PACE Frequently Asked Questions
1. What is PACE?
PACE is a Program of All-Inclusive Care for the Elderly. The goal of PACE is to help older adults remain living in their community as independently as possible for as long as possible. We do this by providing a comprehensive package of medical, wellness and support services.
2. How do people qualify for PACE?
A person qualifies if she or he:
Is 55 years of age or older
Lives in the service area of a PACE organization
Is certified by the State of Michigan as meeting the need for the nursing home level of care (As determined by the PACE eligibility team; see the list of commonly qualifying conditions here.)
Is able to live safely in the community with the help of PACE services when joining
3. Are prescription drugs covered?
All prescription and non-prescription drugs deemed necessary by the PACE interdisciplinary care team are paid for by the PACE program.
4. Are people who do not qualify for Medicaid eligible for PACE enrollment?
If a person meets the income and assets limits to qualify for Medicaid, the program pays for a portion of the monthly PACE premium. Medicare pays for the rest. If a person does not qualify for Medicaid, he or she is responsible for the portion of the monthly premium Medicaid would pay. PACE staff can help determine a person's Medicaid eligibility.
5. If I belong to a Medicare HMO, can I also enroll in PACE? for long-term care services?
You can only enroll in one Medicare health plan. PACE health plans are both Medicare providers and long-term care providers. By enrolling in a PACE health plan you will be automatically dis-enrolled from your current Medicare/HMO.
6. Can I keep my own doctor?
When a person enrolls in a PACE health plan, she or he is assigned a primary care physician who is part of an interdisciplinary team skilled in treating the problems of the aging. This primary care physician works with other members of the team to coordinate all services a member receives.
In some circumstances, participants may be able to visit a former primary care physician when approved by the PACE Interdisciplinary Team. Additionally, participants may continue to receive care from their speciality providers.
7. How do people get to the Day Health Center?
Transportation is a key part of the PACE benefit and is provided between the home and the Day Health Center. In some circumstances, transportation can also be arranged to medical appointments outside the PACE Center.
8. Can I just use a specific service such as home care, meals, transportation or the Day Health Center?
Focusing on a single aspect of care does not provide the participant with the best chance of remaining independent in the community. Upon enrolling in PACE, the Interdisciplinary Team develops an individualized plan of care to provide the participant with a comprehensive health and wellness plan, integrating a variety of services.
9. Do PACE participants attend the Day Center every day?
On average, PACE participants attend the Day Center two times a week. Day Center attendance is based on individual needs and can range from once a week, or every month, to several days a week, as needed.
10. What happens if a PACE participant needs nursing home care?
The goal of PACE is to keep participants out of a nursing home as long as possible. If at some point it is in the best interest of the participant to receive care in a nursing home, PACE will pay for the care, and medical oversight by the interdisciplinary team will continue.
11. If I want to join PACE, what do I do next?
Consult the National PACE Program Locator on the National PACE Association website to determine if PACE is available in the area in which you reside.
Contact PACE plan so they can schedule a home visit with you and your caregiver to tell you more about their plan.
Attend a tour of the PACE site with your family/caregiver(s).
The PACE plan will then schedule a complete medical and social assessment for you by their interdisciplinary team.
12. What happens if a person wants to leave PACE?
A PACE participant is free to dis-enroll from PACE and resume their benefits in the traditional Medicare and Medicaid programs at any time.