FAQs
- How do I apply?
To enroll in PACE, you must contact the PACE organization that serves the area where you live. That organization will guide you through the application and enrollment process.
Enrollment in PACE is voluntary. If an individual meets the eligibility requirements and chooses PACE, an Enrollment Agreement is then signed.
- What does it mean to meet nursing home level of care?
In general, it means you meet the criteria to be eligible for admittance to a nursing home. To find out more about medical eligibility for nursing home services please refer to the state regulations (130 CMR 456.000) for Nursing Facilities.
- Does PACE provide comprehensive care?
Yes. PACE covers all medical and supportive services necessary for your care as determined by the Interdisciplinary Team and you.
- What is the focus of PACE?
You are the focus.
You have a team of experienced health care professionals, the Interdisciplinary Team, to help you make health care decisions. The Interdisciplinary Team usually cares for a small number of people. That way, the team gets to know you, the kind of living situation you are in, and your preferences. You and your family participate as the team develops and updates your plan of care and your goals in the program.
- What is the Interdisciplinary Team?
The Interdisciplinary Team is a group of health-care and social service professionals who assess your needs, develop your care plan, and deliver and coordinate services, including acute care services, and if necessary, nursing home services.
A PACE Interdisciplinary Team is composed of:- primary care physician
- nurse
- social worker
- physical therapist
- occupational therapist
- recreational therapist or activity coordinator
- dietitian
- PACE center supervisor
- home-care liaison
- personal care attendants
- transportation staff
Your Interdisciplinary Team meets regularly to ensure that your needs are met.
- Can I keep seeing my current doctor?
Typically, no. You will need to choose a primary care physician within the PACE organization. Even though you will only be able to see PACE doctors, you will have a whole team dedicated to providing you with high-quality medical care. A PACE organization may include your specialist or be willing to add your specialist as part of your care plan.
Note: Because PACE provides and is responsible for all of your care, with the exception of emergency care, you may be held financially responsible for any care you receive outside the program that is not approved by the PACE Interdisciplinary Team.
- Does PACE cover my medications?
Yes. PACE has Medicare Part-D prescription drug coverage. If you enroll in PACE, you will get your Part D-covered drugs and all other necessary medication from the PACE organization.
Note: If you are in PACE, and you join a separate Medicare Part-D plan, you will lose your PACE coverage.
- Does PACE support family caregivers?
Yes. PACE organizations support your family members and other caregivers with training, support groups, and respite care.
- Does PACE provide services in the community?
Yes. PACE organizations provide care and services in the home, the community, and the PACE Center. The PACE Interdisciplinary Team provides most of your care but the PACE organizations also have contracts with specialists and other providers in the community to make sure that you get all the necessary care.
- Who has a say in my treatment?
You, or your authorized representative, have the primary say!
Your PACE doctor and other care providers are the people who work with you to make decisions about your care. You, your doctor, and other care providers agree on what is best for you. If you disagree with the Interdisciplinary Team about your care plan, you have the right to appeal.
- Is preventive care covered?
Yes. The focus of every PACE organization is to help you live in the community for as long as possible. To meet this goal, PACE organizations focus on preventive care. Although all people enrolled in PACE are eligible for nursing home care, a 2014 MassHealth–commissioned study has shown that nursing home entry is delayed for PACE participants by 20 months.
- What do they do at the PACE Center? Do I have to attend every day?
The PACE Center has clinicians and rehabilitation staff onsite. You will receive most of your healthcare at the center. The PACE Center also has recreational activities, and provides meals and snacks.
You do not have to attend the PACE Center every day. The participant, family and Interdisciplinary Team determine the ideal number of days per week the participant should come to the PACE Center. Some participants come to the center for appointments only.
- What will I have to pay for PACE?
Some participants pay a monthly premium based on income. For eligible individuals, the premium for PACE is covered by Medicare and Medicaid (known as MassHealth in Massachusetts). If an applicant has MassHealth Standard there are no fees for the program. PACE services are also available on a private-pay basis. Many participants qualify for zero monthly cost share or zero premium based on income. In addition, all PACE-covered services are provided with no co-payments or out-of-pocket expenses for program participants.
- How do I get to and from the PACE Center?
If you require transportation, the PACE transportation staff will pick you up at your home on the days you go to the PACE Center–and bring you back home at the end of the day at the end of the day. If you need help getting in and out of your home, the PACE transportation staff will assist you.