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Medicare PACE a New Program for U.S. Seniors Needing Medical Care

Good news for seniors who wish to stay in their home and community instead of going to a senior care facility. A new program offered by Medicare — Medicare PACE — will allow seniors to receive health care from the comfort of their homes and communities. This program is not available in all states.

Medicare PACE stands for Program of All-Inclusive Care for the Elderly. Currently roughly 40,000 seniors participate in Medicare PACE and receive in-home care. The program is optional but is turning out to be a really good support for elderly Americans in need of social services and more inclusive, personal, in-depth medical care.

The Medicare PACE program is designed to allow seniors to continue to live at home and in their communities instead of senior facilities. Seniors may qualify be eligible for the PACE program if they are in need of nursing home-level care, are able to live safely in the community, are 55 or older and are living in a PACE service area.

Those participating in the program have a medical team dedicated to them and their health care needs. Each team features a primary care doctor, occupational therapist, recreational therapist, nurse, social worker, physical therapist, activity coordinator, home care liaison, dietician and various other medical professionals.

With a team working with you, you get personalized, one-to-one care. You may need use a PACE-preferred doctor, but that is to your advantage as the physicians are trained in a multi-disciplinary approach to senior care. There is no deductible/co-payment for medications, services or care approved by your health care team. It is covered under the program for eligible beneficiaries.

What does PACE cover? Currently, it covers a wide variety of services that may change over time or be added to as it grows. The services covered include:

  • Physical therapy
  • Occupational/recreational therapy
  • Laboratory
  • X-ray services
  • Home/Hospital care
  • Emergency services
  • Meals
  • Medical specialty services
  • Nursing home care
  • Adult day primary care
  • Mental health services
  • Dentistry
  • Prescription drugs (partially covered under program)

It is important to note that you may choose to get your medications through the PACE program and can still enroll in Medicare Part D. However, if you do enroll in a prescription drug plan, you are disenrolled from PACE.

What do you pay for PACE? If you have or qualify for Medicaid, you do not pay the premium for long-term care. However, if you do not qualify for Medicaid but have Medicare, you do pay the monthly premium and a premium for prescription drug coverage.