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Life Health > Health Insurance

Feds update application process for PACE health-LTC programs

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The Centers for Medicare & Medicaid Services (CMS) is creating an online application process for organizations that want to set up Program of All-Inclusive Care for the Elderly plans.

PACE programs can provide and coordinate all of the care for an individual age 55 or older who lives at home but already needs the equivalent of nursing home care.

The PACE plan enrollees must qualify for federal Medicare coverage.

Medicare, a program that serves older people at all income levels, normally exclude coverage for long-term nursing home care or other types of long-term care for people who are not recovering from an acute-care health problem.

A state’s Medicaid program normally pays for nursing home care only for people who are poor, or who fit within special state Medicaid nursing home benefits qualification financial guidelines.

In a state that wants its PACE plans to be able to serve a wider range of people, a PACE plan may be able to provide long-term care for an individual with an income up to 300 percent of the federal poverty level.

Related: Feds may ban agents from selling Medicare long-term care plans

Some in Congress have promoted the idea of using an expanded PACE program to meet the baby boomers’ long-term care services needs.

In a packet of information about the new PACE application process, CMS estimates it might get about 10 applications from new PACE plan organizers per year.


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