day center, we provide socialization, medical care, occupational and physical therapy, exercise, nutritional counseling, medications, transportation and so much more.
Like other health care plans, PACE Your LIFE has a network of doctors, specialist and health care services. If you enroll in PACE Your LIFE, you are assigned to a primary care provider at our Adult Day Center who is part of our coordinated care team. Our healthcare network includes doctors, specialists, health services and hospitals located in the local community.
- Age 55 of older
- Eligible for nursing home care – assistance with 1 ADL & 1 IADL
- Live in our service area: 19933, 19934, 19941, 19943, 19946, 19950, 19952, 19954, 19958, 19960,19962, 19963, 19968, 19979
- Able to live safely in the community
PACE Your LIFE services are free to seniors who qualify for Medicare and Long-Term Care Medicaid or Long-Term Care Medicaid only. For seniors that are not interested in exploring Long Term Care Medicaid as an option, there would be a flat monthly fee. Please contact our Medicaid Eligibility Specialist for more information.
If you do not like PACE Your LIFE, which we truly doubt, you may disenroll at any time. PACE Your LIFE is a voluntary program and because of this, the participant reserves the right to disenroll.
Attending the Adult Day Center at PACE Your LIFE is not a requirement and is based on your medical and social needs. Some participants only visit the center for medical appointments, while others come more often to socialize, eat meals and enjoy activities.
The National PACE Association advances the efforts of PACE programs across the country.