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Frequently Asked Questions 

WHAT IS ARCHCARE SENIOR LIFE (PACE)?

ArchCare Senior Life (PACE) is a nationally recognized model of care designed for people age 55 or older who require nursing-home-level care but would rather receive it at home or in the community rather than in a nursing home.

 

For more information about PACE, please visit the National PACE Association website, www.npaonline.org.

 

WHO PAYS FOR ARCHCARE SENIOR LIFE (PACE)?

Payment for ArchCare Senior Life (PACE)  depends upon your eligibility for Medicare and Medicaid:

  • If you are eligible for Medicare and Medicaid or eligible for Medicaid only and do not have a spend-down,* there is no cost to you for PACE covered services.
  • If you are eligible for Medicare only, you will pay the Medicaid monthly rate on a private pay basis along with your Part D premium for prescription drug coverage.
  • If you are not eligible for Medicare or Medicaid, you may enroll in PACE on a private pay basis, with your cost equal to the Medicare and Medicaid rates. You will also pay your Part D premium.

 

There is no additional cost to you for the authorized covered services in the ArchCare Senior Life (PACE) provider network. If you choose to access services on your own that are not covered or obtain services of a nonparticipating provider that are not authorized by ArchCare Senior Life (PACE), you may be subject to payment of these services.

*Spend-down, which is also known as surplus, is the difference between your monthly income and the monthly Medicaid rate.

 

CAN I CONTINUE TO SEE MY CURRENT DOCTORS?

ArchCare Senior Life (PACE) has contracts with specialists, hospitals and other providers throughout the community to make sure you get all the care you need when you need it. You will receive most of your care from your PACE primary care physician and PACE center staff.

 

WHO DECIDES WHICH PACE SERVICES I NEED?

Your PACE primary care physician and team of clinicians will work with you and your caregiver to coordinate all aspects of your care and determine which services you require.

 

CAN ARCHCARE SENIOR LIFE (PACE) PROVIDE SERVICES IN MY HOME?

Yes, ArchCare Senior Life (PACE) can provide services in your home, including home health aides, nurses and social workers as needed.

 

HOW DO I FIND OUT IF A SPECIFIC SERVICE IS COVERED?

Call us toll-free at 1‑866-263-9083 (TTY/TDD: 711), MONDAY THROUGH FRIDAY, 8:30 A.M. TO 5:00 P.M., and speak to one of our Member Service representatives.

 

WHEN WILL ARCHCARE SENIOR LIFE (PACE) BE AVAILABLE IN MY AREA?

ArchCare Senior Life (PACE) centers are currently located in Manhattan, The Bronx, and Staten Island. Our goal is to expand the program to other locations in the New York metropolitan area. In the meantime, consider one of our other health plans, such as ArchCare Community Life and ArchCare Advantage, which coordinate the care members receive while they continue to live in their own homes.

 


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