TRU PACE serves older adult from all walks of life. Our program enrolls individuals who meet the following eligibility requirements:
- At least 55 years old
- Living in our TRU PACE service area
- Certified by the state of Colorado as needing nursing facility care, and
- Able to live safely in the community with TRU PACE services at the time of enrollment.
TRU PACE participants must receive all needed healthcare, including primary care and special physician services (other than emergency services) from TRU PACE contracted providers. TRU PACE participants may be fully and personally liable for costs of any unauthorized out-of-network services.
An inquiring participant, family member or friend calls for information or makes a referral to TRU PACE (Program of All-inclusive Care for the Elderly). When contact with the potential participant is made, our Intake Specialist will talk with you to obtain some basic information regarding your needs, talk through your unique situation and concerns.
Intake staff covers a variety of areas, including discussion of medical, mental health and memory issues, to help determine if the person is eligible for PACE services functionally and financially. We talk about what is and is not working well at home, gaps in care, and whether there is an interest in using our many services.
We also ask questions about finances, as this can help determine if the individual is eligible for Medicaid Long-term Care, which can fully fund our services. During our conversation, we get a better picture of whether or not TRU PACE is a good fit for you, and we help with locating other community options if it is not.
If criteria are met and there is interest, TRU PACE schedules an initial visit with an Enrollment Specialist to begin the enrollment process.
The Enrollment visit is scheduled with the potential participant as soon as possible either in your home, at the day center or over the phone. The Enrollment Specialist reviews the PACE program and answer any questions or concerns.
We discuss your medical history, community support, as well as verify your insurance. We complete releases and consents including a Release of Information form to allow TRU PACE medical team to understand your medical needs. If necessary a Medicaid application is also completed.
This is a great time to schedule a visit to our day center, have lunch and meet our friendly TRU PACE staff.
Members of the Inter-Disciplinary Team (IDT) meet with you at our Day Center or in your home to complete a pre-enrollment assessment, helping to determine your unique medical and mental health needs.
The TRU PACE Inter-Disciplinary Team (IDT) meets to review individual findings to determine if your medical needs and safety requirements meet the level of care provided by the TRU PACE program. The team is required to certify that each potential participant meets State of Colorado Eligibility Requirements for PACE.
Once certified, the Enrollment Specialist calls you and extends an invitation to join the program. If the team is unable to certify PACE eligibility, the Enrollment Specialist calls and sends written information regarding how to appeal the decision as well as present alternative support options.
Welcome to TRU PACE! The Enrollment Specialist arranges to meet with you to sign paperwork and to complete the enrollment process. We discuss the date that TRU PACE services begin and the specifics of the transition to TRU PACE care.
TRU PACE participants may disenroll at the end of any month.
TRU PACE is a Medicare and Medicaid funded program. When pooled together, they provide creative, integrative, and holistic services to the participants. All eligible adults (55+) are welcome to participate even if they do not receive Medicare or Medicaid. If an adult does not have Medicaid, we help find out if they are eligible. Some adults who are not eligible for Medicaid may pay for that portion out of pocket as well as a Medicare Part D premium.
How are TRU PACE Services covered?
- Eligible for Medicaid Long-term Care Only (no Medicare) = Medicaid pays for this program (participant pays nothing). *
- Eligible for Medicare only = Participant pays the Medicaid portion plus Medicare Part D.
- Eligible for Medicare and Medicaid Long-term Care= Participant pays nothing out of pocket. Program is covered 100%*
- Not eligible for Medicaid Long-term Care or Medicare = Participant pays the self-pay rate.
*The only exception is if the individual lives in or moves to supportive housing (assisted living or nursing home), in which case there is a co-pay to that facility.
*If you are permanently placed in a Long Term Care facility, you may be responsible for a portion of your care (instead of skilled nursing).
Do I have to change my doctor? Yes, one of our qualified providers who specialize in geriatric medicine becomes your Primary Care Doctor. In addition to a primary care physician, you have an interdisciplinary team of care providers including social workers, nutritionists, physical therapists, and more.
What about Specialty care and Hospital care? TRU PACE contracts with specialists and providers throughout TRU PACE service area. Our contracted hospitals are Boulder Community Health, Avista Longmont United Health and St. Anthony North.
Do I have to change my insurance? TRU PACE becomes your insurance provider at the time of enrollment. TRU PACE participants must receive all needed healthcare, including primary care and special physician services (other than emergency services) from TRU PACE contracted providers. TRU PACE participants may be fully and personally liable for costs of any unauthorized out-of-network services.
How will I get to the TRU PACE Center? TRU PACE provides transportation to all of your medical appointments.
What does TRU PACE cost? If you have Medicaid and no share of cost, PACE is free!
Can I keep my In-Home Care? TRU PACE provides in-home care services, so there is no need for an In-Home Care provider with TRU PACE.
How often can I come to the TRU PACE Clinic? Services at the TRU PACE Clinic are provided based on your medical needs, so each participant has an individualized plan of care.
Do you have a Day Center for socialization? Yes! Our day center is available for you to enjoy the many recreational activities that are provided. TRU PACE day center is open M-F 8am-4:30pm.
Do you help me with meals? Yes. TRU PACE ensures you have access to food and meal programs, and our home care staff can assist you with grocery shopping, if needed.
Do you have dental services? Yes. Dental services are provided at TRU PACE.
When can I start getting services? As soon as you are enrolled in TRU PACE, our Interdisciplinary Team assesses your needs and begin services right away.
How long does it take to enroll? Our enrollment process takes approximately 4-8 weeks. Our knowledgeable and friendly Enrollment Specialists will guide you every step of the way.
Last updated on October 23rd, 2023 at 02:27 pm