How to Enroll

BEcome A PACE MEMBER


Review of program eligibility

The state and federal governments have set eligibility and enrollment criteria. The intake nurse reviews this information with the potential participant to determine eligibility for the PACE program. If the person is ineligible or not interested in the PACE model, information on other local programs that may meet an individual’s needs will be provided.


Payment/insurance coverage

if you are not currently enrolled in Medicaid, a financial assessment to help determine eligibility is completed; the potential participant will need to provide a summary of income and assets for this assessment. If the decision is made to apply for Medicaid, a list of documents needed for that process is provided, and the Loretto Finance Department will help with the process.


Medicaid and Medicaid-pending status

New York State law requires that persons with Medicaid or who are Medicaid-pending have a conflict-free evaluation by an independent nurse provided by New York State to determine eligibility for any managed long-term care program (MLTC). We will provide the individual with the number to call to schedule this evaluation.


PACE CNY assessment process

The PACE assessment can start after New York State completes its evaluation and has determined the individual is eligible for an MLTC and has chosen PACE CNY as their provider. This process includes an evaluation by the intake RN, a scheduled visit to the day center, and an evaluation by PACE Homecare.

If you would like someone to represent you in your dealings with Medicare, Medicaid or the Social Security Administration, you must fill out, sign and submit a written statement to social security. You can use the appointment of representative form #1696 for this purpose. Please click below on PDF for ‘Appointment of Representative Form’.

Click to Download Appointment of Representative form


Enrollment

Upon enrollment, our interdisciplinary team completes an in-depth healthcare evaluation and develops a comprehensive, individualized care plan based on medical, physical, emotional and social needs. The individual’s enrollment becomes effective of the first of the month.

Download PACE Enrollment Agreement

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