Program of All-Inclusive Care for the Elderly (PACE) in California

The Program of All-Inclusive Care for the Elderly (PACE) in California provides wide-ranging medical and social services to certain groups of the community. California PACE services are for elderly persons who can live at home but need supplemental health care services. The PACE program is designed to provide participants with a comprehensive care package that enables them to receiving care while remaining in their community, rather than having to reside in a nursing home. To enroll in PACE, applicants must meet the requirements of the program, which pertain to age, level of care and location. Most California residents who are eligible for benefits from Medicare, Medicaid or both are also eligible for PACE enrollment. Find out more about PACE eligibility in California, continue reading below.

Who is eligible for PACE in California?

To qualify for PACE in CA applicants must meet certain conditions. Seniors can apply for PAC if they are 55 years of age and older and meet the requirements for home care services according to the program. The PACE application process requires an interdisciplinary team assessment of applicants, as well as certification from the California Department of Healthcare Services.

Since the intention of the program is to keep enrollees in their home rather than in a nursing home, petitioners must be able to live safety in their residence and community. Likewise, seniors must live in the vicinity of a PACE program location in order to receive coverage.

Find out more about PACE eligibility in our comprehensive California guide here.

What services are covered by the California PACE program?

Participants who qualify for PACE in California can receive assistance with medical services, personal care and even meals. PACE services are coordinated by an interdisciplinary board of health care professionals. The PACE program interdisciplinary team includes medical professionals, a social worker, the PACE center supervisor and other persons who aide in care. When needed, the composition of the team can include therapists, home care liaisons, personal care attendants and drivers.

PACE provides comprehensive health care to all participants. The PACE program covers over-the-counter and prescription medications authorized by the team and included as part of the care plan. PACE services cover all benefits provided by Medicaid and Medicare including adult day care, emergency services, dental care, vision care, x-ray and laboratory services, hospital care and medical specialty services. Persons who require end-of-life care will received all the necessary medical, pharmaceutical and social services.

The PACE program also offers additional services, which maybe added on an individual basis if the interdisciplinary team deem them necessary. These extra PACE services improve and maintain the quality of each individual’s health, such as nutritional counseling. Many of PACE’s services are offered in local adult day health centers throughout California. While providing care and services within the homes of participants and the local community PACE programs also support family members and other caregivers who are part of enrollees’ daily life.

How California Residents Enroll in PACE

The PACE application process is voluntary. If you meet the PACE eligibility requirements, then you will need to sign an enrollment agreement, which details your personal information as well as the type of benefits and care you will receive. Part of determining eligibility for PACE in California is the initial comprehensive assessment that must be completed following enrollment. When Medicare and Medicaid participants enroll in PACE, the program becomes their single source of services. You can voluntarily leave the program at any time. Currently there are 11 PACE programs operating throughout the state of California.

Discover more about the California PACE application process by downloading out in-depth guide.

Cost for California PACE Program Enrollment

Once enrolled in PACE, cost for PACE services in California will depend on your financial situation. PACE programparticipants who are receiving Medi-Cal (Medicaid) benefits will not be required to pay a monthly premium for the long-term part of your PACE benefits. If applicants are receiving Medicare benefits, then they will be required to pay a monthly premium to cover the cost of the long-term care and Medicare Part D prescription medication coverage. California enrollees will not need to pay any deductibles or copayments for any medications, services or supplies that have been approved by the health care team. Petitioners also have the option of paying for PACE privately. Because financing for the PACE programis capped, providers can deliver services to eligible participants based on their individual needs, rather than only those covered by Medicare and Medicaid fee-for-service plans. Referral services and in-home programs that are based on each participant’s needs further supplement them.

Learn more about PACE services in California in our digital state guide.

What Are the Available Health Services in California?

Low-cost, and even free health benefits are available to a large number of California residents, with some being offered to low-income applicants and others being offered to elderly or disabled individuals. However, before you can access these health services, you need to submit the appropriate application and prove that you meet the necessary qualifications. To learn all about the different health benefits you can receive in California and the application procedures that you must undergo to obtain these benefits, download our free comprehensive guide.

Who Is Eligible to Obtain California Health Benefits?

California’s health programs have various eligibility requirements that applicants must meet in order to successfully enroll. Income, age and other factors are all taken into consideration in the eligibility verification process. Find out which health benefits you qualify for here.