Tag: Pace Program

Seniors over the age of 55 and in need of care may be eligible for the Medicare Pace Program ( Programs of All-inclusive Care for the Elderly) Designed to provide personalized, coordinated care for the disabled in a community setting. The goal is to help Illinois seniors preserve their independence and delay nursing home care as long as possible.

Eligibility

Enrollment in the 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. Must reside in the service area of the PACE organization and be capable of living safely in the community. Seniors who are eligible for Medicare, Medicaid, or both can enroll. 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 pay a monthly premium for long-term care and prescription drugs. In either case, there are no deductibles or coinsurance. 

Coverage

Benefits in Illinois 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 will 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.

Primary care physician

Activity Coordinator

Nurse

Dietitian

Social Worker

Center supervisor

Physical therapist

Home care liaison

Occupational therapist

Driver

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 health professionals.

References:

https://www.medicare.gov/your-medicare-costs/help-paying-costs/pace/pace.html

MUC13-2016-SSI/CDIS