Eligibility

IS PACE FOR YOU?

ARE YOU ELIGIBLE?

You are eligible to enroll in PACE CNY if you are:

  • At least 55 years of age;
  • A resident of Onondaga County; and
  • Eligible for nursing home level of care as certified by New York State.

All of these eligibility criteria and conditions of enrollment must be met in order to enroll in PACE CNY.

Additionally you must meet the following conditions of enrollment:

  1. Determined to be capable of safely residing in the community with PACE CNY support services at the time of enrollment;
  2. Require more than 120 days of community based long term care services

PACE CNY may choose not to enroll participants whose condition is such at the point of enrollment that their health and safety would be jeopardized by remaining in their home and community.

Eligible individuals who are enrolled in a facility or any Home and Community Based Services Waiver program will not be accepted for enrollment until they have been disenrolled from the facility or the waiver program.

To know if you are eligible for PACE you need to have an assessment. There are two ways you can choose to have your assessment.

Direct Eligibility: You can have PACE CNY complete your assessment, which will see if you are eligible to join our plan. If you select Direct Eligibility our Plan will conduct your assessment. We will let you know if you are eligible for PACE. If you are found eligible, we can work with you to join our Plan. All Direct Eligibility assessments will be reviewed by the New York Independent Assessor (NYIA) to see if you can remain in the Plan. You should note that our Direct Eligibility assessment only applies towards enrollment into PACE CNY.

OR

New York Independent Assessor: You can contact NYIA to schedule an assessment. NYIA is the state-contracted independent assessor, that oversees and conducts assessments for individuals seeking personal care services, consumer directed personal assistance services, or Managed Long Term Care (MLTC), including PACE. If you choose to have a NYIA assessment and you are found eligible for PACE enrollment, there will be no further review. If you are not eligible for PACE enrollment, the NYIA assessment can also be used to see if you are eligible for other MLTC programs.

You will receive the PACE Direct Eligibility Disclosure Letter which you should review carefully prior to deciding between either PACE Direct Eligibility or New York Independent Assessor.

For more information

Please Call: (315) 452-5800
Toll free: 1-888-728-7223
TTY# 1-800-662-1220
Office hours are Monday through Friday, 8:00 a.m. to 5:00 p.m.

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