Someone told me that PACE may be able to help me or a loved one. What exactly is PACE?
PACE, or Program of All-Inclusive Care for the Elderly, is a comprehensive managed care program of services and supports designed to help keep people living at home for as long as possible. Each participant in PACE has a team of at least eleven (the interdisciplinary team ) that creates an individualized care plan to meet his or her needs. Financing for the program is capped, which allows PACE providers to deliver all services participants need, rather than limit them to those reimbursable under Medicare and Medicaid fee-for-service plans. This gives PACE flexibility.
PACE sounds like something that could really help me or my loved one. What is the process and what do I do next if I am interested?
First, find out if there is a PACE program that serves your area of the state (see below). If there is, contact the PACE organization in your area and ask to speak to an enrollment specialist. They will tell you more about the program and the steps to enrollment. Typically someone will come and visit you in your home. You'll also want to visit the PACE center, where they may conduct a clinical assessment. Each PACE program in the state is an independent, nonprofit organization, and they all do it a little bit differently. Contact your local PACE program and they'll let you know exactly how it works, and walk you through the process.
My Area of the State
How do I find out if there is a PACE program in my area?
for a listing of all operational PACE programs in North Carolina, with contact information.
What if there is no PACE in my community?
Contact your state legislators (look them up here
), and let them know that you'd like to see PACE in your community. We have organizations that have either already applied to the State to serve your area, or there is an existing PACE program interested in expanding to your county in the future.
Do I have to be below a certain income to be eligible for PACE?
No. PACE is open to all, regardless of financial situation, as long as you meet the other eligibility requirements
How much does PACE cost?
PACE is a capitated program, meaning it operates at a set monthly cost, regardless of services or benefits provided. That provides an incentive for PACE to keep its participants as healthy as possible. If you have Medicaid, you will likely not have any cost for the program. If you have Medicare only, you will have to pay the portion of PACE that is the long term care benefit and Part D drugs. If you have neither Medicare nor Medicaid, you can private pay. PACE becomes both your insurer and provider; you won't need or have separate health insurance coverage, Contact your local PACE program
and ask for an enrollment specialist to discuss your specific situation and learn more about what your cost for PACE would be.