Frequently Asked Questions
How do people qualify for PACE of Southwest Michigan?
To be eligible for PACE a person must:
- Be aged 55 or older
- 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
We Serve the Following Communities:
Bangor, Baroda, Berrien Center, Berrien Springs, Benton Harbor, Bridgman, Buchanan, Cassopolis, Coloma, Covert, Decatur, Dowagiac, Eau Claire, Edwardsburg, Galien, Grand Junction, Harbert, Hartford, Lakeside, Lawrence, Lawton, Marcellus, New Buffalo, New Troy, Niles, Paw Paw, Sawyer, Sodus, South Haven, Stevensville, St. Joseph, Three Oaks, Watervliet, Union Pier
- Able to live safely in the community with the support of PACE
Are prescription drugs covered?
Do PACE participants attend the day center every day?
No. On average, PACE participants attend the day center 2-3 times a week. 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 Care Team.
How do participant’s get to the day center?
PACE programs provide transportation to the day center. Transportation is a key part of the PACE benefit. Transportation is not only provided between the home and the day center, but also to appointments with medical specialists and activities arranged and approved by the Care Team.
How much does the PACE of SW Michigan 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). Also, once enrolled in PACE and Medicaid eligible, if 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. 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. PACE enrollment staff can help determine a person’s Medicaid eligibility.