Frequently Asked Questions

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What is PACE?

PACE provides and coordinates the healthcare of each participant enrolled in the program. This healthcare includes social activities and social services support, and transportation to medical appointments.

PACE services are personalized for each participant’s unique needs, so they can live safely in the community.

PACE is the Program of All-inclusive Care for the Elderly.

Who is eligible for PACE of the Triad?

The easiest way to learn if you qualify is to call us at (336) 550-4046.

A person is eligible for enrollment in PACE of the Triad if they:

  • Are 55 years of age or older;
  • Lives in Guilford or Rockingham counties, North Carolina; and
  • Are able to life safely in the community, at the time of enrollment.

Additionally, the individual must have appropriate healthcare needs. Examples include:

  • Recurrent hospitalizations and emergency room visits.
  • Frequent need for acute office visits.
  • Needs assistance with activities of daily living, such as walking, getting in and out of bed, incontinence, personal hygiene, getting dressed, and eating meals.
  • Lives with dementia, Alzheimer’s, or depression.
  • Lives in a nursing home or rehabilitation hospital, and desires to return home to family care.
  • The family caregiver is stressed by care responsibilities.

Each individual’s medical needs are determined by the North Carolina Division of Medical Assistance.

Does PACE accept insurance?

PACE is the insurer and health care provider. Private health insurance and/or Medicare Advantage Plans (such as Aetna, Humana, United Healthcare) are unneeded.

How much does PACE cost?

If you have both Medicare (for people 65+) and Medicaid (income-tested), then you may pay nothing.

People without Medicare or Medicaid pay a monthly premium. The amount of this premium depends on your healthcare and financial needs.

Long-term care insurance may pay for your PACE care. This coverage is determined by your insurer.

Do I need to have Medicaid or Medicare to enroll?

No, you do not.

Can I use just one service, such as home care or transportation?

No. PACE services are only available as a complete package to enrolled participants.

Do you provide housing?

No. PACE does not provide housing. When you enroll in PACE, you continue to live in the community — in your home, a care home or other residence.

To enroll, do I need a doctor’s referral?

No. Any individual, caregiver, friend or neighbor can contact us directly at (366) 550-4046. Professionals can refer a person by phone, or by completing a referral form and sending to PACE via fax or email.

Can I keep my current doctor?

Sometimes. We appreciate that people have long-standing relationships with their current doctors. To make it smoother for you to change healthcare plans, we may allow you to visit your current doctor. These visits must always be pre-authorized by us.

When you enroll in PACE, you will have a new primary care doctor or nurse practitioner.  Your new PACE doctor or nurse practitioner works specializes in the care of older adults. They collaborate with our entire team to provide the unique care and supports available through PACE.

Can I keep the same specialist or dentist?

Sometimes. We have a broad network of specialists and dentists familiar with the PACE program and participant needs. This network may already include your specialist or dentist. If not, we may try to contract with them, so you can continue with the same specialist or dentist. This is not guaranteed, however. If they do not contract with us, you will have a new specialist or dentist who is in our network.

Can I get care from health professionals who are not part of PACE?

Yes, but only with pre-authorization. Once enrolled in PACE, you must ask for pre-authorization to receive care from a healthcare professional who is not in our network. If this care is not pre-authorized, you can be personally liable for paying all expenses related to that care.

What happens if I have an emergency after-hours, or on the weekend?

After you enroll in PACE, you can use our after-hours and weekend phone number to speak directly to a nurse. If there is an emergency, an ambulance will be sent to your home.

Do I have to go to the PACE center?

No, you don’t need to participate in any social activities at the PACE center after you enroll. However, you will need to come to the PACE center to see your doctor and nurse, and we will pick you up and bring you home.

How often can I go to the PACE center?

This depends on your individual needs. We’ll discuss this with you during the enrollment process. Some people come once per week, others may come every day. This is based on each individual’s needs, and allows our staff to closely monitor health concerns, prevent emergency room visits and hospitalizations.

Can I live alone?

Yes, as long as you are safe living at home alone. A nurse will visit your home for a safety check to make sure.

Is there a waiting list for PACE?

No, there is not a waiting list.

Can I dis-enroll from PACE?

Yes, you can leave PACE for any reason. You can then resume the benefits of traditional Medicare and Medicaid programs.

Are there other PACE locations in North Carolina?

Yes. PACE of the Triad supports individuals in Guilford and Rockingham counties, and soon, Winston-Salem.

Other PACE serve Asheboro, Asheville, Burlington, Charlotte, Durham/Raleigh, Fayetteville, Gastonia, Hickory, Lexington and Wilmington, North Carolina. You can search by zip code at this website.