Reid Health PACE FAQs

To meet the requirements for participation, you must:

• be age 55 or older
• live in the service area
• be eligible for nursing home-level of care
• be able to live safely in the community with assistance from Reid Health PACE

• What you pay for PACE depends on your eligibility under Medicare and Medicaid.

• If you are eligible for Medicaid, or dually eligible for both Medicare and Medicaid, you won't pay a monthly premium for PACE.

• If you don't qualify for Medicaid, but you have Medicare, you'll be charged a monthly premium for PACE.

• There's no deductible or copayment for any prescription drug, service, or care approved by your healthcare team.

• If you don't have Medicare or Medicaid, you can pay for PACE privately.

• If you are eligible for Medicaid, or dually eligible for both Medicare and Medicaid, you won't pay a monthly premium for PACE.

Contact us at (765) 935-8959 (TTY for the hearing impaired: (800) 643-2255) and ask to speak to an enrollment specialist. We welcome the opportunity to visit with you and your family about your needs to help determine the best care options. A personal tour can be arranged to visit our center.

Before enrolling, your current Medicare and Medicaid must be converted to PACE Medicare and PACE Medicaid. All services are provided and authorized by the Reid Health PACE program. This means you maintain benefits covered by Medicare and/or Medicaid and become eligible for additional benefits deemed medically necessary by the Reid Health PACE Interdisciplinary Care Team (IDT). Reid Health PACE enrollment specialists will guide you through this process.

Reid Health PACE is considered a Medicare Advantage Plan, therefore, if you enroll in any other Medicare health or prescription drug plan, you'll be automatically disenrolled from Reid Health PACE.

Yes! If you currently don't have Medicaid, we'll work to see if you qualify for Medicaid under the new income guidelines that applies to individuals that want to participate in PACE services.

Reid Health PACE is designed for individuals who require nursing home placement but prefer to receive support that allows them to safely remain in their homes and communities. Reid Health PACE supports this by providing an all-inclusive program of care that meets each individual's unique needs.

No, PACE participants reside in their own homes within the community.

Yes. Reid Health PACE will provide all your medically necessary pharmacy needs. You cannot be in more than one Medicare health or drug plan at a time. Reid Health PACE covers the cost of all approved prescriptions, and many non-prescription approved medications as well. Medical staff will work with our network pharmacy to provide your medications to you in your home as part of our medication administration system.

Reid Health PACE is considered a Medicare Advantage Plan that includes Part D, therefore, if you enroll in any other Medicare health or drug plan, you will be automatically disenrolled from Reid Health PACE.

Attending the Reid Health PACE Center offers many advantages. Regularly scheduled attendance is encouraged as the staff would like the opportunity to monitor your health. You will be able to visit with a nurse about your healthcare, and your provider will see you routinely at the center. If you require physical, occupational, or speech therapy, staff is trained and equipped to meet your needs.

Lunch is served daily, Monday through Friday. The activities staff plan fun and stimulating programs for your enjoyment and relaxation. Birthday parties, musical programs, exercise groups, shopping excursions, group or individual activities, and holiday celebrations are among the many activities you may participate in to help make your visit to the day center a welcome and enjoyable experience.

If you cannot attend your regularly scheduled visit to the day center for any reason, we ask that you call and let us know. If you don't feel well, you might ask to speak to a nurse. Depending on the situation, a caregiver might come out to see you or we'll help you come to the day center to be seen in the clinic.

Reid Health PACE has its own providers that are part of our network, and you must use Reid Health PACE providers for all services. Participants enjoy personal relationships with our interdisciplinary team and will notice they have more access to healthcare providers than they did before enrolling in the program. We help make the transition easy.

Participants in the program must receive all needed healthcare services (other than emergency services) from Reid Health PACE, or an entity authorized by Reid Health PACE, and might be responsible for the cost of unauthorized or out-of-program services.

If you need to see a specialist, such as a cardiologist or pulmonologist, our interdisciplinary team will authorize the visit with a Reid Health PACE network provider and will assist you with any necessary transportation. Reid Health PACE participants might be fully and personally liable for the cost of unauthorized or out-of-PACE program agreement services.

It is our goal at Reid Health PACE to do everything possible to keep you in your own home. However, if the time arrives when you're no longer able to live safely at home, we'll work with care facilities in the community to meet your needs.

You can withdraw from Reid Health PACE at any time. However, enrollment is on a month-to-month basis. You must continue to use Reid Health PACE for all of your services until the first of the next month. A social worker will answer your questions and assist you should you decide to withdraw.

If you need to file a grievance, please follow the process outlined on this page.