| Mon, Jul 18, 2011 @ 09:00 AM

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

Posted by Medicare Made Clear

DirectionsPACE helps individuals over the age of 55 who meet their state’s criteria for nursing home care get the medical, rehabilitative, and social services they need to get the care they need to safely remain in their homes.

Who qualifies for PACE?

A person may qualify for PACE if he or she is:

  • 55 or older,
  • living in an area that has PACE service,
  • able to safely live in the community with PACE services and
  • certified by the state as needing a nursing-home level of care.

It is not necessary to be a Medicare or Medicaid beneficiary to qualify.

What does PACE cover?

PACE services are available 24 hours a day, 7 days a week, 365 days a year. Services are often provided in a community’s PACE center, but may also be provided in the beneficiary’s home or by other providers contracted to work with PACE enrollees.

Medicare and Medicaid services are combined with the services deemed necessary by physicians, nurses, occupational, physical and recreational therapists, social workers, personal care attendants, dietitians and drivers. Services may include, but are not limited to:

  • primary care
  • preventative care
  • hospital care
  • home care
  • adult day care
  • nursing home care
  • emergency services
  • physical or occupational therapy
  • social services
  • restorative therapies
  • personal care
  • recreational therapy
  • lab and X-ray services
  • transportation
  • supportive services
  • nutritional care

What does PACE cost?

There is never a deductible or copayment for any drug or service approved by the PACE care team. The amount paid for other services depends on the enrollee’s personal situation.

Medicaid beneficiaries do not have to pay a monthly premium for long-term care benefits. If the enrollee has Medicare but not Medicaid, there may be a monthly premium to cover long-term care and a premium for Medicare Part D drug coverage. An enrollee may pay for PACE privately if he or she doesn’t have Medicare or Medicaid.

A beneficiary may elect to discontinue PACE services at any time.

How do I learn more?

Contact your state’s Medicaid office to find out if there is a PACE program in your community and whether you or a loved one qualifies. You may search for programs by area at www.Pace4You.org. You may also download a copy of “Quick Facts about Programs for All-Inclusive Care for the Elderly (PACE)” or contact Medicare for a paper copy at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week.

Additional Resources

Get information about PACE and what it covers; sponsored by the National PACE Association.

Medicare offers information on the PACE program.

Y0066_110624_162531 File & Use 07062011