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What is PACE and How Will it Help Me?

PACE is a Medicare program for elderly individuals as well as people aged over 55 who are living with disabilities. This program provides community and home-based care and services to those who may otherwise need a level of care that can only be given in a nursing home.

PACE was created as a way to offer these individuals, their families, their caregivers, as well as the wider professional health care provider base, the flexibility to meet all required health care needs and to help these individuals to continue living in their own homes and their own communities.

An interdisciplinary team of professionals are highly trained to provide the coordinated care these individuals need. These professionals are also experts in working with older people, and will work together with participants and their families (if appropriate) to develop the most effective plan of care.

 

What Services are Covered?

PACE provides all care and services covered by Medicare and Medicaid, as authorized by the interdisciplinary team, as well as any additional medically-necessary care and services not covered by Medicare and Medicaid.

PACE provides coverage for:

  • Prescription drugs
  • Doctor care
  • Transportation
  • Home care
  • Checkups
  • Hospital visits
  • Nursing home stays whenever necessary

 

Focusing on the Individual

A full team of health care professionals are available to help make these important health care decisions. Our team is experienced in caring for the individual, meeting their unique personalities, living situations, and preferences. They work together not just with the individual, but with those who surround them in their everyday life, working to develop care plans and program goals that maintain the highest quality of life.

Covering Prescription Drugs

PACE organizations offer Medicare Part D prescription drug coverage. Joining a PACE program will include all required Part D-covered drugs plus any other necessary medication from the PACE program.

 

Supporting Family Caregivers

PACE organizations support family members and other caregivers with caregiving training, support groups, and respite care, to help families keep their loved ones in the community.

 

Services in the Community

PACE organizations provide care and services in the home, the community, and the PACE center. We have contracts with many specialists and other providers in the community to make sure that every PACE participant gets the care they need. Most PACE participants get the majority of their care from staff employed by the PACE organization at the PACE center. All PACE centers meet state and federal safety requirements and include adult day programs, medical clinics, daily living activities, and occupational and physical therapy facilities.

 

Sponsored by the Health Care Professionals Who Treat You

PACE programs are provider-sponsored health plans. This means that each participant’s PACE doctors and care providers are the same individuals who work with them to make the decisions about their care. No higher authorities will overrule what the individual, their doctor, and their other care providers agree is best. Any individual in disagreement with the interdisciplinary team about a care plan has the right to file an appeal.

 

PACE Medical Transportation

PACE organizations provide all medically-necessary transportation to and from the PACE center for all activities or medical appointments. Transportation is also available for appointments in the wider community.

Credit: My Health, My Medicare, January 2008

 

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Page last updated on October 14, 2020

Website H3563 GMWP Website 1 CMS approved 01/04/2019