Learn About Medicaid’s New Senior Health Insurance Program

Medicaid has launched a new program known as PACE or Programs or All-Inclusive Care for the Elderly as an alternative to costly nursing homes. This program simplifies the healthcare process for elderly patients that qualify for the program, allowing them to be taken care of in their home by someone they know or love. This can make the patient more comfortable and help the government save money by not having to pay for a spot in a nursing home. Learn more about this exciting new senior health insurance program and the pros and cons of switching to PACE.

How Does PACE Work?

When a person enrolls in the PACE program, almost all of their healthcare comes from a PACE center in the community, in which many different doctors and nurses provide a range of services, including adult day care. This concentrated pool of healthcare providers also works with specialists in the area to make sure the patient receives all the care they need. If a certain operation or special scan is required, the person’s PACE team will need to approve it beforehand.

The program also reimburses a patient’s loved one for taking care of them in their own home. Many elderly patients prefer to stay in their own home instead of moving to an assisted living community. This helps the patient feel more comfortable and connected to their surroundings, and it gives the patient’s loved one a break by rewarding them for all the work and effort they put into caring for their parent, partner, or family member.

Who’s Eligible for PACE?

Patients need to meet the following criteria in order to enroll in the PACE program:

  • Age 55 or older
  • Live in a designated service area of a PACE organization
  • Requires nursing home-level of care (as certified by your state)
  • Be able to live safely in the community with help from PACE

One of the downsides of the PACE program is that it’s only available in certain geographic locations around the U.S. Some states and zip codes are not eligible for the program. Patients and their loved ones can find out if they qualify for the program using the PACE Plan Search tool.

What Does It Cost?

PACE covers all of a person’s healthcare expenses. The following services are covered by PACE:

  • Adult day primary care (including doctor and recreational therapy nursing services)
  • Dentistry
  • Emergency services
  • Home care
  • Hospital care
  • Laboratory/x-ray services
  • Meals
  • Medical specialty services
  • Nursing home care
  • Nutritional counseling
  • Occupational therapy
  • Physical therapy
  • Prescription drugs
  • Preventive care
  • Social services, including caregiver training, support groups, and respite care
  • Social work counseling
  • Transportation to the PACE center for activities or medical appointments, if medically necessary. You may also be able to get transportation to some medical appointments in the community.

If the patient has Medicaid, they won’t have to pay a monthly premium for the long-term portion of their care.

If the patient does not have or qualify for Medicaid but they have Medicare, they will need to pay a monthly premium for long-term care and a premium for their Part D prescription drugs.

However, there are no copays or deductibles for drugs or medical services that have been approved by the patient’s PACE team.

 

This program has the potential to make a positive impact in the lives of the elderly and their loved ones. If a person is thinking of caring for their loved on in their own home, they can stock up on home medical supplies at OurCareSupplies.com.