Common Questions

Common Questions

Below are some common questions and answers about CalOptima PACE. If you do not see your question answered here, please call our PACE enrollment coordinator(s) at 1-714-468-1100. We are here to help you and make sure you get access to the best health care possible.

  1. What will I do at the PACE center?

  2. How do I get to and from the PACE center?

  3. Is my medication covered by PACE?

  4. Do I have to change doctors?

  5. How do I pay for PACE services?

  6. What happens if I need to go to a nursing facility?

  7. Does my family have a say in my care in PACE?

  8. What if I enroll in PACE and then move outside of the service area?

  9. What if I am not satisfied with PACE?

1. What will I do at the PACE center?

Attendance at the PACE center depends on your individual needs and can vary from once a week to five times a week. While you are at the PACE center, you may receive medical care or social services. There will also be social and recreational activities, lunch, and opportunities to interact with other participants.

2. How do I get to and from the PACE center?

Our transportation staff will pick you up and bring you to the PACE center and then take you home after the programming is over. We will also provide transportation to medical appointments for specialists and other activities.

3. Is my medication covered by PACE?

PACE organizations offer Medicare Part D prescription drug coverage. If you enroll in a PACE program, you will get your Part D-covered drugs and all other necessary medications from the PACE program. If you are in a PACE program, you do not need to join a separate Medicare drug plan.

4. Do I have to change doctors?

Yes. Participants must agree to receive all health care services exclusively from our doctors and nurses. Our staff will coordinate your care to ensure better access and a much easier process for seeing specialists.

5. How do I pay for PACE services?

  • If you have Medicare and Medi-Cal (with no Share of Cost), all CalOptima PACE services are covered at no cost to you.

  • If you have Medicare and Medi-Cal (with a Share of Cost), you must pay your Share of Cost.

  • If you only have Medicare, you will need to pay a monthly premium to take part in CalOptima PACE. Please contact our enrollment coordinator at 1-714-468-1100 for more information.

  • If you have Medi-Cal only (with no Share of Cost), all CalOptima services are covered at no cost to you.

  • There are no co-payments or deductibles when you are enrolled as a CalOptima PACE participant.

6. What happens if I need to go to a nursing facility?

Our goal at PACE is to keep you out of a nursing facility as long as possible. If at some point you need to live in a nursing facility, PACE will continue to oversee your health care needs and visit you regularly.

7. Does my family have a say in my care in PACE?

Yes. You and your family participate in making your care plan and setting personal health goals. PACE organizations support your family members and other caregivers to help families keep their loved ones in the community.

8. What if I enroll in PACE and then move outside of the service area?

If you move out of the PACE service area, you will have to disenroll from PACE. However, there are PACE programs throughout the United States. Our staff will assist you in finding new health care services and provide you with a 30-day supply of medications.

9. What if I am not satisfied with PACE?

We work very hard to keep our participants satisfied. If you are not happy with our services for any reason, you can disenroll from the program.

Date Revised June 7, 2017

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