PACE – Letting the elderly live at home

If you are trying to care for elderly relatives, then you only have limited alternatives such as moving them out of their homes to a nursing home or to your home. Nursing homes are costly, with long waiting lists and you may not be equipped or able to care for your parents at home. Moreover, moving them from familiar surroundings can be scary and traumatic for them.

With the PACE (Program of All-Inclusive Care for the Elderly) program from Medicaid, the elderly who would be moved out of their homes stay in their own homes or with their families and receive the same type of nursing home care. This care includes inpatient and outpatient medical care, social services, in-home care, meals, transportation, social services, housing assistance, activitie, and specialty services like dentistry and podiatry.

Nursing homes are expensive and often too expensive for families. Medicaid can pay for the costs of a nursing home, but those costs can be high to the state. PACE allows a lower cost to the state by ensuring that the individual has appropriate care while living at home. This allows the person to live in familiar surroundings, but still receive the care and attention they need. Community service is provided by either non-profit private or public organizations that provide the PACE services. The organizations work with Medicaid and the medical community to ensure that the care the patient needs is available and provided.

How to apply for PACE

PACE is available to people with Medicare or Medicaid in 31 states. In some states, PACE is only offered under Medicaid. To join the PACE program, patients must be 55 or older, live in the area of a PACE organization and be certified as needing the level of care of a nursing home, but be able to live safely outside a nursing home if they receive PACE care. Patients can leave a PACE program at any time.

If the applicant qualifies for Medicaid, then they will not have to pay any monthly premium for the long-term care part of PACE. If they have Medicare, and do not qualify for Medicaid, then they will have to pay a monthly premium for the long-term care part of PACE and the Medicare Part D drugs. Once they pay the monthly premiums, they are not charged any deductible or copayment for any drug, service or care from the PACE program. PACE can be paid for privately if they do not have Medicare or Medicaid.

To join PACE, PACE4You provides a PACE program finder that will direct you to the PACE organization in your area, if one exists.

What does PACE cover?

Since PACE’s mission is to keep the elderly in their homes as long as possible, PACE covers a wide variety of services. Health-related services such as inpatient and outpatient medical care, specialty medical care and preventive care are covered. Social services are covered, as well as in-home care, some meals, transportation to medical appointments or to the PACE center and housing assistance. PACE centers meet federal and state safety requirements, and provide activities such as adult day programs, medical clinics, occupational therapy and physical therapy.

For caregivers, PACE provides training for the caregivers, and provides respite care. This support allows the elderly to stay with their families in their community. End of life care that requires medical, pharmaceutical and psychological and social services are covered. If hospice care is preferred, the patient must unenroll from the PACE program.

Who provides the care?

Rather like a health insurance network, PACE organizations partner with specialists and health care providers in the community. The PACE organization creates a team of doctors and health care professionals that work with the patient. The team includes the primary care physician, a nurse, social worker, physical and occupational therapist, a dietitian, recreational therapist or activity coordinator, a home care liaison and personal care attendants that work with the PACE center supervisor to determine the best approach for the patient. This interdisciplinary approach means that the care is comprehensive for the patient’s medical and social needs.

Since Medicare and Medicaid covers the care and services that are provided by the PACE program, all treatment options are Medicare approved. If there are treatments that Medicare and Medicaid don’t cover, the PACE program may still cover them.

How do I find out more about PACE?

Find more about PACE at The National PACE Association provides information about PACE, including federal policy, education and programs for PACE providers as well as information for users.

Currently PACE is available in 31 states. PACE has been shown to provide better care at a lower cost to patients and states than nursing home care. You can see if PACE is available in your area at PACEFinder on the PACE Association website. If you think the PACE program would benefit you or your relatives, and it is not available in your area, write to your state governor or legislature and ask them to expand the program.