Frequently Asked Questions
How do people qualify for enrollment in PACE of Southwest Michigan?
To be eligible for PACE a person must:
• Be age 55 or older
• Be eligible for nursing home level of care as determined by the State of Michigan
• Live in our designated service area of Berrien County or portions of Cass and Van Buren Counties
• Be able to live safely at home with PACE help
Click Here for our service area.
Are prescription drugs covered?
Yes. All prescription and non-prescription drugs deemed necessary by the PACE Interdisciplinary Team are paid for by the PACE program.
How often will I be able to go to the Day Center?
Day Center attendance is based on individual needs and can range from once a week to several days a week, as deemed necessary by the Interdisciplinary Team. Regular Day Center attendance is not required, though it is encouraged!
Note: PACE is currently limiting Day Center attendance during the pandemic to keep participants and staff safe. A limited number of participants are allowed in the Day Center and we are following strict infection control guidelines.
How do participants get to the Day Center?
PACE programs provide transportation to the Day Center. Transportation is a key part of PACE services. Transportation is not only provided between the home and the Day Center, but also to necessary medical appointments as well as activities arranged and approved by the Care Team. If desired, participants can also coordinate their own transportation to the Day Center.
How much does PACE cost?
There are no out-of-pocket costs for the program if you are Medicare and Medicaid eligible and you use only those services and providers that have been arranged for you by the Care Team. A PACE participant may be fully liable for the cost of medical services from an out-of-network provider or without previous authorization (except for emergency services.) If you qualify for Medicaid and are enrolled in PACE and nursing home care is deemed necessary, you may be liable for a patient pay amount as determined by the State of Michigan.
Are people who do not qualify for Medicaid eligible for PACE enrollment?
Yes, PACE offers a private pay option for those who do not qualify for Medicaid. If a person meets the income and asset limits to qualify for Medicaid, the program pays for a portion of the monthly PACE premium. Medicare pays for the rest. If a person does not qualify for Medicaid, he or she is responsible for the portion of the monthly premium Medicaid would pay. If a person does privately pay that monthly amount, there are no additional costs for the program, regardless of the medical needs of the participant. PACE enrollment staff can help determine a person’s Medicaid eligibility.
What happens if a person wants to leave PACE?
A PACE participant is free to withdraw their enrollment from PACE and resume their benefits in the traditional Medicare and Medicaid programs at any time.