PACE for Medicare Beneficiaries

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( — August 15, 2019) — PACE is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or any care facilities. PACE stands for Programs of All-Inclusive Care for the Elderly.

Anyone who enrolled in the PACE program will have a team of healthcare professionals working with them or their family to make sure that the beneficiary gets the care that they need.

The team that cares for the beneficiaries are members that are hand-picked with experience and works in a small number to enhance the feel of engagement with that beneficiary.

To those who are interested in enrolling to the PACE program, that person is required to use a PACE preferred doctor.

These doctors are the ones that are considered to be the best in the field and knows what are best suited to help the beneficiary make health care decisions. This is also one of the programs that serve as a Medicare Advantage 2020.

Only certain people are eligible to be in the PACE program. Those who have either Medicaid or Medicare or even both are able to join this program. However, this program is only available in some of the states in which PACE is offered under Medicaid.

To qualify to enroll in this program, someone has to meet certain criteria such as:

  1. Be of age fifty-five or older.
  2. Need a nursing home-level of care. This requirement have to be certified in accordance with the state where you live.
  3. Be able to live safely in the community with the help of PACE.
  4. Live in the service area of a PACE organization.

PACE provides all the care and services covered by Medicare and Medicaid if authorized by the beneficiaries’ health team. If they do so, then the beneficiary health team decides that there are treatments needed outside what medicare and Medicaid cover, PACE might still be able to cover them.

Some of the basics services that PACE covers;

  1. Adult day primary care. This includes the doctors and recreational therapy nursing services that the beneficiary require.
  2. Dentistry
  3. Emergency services
  4. Home care
  5. Laboratory
  6. Meals
  7. X-Ray services
  8. Hospital care
  9. Medical specialty services
  10. Physical therapy
  11. Prescription drug
  12. Nutritional counseling
  13. Preventive care
  14. Social services
  15. Social work counseling
  16. Transportation to PACE center for activities and medical appointments, if it is medically necessary.

Not to mention for anyone who joins the program, they will automatically get part D covered drugs and all other necessary medication from the Pace program. 

Anyone who would like to apply only needs to any PACE plans in the area. For anyone who is qualified for a Medicaid will not need to pay a monthly premium for the long-term care portion. For those who do not qualify to get Medicaid, will be charged a monthly premium to cover the long term care, and a monthly premium to cover part D drugs.