Do you struggle to keep up with your needs, but consider living in a nursing home out of the question? If so, it’s understandable. Many people want to stay in their own home, where they maintain independence. That doesn’t mean you have to sacrifice access to quality health care.
PACE, or Programs of All-Inclusive Care for the Elderly, may be able to help you get the care you need in or near your home. If you live in a PACE service area, this program may be the answer to your care problems.
What is PACE?
PACE is a joint Medicare and Medicaid program that helps seniors “in the community” instead of a care facility. Like hospice care, PACE will give you access to an interdisciplinary team that’ll make many determinations about your health care. At a minimum, Medcaid.gov says this team will consist of a:
- Home care liaison
- Occupational therapist
- PACE center supervisor
- Personal care attendant
- Physical therapist
- Primary care physician
- Recreational therapist or activity coordinator
- Social worker
What Services Does PACE Cover?
For one, PACE should cover any services or care covered by Medicare and Medicaid, as long as your care team authorizes that you need them. This includes coverage for emergency services, preventative care, hospital care, and prescription drugs. That’s not all, though. PACE can also cover services like respite care, adult day care, and meals.
Your costs depend on if you’re enrolled in Medicaid, Medicare, both programs, or neither program.
Your costs depend on if you’re enrolled in Medicaid, Medicare, both programs, or neither program. As long as you’re enrolled in Medicaid, you shouldn’t have to pay premiums for your PACE long-term care benefit. If you only have Medicare, and not Medicaid, you’ll have to pay premiums for the PACE long-term care benefit and Medicare Part D drugs. Beyond this, you won’t pay any deductible or copayment for approved drugs, services, or care.
In general, PACE is a pretty robust program that covers many of the services you may need. You can also leave at any time, if you feel your needs are best served elsewhere.
To be eligible for PACE, you must meet basic requirements based on age, access, need, and ability.
You must be at least 55, live in a PACE service area, and be certified to need nursing home-level care.
You must be at least 55 years old. You must also live in an PACE service area. Currently, PACE programs are available in 31 states. Additionally, you must be certified by your state to need nursing home-level care, and able to live in your home safely with help from PACE. In other words, you must be able to live on your own when the PACE team isn’t there to help you.
You don’t need to have Medicare or Medicaid to join PACE; however, if you aren’t enrolled in either program, you’ll have to pay for PACE privately if you’d like to join it.
How Do I Join?
OK, so you’re interested in finding a PACE center near you and applying. You tick all the eligibility boxes. It’s time to apply.
To apply, you must locate a PACE plan near you. If there’s a plan nearby, you can contact the plan directly. You can also use the National PACE Association’s plan finder, which allows you to search for plans by your state and zip code. If you have any further questions or need extra help, you can always contact your local Medicaid office.
● ● ●
If you’re eligible for PACE, it can be a one-stop option for health care that can keep you healthy and in your home longer. With everything handled by your team, you can once again focus getting the most out of life!