Page Reviewed / Updated - Feb. 2014
Medicare PACE is not a source of funds for paying for senior care; rather it is an optional program that covers all of a participating senior’s medical needs as well as some personal care. The program is open to both Medicare and Medicaid beneficiaries and provides comprehensive medical and social services at home, adult day health centers and inpatient facilities as an alternative for those who would otherwise require nursing home care.
All of a patient’s medical needs are determined and provided by a set group of medical service providers. This includes medications and medically-necessary transportation.
This model of care is sometimes referred to as Managed Care at Home and in certain states PACE Programs are called LIFE Programs. PACE is an acronym for Programs of All-inclusive Care for the Elderly and LIFE is an acronym for Living Independence for the Elderly.
PACE programs are intended for families that wish to have the care recipient live at home instead of instead of in a skilled nursing home / facility. Participating families are expected to provide some personal care themselves and not rely entirely on the program for 24 hr care. However, if a PACE program can no longer safely support the care of an enrolled participant at home or in adult day care, the program will pay for care in a skilled nursing home.
PACE programs are a very good option for families that are able to provide some level of care,. Unfortunately, they are currently available in approximately 35 states and only within certain regions of those states. Another drawback to this program is that seniors must give up their primary care physician to enroll in the program. Finally, in some areas it can take many months to apply and have the application processed prior to enrollment.
|States with PACE / LIFE Programs||States without PACE / LIFE Programs|
PACE benefits come only in the form of medical and care services. Seniors do not receive cash payments. Benefits are determined on a case by case basis are provided by a dedicated team of health care professional and can include any of the following.
While there are many positives to these programs, an unfortunate reality is the application process can require patience and perseverance. For some programs in certain areas, the application and approval process can take as long as 9 months. This is by no means the case everywhere, but applicants and their families should be aware of this drawback.