It has never been more important than now to have personal health insurance coverage and to understand how it works. The most critical consideration is for medical services for the elderly that may not be included in your health insurance.
The national PACE program, also known as Program of All Inclusive Health Care for the Elderly, is an alternative to Medicaid. It aims to help elderly people who would normally require institutionalization to be placed in assisted living facilities overseen by a professional health team.
PACE is offered in States that have chosen to include it under MEDICAID as an optional benefit. Patients have to pass certain criteria to be eligible for medical and social services provided at adult care centers, in-patient facilities or at their own homes.
If an individual qualifies for this option in personal health insurance coverage, it would permit provision of medical services at home by a team of health professionals. For most patients, it permissible to receive necessary medical services at home and avoid being placed in an institution. Individuals who enroll in PACE can be qualified for Medicare and Medicaid. The primary consideration is an individual’s health, not age or income. Enrollees are required to pay a monthly premium, depending on their qualification for Medicare and Medicaid.
Benefits Provided by PACE
Program of All Inclusive Care for the Elderly provides all medical services needed by a patient to preserve quality of life and independence, whether at home or in a community. The health package must provide for all Medicare and Medicaid services included in the State’s health program. Some examples of services provided by a PACE center include restorative therapy
- personal care
- counseling
- prescription drugs
- primary care
- social services
In general, medical services are provided at adult health centers but can also include at-home and other services an enrollee may require. These services include laboratory and diagnostic tests, nursing home care and hospital services.
A medical team determines an enrollee’s need for PACE services. The team is composed of primary care specialists, nurses, social workers and dietitians, among others.
Who Qualifies for PACE
PACE is a voluntary option. To qualify, a person must be living in a PACE covered area
- Be at least 55 years old
- Certified by a team of doctors to require nursing home care
- Living in a community setting
Critical planning cannot be emphasized enough as the cost for elderly care keeps escalating. It is important to get the right amount of health insurance. If you have questions regarding PACE, let Blue Sky Coverage help you find a policy. Call us today for your health insurance needs.