Program of All-Inclusive Care For The Elderly (PACE)

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

The Program of All-inclusive Care for the Elderly (PACE) is operated by Health First Colorado (Colorado’s Medicaid program) and Medicare. PACE is a capitated managed care benefit for older adults who qualify. PACE provides a comprehensive medical and social service delivery system using an interdisciplinary team (IDT) approach in an adult day health center that is supplemented by in-home and referral services in accordance with participants' needs. IDT members deliver much of the care directly, enabling them to personally monitor participants’ health. The team also is responsible for managing and paying for services delivered by contracted providers such as hospitals, nursing homes, and specialists.

PACE becomes a participant’s sole source of services and covers all Medicare Parts A, B and D benefits, Health First Colorado (Medicaid) benefits, and any other services determined necessary to improve and maintain the participant’s health status. Further, PACE allows most participants to continue living in the community for as long as possible.

Who Qualifies?

  • You must be 55 years of age or older;
  • You must meet nursing facility level of care (this is determined by a Single Entry Point agency);
  • You must live in the service area of the PACE organization; and
  • You must be able to live in a community without risking your health or safety.

Benefits and Services

  • Adult day services
  • Dental services
  • Emergency services
  • Durable medical equipment
  • Home care services
  • Hospital care
  • Laboratory/X-ray services
  • Meals
  • Medical specialty services
  • Nursing home care
  • Nutritional counseling
  • Occupational therapy
  • Optometry
  • Physical therapy
  • Prescription drugs
  • Preventative care
  • Primary care (including doctor and nursing services)
  • Recreational therapy
  • Respite
  • Social services
  • Transportation
  • and more...

​​PACE also includes any services determined necessary by your interdisciplinary team to improve and maintain your overall health. Note: You may be fully and personally liable for the costs of unauthorized or out-of-PACE program agreement services. 

How do I get these services?

Your interdisciplinary team will develop a care plan with you and anyone you designate, to coordinate all the services you need to stay safely in your community. Your interdisciplinary team will arrange for you to receive services at a PACE Center or through providers within the PACE network.  Your primary care provider and interdisciplinary team will complete regular assessments of your needs.

What is the Interdisciplinary Team?

The interdisciplinary team is a group of health-care and social service professionals who work with you to assess your needs, develop your care plan, and deliver and coordinate services, including acute care services and if necessary, nursing home services.  This team meets regularly to ensure your needs are being met. The interdisciplinary team is comprised of:

  • Primary care physician
  • Registered nurse
  • Master’s-level social worker
  • Physical therapist
  • Occupational therapist
  • Recreational therapist or activity coordinator
  • Dietitian
  • PACE center supervisor
  • Home-care coordinator
  • Personal care attendant
  • Transportation staff

Who has a say in my treatment?

You and/or your authorized representative have the primary say.

You, your doctor and other care providers agree on the services that meet your needs. If you disagree with your interdisciplinary team about your care plan, you have the right to appeal.

What if I disagree?

If your request for a service is denied or a service is reduced or suspended, you may appeal that decision through an impartial third party provided through your PACE provider, a Medicaid Administrative Law Judge, or the Medicare Independent Review Board. To file an appeal, contact a member of your interdisciplinary team. You may also contact the PACE ombudsman for additional assistance.

If you have a complaint about service delivery or the quality of services received, you may file a grievance with the PACE provider. To file a grievance, contact a member of your interdisciplinary team. You may also contact the PACE ombudsman for additional assistance.

What Does It Cost?

PACE participants who qualify for only Health First Colorado or who qualify for both Health First Colorado and Medicare will receive services at no cost. PACE participants who qualify for only Medicare will pay the Health First Colorado payment plus Medicare Part D. There is also a private pay option for individuals who do not qualify for either Health First Colorado or Medicare. 

How to Apply

You must contact the PACE organization in your area to apply. The Colorado PACE organizations and the areas they serve are in the table below. 

COUNTY

PACE ORGANIZATION

PHONE NUMBER

Adams, Arapahoe, Broomfield, Denver, Jefferson, Larimer, Pueblo, Weld

 

Total LongTerm Care, Inc/InnovAge Colorado PACE

Toll Free: 844-948-0792 

TTY: 711

Boulder, Weld (Southwest)

 

TRU Community Care/TRU PACE

Toll Free: 844-350-7223

TTY: 800-659-2656

El Paso

 

Rocky Mountain Healthcare Services/Rocky Mountain PACE

Toll Free: 855-207-0702

TTY: 800-659-2656

Delta

 

VOANS/Senior CommUnity Care PACE

Toll Free: 866-961-1451

TTY: 970-435-4018

Montrose

 

VOANS/Senior CommUnity Care PACE

Toll Free: 866-961-1451

TTY: 970-435-4018

Need help or have questions?

If you’d like help finding a provider, understanding your benefits, or have more questions about this program, please contact your PACE organization, local Single Entry Point Agency, or the Health First Colorado Member Contact Center. If you would like information on other programs, visit the Long-Term Services and Supports Programs page.

If you have questions about your health care, please talk with your doctor.

PACE Ombudsman

The PACE Ombudsman Program protects the rights of PACE applicants and participants in Colorado. The program offers free, confidential advocacy and assistance with issues like, access to services, denial of services, care coordination, grievances, appeals, and more.

For more information, visit the Disability Law Colorado website or the Colorado Long-Term Care Ombudsman website.