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Interested in my mom signing up for the PACE Healthcare program.


She would have to give up her current health insurance.

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Maxie

Go to the green bar up to the right and do a search for
igloo pace

Igloo is very knowledgeable on this program. You will see several posts where she has given many details such as the one I pasted below.

igloo572
Oct 13, 2023
Barb, Ahhhh PACE the latest cute girl in town for doing cost containment for Medicare $$$. We have two in my city. I think they can work to some degree if the person in PACE have dedicated on site family to be in the home always for all the nonPACE time and if they have an experienced partner who is running the program. One very important aspect of PACE is it is a community health Medicaid program so IF your State includes community in how they do the talley for estate recovery, all the cost paid by PACE for you is included. 

Our PACE is set up to be a day program where they go 2-4 days a week with transportation provided and spend a fairly long day and all their health care is now funneled either done at the center or to their partner healthcare institution(s). Meals & activities as well. In-home visits if needed. But has to have the on site family “case manager”.

For us, it’s run by the healthcare division of Catholic Charities and they partner with Tulane / LSU teaching hospital systems. CC also has low income housing and congregate living places, so CC can draw from that population to find folks to be enrolled.

If you go onto PACE, your Medicare gets a new # AND the program is designed for you to become a “dual” so on Medicaid for your secondary health insurance. With a Medicare as the primary but they both fold into the PACE system and PACE gives them a new #. If you have an other health insurance, it’s given up and you go onto Medicaid although this has been successfully challenged.** The new # is billed AND all your care is directed by the PACE within their partners facilities IF care cannot be done at the PACE. If care plan gets beyond PACE capability, the PACE deals with getting them placement into a NH and onto LTC Medicaid. Healthcare coverage is limited to the PACE network, which is local, so if you travel, that’s a problem. 

*the 1st center was done at an old Catholic Church and nunnery and it drew from CC existing outreach & programs for low income folks. Is pretty fabulous as ton of $ donated by wealthy benefactor & new wf in honor of old wf who a devoted Catholic. 
** 2nd center has totally different demographics. Lots of oil & gas retirees with $, great employer based secondary health insurance as retirement perk. Lots of couples, who own and live in their home, where only 1 needs a day program. These folks aren’t going on Medicaid and they most certainly don’t want State Medicaid program being able to do Estate Recovery if they can help it. They aren’t being told what to do for healthcare providers and not able to travel without worry of 1 being uninsured. LSS a group filed a challenge to “dual” requirement and won. So now to enroll in PACE all you need is Medicare & have health concerns that the PACE program can deal with but have to pay a monthly fee. The costs vary but tend to be abt 3K a month.
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