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Program of All-Inclusive Care for the Elderly (PACE) - MassHealth

The PACE program is a comprehensive health program that is designed to keep frail, older individuals who are certified eligible for nursing-facility services living in the community.

·   A complete range of health-care services are provided by one designated community-based program with all medical and social services coordinated by a team of health professionals.

·   The Division of Medical Assistance (DMA) administers the program as the Elder Service Plan (ESP).

Eligibility

To be eligible for PACE, an applicant must:

·   Be aged 55 or older;

·   If aged 55 through 64, have a disability;

·   Be certified by DMA to be in need of nursing-facility services;

·   Live in a designated service area;

·   Have medical services provided in a PACE program;

·   Have countable assets whose total value does not exceed $2,000 or, if married and living with a spouse, does not exceed $3,000; and

·   Have a countable-income amount, including income of a financially responsible spouse, equal to or less than 100% of the federal poverty level; or meet a deductible as described in 130 CMR 520.028. (Countable income is defined in 130 CMR 520 for this population. It is similar to countable income as used in the calculations for SSI.)

NOTE: The current version of WorkWORLD does not calculate the income and asset eligibility for this population. If you would like WorkWORLD to do such calculations, go to http://www.workworld.org and contact us.

Additional Information

Summary information about the PACE Program may be found online at:
http://www.mass.gov/portal/index.jsp?pageID=eohhs2terminal&L=5&L0=Home&L1=Consumer&L2=MassHealth+and+Insurance&L3=Apply+for+MassHealth+Coverage&L4=Applicants+of+Any+Age+Who+Need+Long-Term-Care+Services&sid=Eeohhs2&b=terminalcontent&f=masshealth_consumer_applicant_ltc_athome&csid=Eeohhs2#Anchor-Kaileig-7944

The Code of Massachusetts Regulations (CMR) is available at:
http://www.lawlib.state.ma.us/cmr.html.

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