Eligibility

Those eligible for Carolina SeniorCare:

• must be a minimum of 55 years of age,
• qualify for nursing facility level of care determined by the State Medicaid Agency, and
• be able to live safely at home with the support of PACE services.

Participants must live within the defined service area of the Carolina SeniorCare PACE Program (Davidson, Rowan, Davie and Iredell Counties).

Each participant must sign an Enrollment Agreement. Upon acceptance in the program, all services delivered, with the exception of emergency services, must be approved in advance by Carolina SeniorCare. You may be charged for the full cost of services from an out-of-network provider or for services you receive that are not approved by Carolina SeniorCare in advance. Once enrolled in Carolina SeniorCare, there are no deductibles, co-pays or co-insurance. A participant may disenroll from PACE at any time.

If you qualify for Medicare, all Medicare-covered services are paid for by Medicare. If you also qualify for the North Carolina Medicaid program, you will either have a small monthly payment or pay nothing for the long-term care portion of the PACE benefit. If your income is over the threshold determined by Medicaid, you may still be eligible to participate by paying a premium or a Patient Monthly Liability. Patient Monthly Liability is determined by Medicaid based on your assets and income. If you only qualify for Medicare, there is a set monthly fee you will be asked to pay.

Carolina SeniorCare provides most of its service at the PACE Center, located at 802 East Center Street, Lexington, NC. All services are either delivered or coordinated by the staff at the PACE Center.

PACE was created as a way to provide frail seniors, their family, caregivers, and professional health care provider’s flexibility to meet health care needs while they continue to live in their community.

An interdisciplinary team of professions will provide the coordinated care needed. These professionals are also experts in working with older people and will work with individuals and families to develop the most effective plan of care.

PACE provides all the care and services covered by Medicare and Medicaid, as authorized by the interdisciplinary team, as well as additional medically-necessary care and services not covered by Medicare and Medicaid. PACE provides coverage for prescription drugs, physician care, transportation, home care, check-ups, hospital visits, and even nursing home stays when necessary. With PACE, your ability to pay will never keep you from getting the care you need.

PACE is a voluntary enrollment program. You may have either Medicare or Medicaid or both to join PACE. A participant may disenroll at any time.

For more information, call us at 336.746.3500, toll free at 1.833.223.4476 or TTY at 1.800.735.2962.