AgeWell PACE Frequently Asked Questions
Questions We Commonly Hear…
What is PACE?PACE is a nationally recognized healthcare model that stands for Program of All-Inclusive Care the Elderly. It is a unique program that provides comprehensive medical, social, and rehabilitation services to older adults who are eligible for Medicaid or Medicare. The goal of PACE is to help seniors live independently in their own homes and communities for as long as possible.
How do people qualify for AgeWell PACE?
- 55 years of age or older;
- Certified as meeting the need for nursing home level of care as determined by the California Department of Healthcare Services;
- Live in a service area (county and zip code) served by a AgeWell PACE program, and;
- Able to live safely in the community with the services of AgeWell PACE.
Are prescription drugs covered?Yes.All prescription and non-prescription drugs deemed necessary by the PACE interdisciplinary care team are paid for by the AgeWell PACE program.
Are people who do not qualify for Medi-Cal eligible for PACE enrollment?Yes. If a person meets the income and assets limits to qualify for Medi-Cal, the program pays for a portion of the monthly AgeWell PACE premium. Medicare pays for the rest. If a participant does not qualify for Medicaid, the participant is responsible for the portion of the monthly premium Medicaid would pay. PACE staff can help determine a person’s Medi-Cal eligibility.
If I belong to a Medicare HMO, can I also enroll in Age-Well PACE for long-term care services?No. You can only enroll in one Medicare health plan. AgeWell PACE is both Medicare provider and long-term care provider. By enrolling in AgeWell PACE health plan you will be automatically disenrolled from your current Medicare/HMO.
Can I keep my own doctor?Upon enrollment to AgeWell PACE, the participant is assigned a primary care physician that works with other members of the AgeWell PACE team to coordinate all services a member receives. AgeWell PACE participants agree to receive all health care services exclusively from the AgeWell PACE’s interdisciplinary team which usually consists of a physician, clinic & home care nurses, social worker, physical, occupational, speech, and recreational therapists, healthcare worker and transportation representative.
How do people get to the day health center?AgeWell PACE provides transportation to the day health center. Transportation is a key part of the AgeWell PACE benefit. Transportation is not only provided between the home and the day health center, but also to appointments with specialists and other activities.
Can I just use a specific service such as home care, meals, transportation, or the day health center?​No. Focusing on a single aspect of care does not provide the participant with the best chance of remaining independent in the community. For example, a member may need rehabilitation after a stroke, which could include a special diet or medications for hypertension, diabetes, and other chronic problems. The participant may also feel lonely and isolated. AgeWell PACE can address these problems through a team of experienced professionals and a treatment plan that deals with the complete picture.
Do AgeWell PACE participants attend the day health center every day?No. On average, it is not required to attend the day health center every day. Day health center attendance is based on individual needs and can range from once a week, or every month, to several days a week, as needed.
What happens if an AgeWell PACE participant needs nursing home care?The goal of AgeWell PACE is to keep participants out of a nursing home as long as possible. If at some point it is in the best interest of the participant to receive care in a nursing home, AgeWell PACE will pay for the care and the supervision of the interdisciplinary team will continue.
What do I do if I want to enroll on AgeWell PACE?
- Contact AgeWell PACE so we can schedule a home visit with you and your caregiver to tell you more about their plan.
- Attend a tour of the AgeWell PACE site with your family/caregiver(s). AgeWell PACE will then schedule a complete medical and social assessment for you by their interdisciplinary team.
- AgeWell PACE will then schedule a complete medical and social assessment for you by their interdisciplinary team.