Eligibility
TRU PACE serves seniors from all walks of life. Our program can enroll individuals who meet the following eligibility requirements:
- At least 55 years old
- Living in our PACE service area
- Certified by the state of Colorado as needing nursing facility care, and
- Able to live safely in the community with 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.
6-Step Enrollment Process
Step 1: Contact TRU PACE
When you call our center (translation services available), we will explain our program services, program eligibility requirements and any costs of TRU PACE. We can help you see if TRU PACE would be a good fit for you or a loved one. We will schedule an in-home visit with our enrollment specialist.
If you do not currently receive Medicaid benefits, you may be eligible and we can help you apply.
Step 2: Home Visit
Our Enrollment Specialist will meet with you and a loved one in your home to discuss your needs and TRU PACE. We will discuss PACE financial coverage and begin paper work for our program. We will need documents signed such as a release of your medical records from your current care provider. Our Enrollment Specialist will schedule a second visit called an in-home assessment with a few members of our healthcare team. Paperwork will also be submitted to the county and they will contact you about a functional assessment. (They assess whether you meet the Skilled Nursing Level of Care.)
Step 3: In-Home Assessment
Our healthcare team members will come and visit you in your home. They will ask you more questions about your healthcare needs, medical history, and your living situation. This will help us determine what type of care plan you will need. They will also ask you questions about your medications and how you are feeling physically. During this visit, they will schedule your TRU PACE Center visit.
Step 4: TRU PACE Center Visit
We would like you to come and visit our PACE Center. You will have lunch, get a tour, and visit with additional members of our healthcare team. Each team member will conduct an assessment and will put together a personalized plan of care for you.
Step 5: Meet at Your Home
Once all of the assessments, paperwork and financial applications have been completed, the Enrollment Specialist will meet with you in your home. They will present to you and your loved ones your personalized plan of care as a PACE participant. If you agree, you will sign your Enrollment Agreement.
Step 6: Welcome to TRU PACE
You are now a TRU PACE participant and you will start on the first day of the following month. WELCOME!
TRU PACE participants may disenroll at the end of any month.
How do I pay for TRU PACE services?
TRU PACE is designed to combine a senior’s Medicare and Medicaid funds. When pooled together, they can provide creative, integrative, and holistic services to the participants. All eligible seniors (55+) are welcome to participate even if they do not receive Medicare or Medicaid. If a senior does not have Medicaid, we will help you see if you are eligible for it. Some seniors who are not eligible for Medicaid may pay for that portion out of pocket as well as a Medicare Part D premium.
- Eligible for Medicaid = 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 = Participant pays nothing.*
- Not eligible for Medicaid 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).