Program of All-Inclusive Care for the Elderly (PACE) in Pennsylvania
The Program of All-Inclusive Care for the Elderly (PACE) in Pennsylvania is designed for older individuals who have long-term health care needs or chronic medical conditions. PACE services are intended to help eligible applicants receive the health care that they need within their community instead of moving to a nursing home or assisted living facility. Many of the people who qualify for PACE benefits would need to live in one of these facilities if the program did not exist. PACE has its team of health care providers, meaning that beneficiaries receive coordinated care from medical professionals who are familiar with their individual needs. PACE is run by Medicaid and Medicare, and as such, most people who are qualify are also dually eligible for both programs. Even though the PACE program is a federal initiative, it is coordinated on a state level. In Pennsylvania, the PACE may also be referred to as Living Independence for the Elderly. Learn more about PACE program in Pennsylvania and find out how to apply in the below topics.
PACE Eligibility Requirements in Pennsylvania
PACE programs in Pennsylvania are only available if you meet a few eligibility criteria. To enroll in PACE, you must:
- Meet the minimum age requirement for the program.
- Live in an area of Pennsylvania that is served by a PACE organization.
- Require the level of care offered in a nursing home.
- Receive certification from the state that you require such care.
- Be able to remain in the community and live there safely while receiving help from PACE.
Note that most people eligible for PACE in Pennsylvania are already enrolled in Medicare or Medicaid, or are receiving benefits from both. You may still be qualified for PACE if you are not in one of these programs. However, receiving services from PACE, in this case, will require that you pay all of your costs individually. Most people who are eligible for Medicare or Medicaid receive PACE savings for being enrolled in these programs.
PACE Application Process in Pennsylvania
Enrolling in PACE in Pennsylvania may require that you contact an organization directly rather than applying through Medicare or Medicaid. Since PACE programs are offered by a variety of organizations throughout the state, it is beneficial to check whether you live in a service area first by looking at Medicare's online PACE search tool. Pennsylvania is fortunate to have a variety of PACE organizations available. While some areas of the state may not be covered, it is beneficial to check for programs in your area if you are eligible. Note that most programs for PACE in PA will include “LIFE” in their name, which will help you identify programs easily. Unlike applications for Medicare or Medicaid, there is not a standard form you can submit to enroll. Instead, when you have found a program that serves your area, you will need to contact the individual organization. Some programs will allow you to apply for PACE online, while others may require you to call or submit a paper form. If you cannot find information on programs in your area, then it is recommended that you contact Medicare or Medicaid for assistance. Learn more about PACE applications in Pennsylvania by downloading our detailed health care guide.
What does the PACE service cover in Pennsylvania?
Since PACE services in Pennsylvania are coordinated by Medicare and Medicaid, participants in PACE will receive the same care provided by these programs. Those who qualify for PACE can also benefit from a variety of additional services that Medicare or Medicaid may not specifically provide.
First, PACE programs in Pennsylvania provide hospital and nursing services that to meet the basic medical needs of enrollees. Second, those who qualify for PACE in PA will receive dental, hearing, vision, speech and other similar care. Third, enrollees can benefit from both medical and non-medical transportation as well as recreational and social activities that enrich their lives. Fourth, PACE provides medical equipment, medications and lab work that are essential to beneficiaries' health. Finally, enrollees who are nearing the end of their lives can get specialized care to help with their needs. By receiving all of these services for PACE, more people can remain in their community and have their health care needs covered at home. Being able to stay in one's home longer is beneficial in itself. Download our health insurance guide to learn more about the services available from this program.
Costs for PACE Programs in Pennsylvania
Pace services in Pennsylvania may be available for free in some cases. Other times, the PACE program requires that you pay a premium. Your expenses depend on your income and eligibility for Medicaid and other programs. You usually do not have to pay anything for your care from PACE if you are currently receiving Medicaid. When you have Medicare alone, you typically need to pay for prescriptions and pay for long-term PACE care that you receive. PACE programs do not charge deductibles or copayments in most cases. However, when you are not enrolled in Medicare or Medicaid, you will have to pay for your PACE health care needs on your own.