A Different Medicare Advantage Plan – PACE

by Mary Jane Stern

If you are a caregiver and need some extra help without having to put your loved one in an institutionalized setting, nursing home consider PACE – Programs of All Inclusive Care for the Elderly.  It works like the Medicare Advantage Plans (Part C).

The major difference, it’s a plan that focuses completely on the elderly, frail individual, generally over the age of 80 who would meet their state’s requirements for nursing home care. Almost half of the PACE participants have been diagnosed with dementia, but the program allows them to live in their own home and community. This plan is an option under both Medicare and Medicaid.

There are eligibility requirements and you don’t have to be enrolled in Medicaid to be eligible for the PACE program.  The primary qualification to enroll in PACE is health status, rather than income levels or age.

PACE receives their funding through Medicare, Medicaid and private sources.  PACE receives a monthly payment just like any other Medicare Advantage plan.  Depending upon your financial status, you might have to pay a monthly premium.

How PACE Operates

PACE is regulated under individual state licensing regulations.  They operate as an Adult Day Care Center.  The center is where the program is run and where you receive medical and supportive needs while living at home.

What They Cover

• Adult day health care
• Medical care provided by a PACE doctor along with specialists
• Home health care and personal care
• Prescription drugs
• Social services
• Respite care
• Hospital and nursing home care when necessary
• Hospice care

Eligibility and Qualifications

• Coverage is available to persons who are: 55 or older
• Certified by their state to need nursing home care
• Able to live safely in the community at the time of enrollment

PACE is not available in all parts of the country, but if you want to find out if service is available in your area here’s a link for the PACE service areas.

PACE is an alternative to nursing homes and operates like the Medicare Advantage Plans.  It could very well give you the peace of mind you need during the day.  It has also been said that people enrolled in PACE, love it and it’s the highlight of their day.

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