Many elderly need specialized long-term care – social and medical services that traditionally take place in nursing homes. Seniors who are over the age of 55 and in need of care may be eligible for Programs of All-inclusive Care for the Elderly, or PACE. A Medicare program designed to provide personalized, coordinated care for the disabled in a community setting, the goal of PACE is to help seniors preserve their independence and delay nursing home care as long as possible. Here is some information on the PACE program and how it works to help older adults in need of services.
Eligibility and Cost
Enrollment in the PACE program is involuntary, but to be eligible to receive benefits, seniors must meet a few conditions. Applicants must be at least 55 years old and certified by the state as requiring a nursing home level of care. Recipients must reside in the service area of the PACE organization and be capable of living safely in the PACE community. Seniors who are eligible for Medicare, Medicaid, or both can enroll in PACE.
While PACE uses Medicare and Medicaid funds to pay for care and services, the cost of the program depends on each applicant’s financial situation. Medicaid recipients may pay nothing at all or a small fee for services. Medicare-only recipients who join PACE pay a monthly premium for long-term care and prescription drugs. In either case, there are no deductibles or coinsurance.
PACE Benefits
PACE benefits include all Medicare and Medicaid-covered services in addition to some services not covered by Medicare. This includes doctor and nursing services through a primary care physician, care while in the hospital (including laboratory and x-ray services), emergency services, physical and occupational therapy, nursing home and home care, prescription drugs, dental, meals, and nutritional counseling, social services, and transportation. Seniors who enroll in PACE receive all of their Medicare benefits through the program.
Each applicant is assessed daily on an individual basis by a team of skilled healthcare professionals. The team consists of the following:
Primary care physician
Activity Coordinator
Nurse
Dietitian
Social Worker
Center supervisor
Physical therapist
Home care liaison
Occupational therapist
Driver
Is PACE the Right Choice for You?
For older adults suffering from a disability or chronic condition, having medical and supportive services available in a community setting offers peace of mind, promoting independence and delaying nursing home care. The mission of PACE is to help well-deserving seniors and their families accomplish this goal by offering comprehensive medical and social services provided by a team of interdisciplinary health professionals. Individual states elect to provide PACE benefits to Medicaid recipients.
References:
https://www.medicare.gov/your-medicare-costs/help-paying-costs/pace/pace.html
MUC13-2016-SSI/CDIS
