Element Care PACE provides all-inclusive care to aging adults – empowering you to live independently at home and stay engaged in your community.
You are age 55 or older
You live within the Element Care PACE service area
You can live safely in the community with the help of PACE services at the time you enroll
You need enough assistance to qualify for a nursing home level of care, but want to continue living at home
As a health insurance plan, Element Care PACE pays for all of the care and services that participants receive through our program. There are no copayments, deductibles, or coinsurance for covered services. The monthly premium for Element Care PACE may be covered by Medicare and/or Medicaid (MassHealth). There is also an option for private pay. This means that you can pay the monthly premium yourself. Most program participants qualify for financial assistance and pay no out-of-pocket costs at all.
Not sure if you qualify?
Call us at 877-803-5564 [TTY 711] and we can help you determine your eligibility and even help you file your MassHealth application.
Call Element Care PACE at 877-803-5564 (TTY 711) and speak with one of our enrollment specialists.
We’ll determine your eligilbility, discuss program costs and help you with enrollment paperwork
Element Care processes the paperwork and enrollment application.
1. Contact us to start the conversation
Call Element Care PACE at 877-803-5564 (TTY 711) or complete an intake assessment form. One of our enrollment specialists will be in touch with next steps.
2. Schedule a home visit
We’ll review your eligibility, discuss program costs and help you with enrollment paperwork.
3. Complete application process
We send out all the paperwork for your MassHealth application, which can take about a month to process. MassHealth may request more information at any time.
4. Visit and tour
Come and meet our team, which may include a primary care provider, nurse practitioner, behavioral health therapist, nutritionist, physical therapist, occupational therapist, activity specialist and social worker.
5. Set up personalized plan
Once approved, we coordinate a time to sign enrollment paperwork and discuss your personalized healthcare plan – where we gather more information from you and your family about your medical history, cultural and spiritual values, activity interests and socialization needs.
Upon enrollment, you must receive all needed healthcare services, including primary care and specialist physician services (other than emergency services), from Element Care PACE.
Note: Please don’t cancel your medical insurance or any medical appointments until enrollment is complete.
If you qualify for Medicare and Medicaid, there are no premiums, copays or out-of-pocket expenses. If you do not qualify for Medicaid, there is a small monthly premium. There’s no deductible or copayment for any drug, service or care approved by your healthcare team. However, Element Care PACE participants may be fully and personally liable for the costs of unauthorized or out-of-PACE program agreement services.
Private pay options are also available at a fraction of the cost of a nursing home – and you get to live in the comfort of your home and community.
To be eligible for the program, you must:
Yes, you will just be financially responsible for the portion of the monthly premium Medicaid would pay. (For individuals who meet the income and asset limits to qualify for Medicaid, Element Care PACE pays for a portion of the monthly PACE premium, and Medicare pays for the remainder.)
Unsure about your Medicaid eligibility? Contact us and our staff can help determine if you qualify.
No, your Medicare coverage/eligibility is not affected by enrolling in Element Care PACE. You will continue to pay your Medicare premium, and Medicare in turn pays a portion of the cost to Element Care PACE.
If you wish to disenroll from Element Care PACE, your Medicare is quickly and seamlessly set back to how it was before you joined the program.
An Element Care PACE participant has the right to disenroll at any time and resume care with the providers of their choice. Disenrollment occurs on the 1st of every month. For example, if a participant requests to disenroll on June 20th, their official date of disenrollment from the program will be July 1st.
Still have questions?
Call us at 877-803-5564 (TTY 711) and we can help you determine your eligibility – and even help file your MassHealth application.
