What is Medicare Part E also known as PACE?

Part E or PACE of the Medicare statute, which is less well-known, governs many additional programs, including Medicare cost plans (which also cover Part A and Part B benefits) Medicare Cost plans are primarily available in rural areas and are only available in a small number of states. PACE, sometimes informally referred to as "Medicare Part E" due to its comprehensive nature, is a joint program administered by Medicare and Medicaid. It offers a range of medical and social services to assist beneficiaries in maintaining their independence and receiving care at home or in community-based settings.

Medicare Part E is not an official term used in the Medicare program. However, there is a program known as PACE (Program of All-Inclusive Care for the Elderly) that provides comprehensive healthcare services for eligible individuals who are 55 years of age or older and qualify for nursing home-level care but prefer to live in the community.

Here are some key details about the PACE program:

1. Comprehensive care: PACE provides coordinated and integrated healthcare services, including medical care, prescription drugs, social services, and support services, all managed by an interdisciplinary team of healthcare professionals.

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2. Home and community-based care: PACE is designed to support individuals who would otherwise require nursing home-level care. The program aims to enable participants to live in their homes or communities for as long as possible while receiving the necessary care and services.

3. PACE organizations: PACE is delivered through PACE organizations, which are responsible for providing all the necessary care and services to participants. These organizations are typically affiliated with healthcare providers and may operate through partnerships or contracts with various community-based organizations.

4. Enrollment and eligibility: To be eligible for PACE, individuals must meet certain criteria, including age (55 or older), living in the service area of a PACE organization, and requiring a nursing home-level of care as determined by the state. Additionally, participants must be eligible for both Medicare and Medicaid or be able to pay privately if they are not eligible for Medicaid.

5. Financing: PACE is a fully capitated program, meaning that PACE organizations receive a fixed monthly payment from Medicare and Medicaid for each enrolled participant to cover all necessary covered care and services.

Supplemental Medicare insurance (Medigap Plans) and the geriatric care program are all-inclusive (PACE) and are also technically part of Medicare Part E health coverage.

PACE was a distinct kind of health plan that offered all the treatments and services covered by Medicare and Medicaid, as well as extra treatments and services that are medically essential depending on your requirements, as established by an interdisciplinary team. PACE helped elderly people who were fragile and in need of nursing home care but still able to live independently. PACE includes long-term care, medical, social, and prescription drug coverage.

MedHelpCenter.us recommends that you call the Senior Health Insurance Agency at 813-592-8568 for further help and explanation.