As an insurer, the Elder Service Plan pays for all medically necessary services covered under Medicare and Medicaid regardless of your original insurance, when approved by your health care team.
Once enrolled in the Elder Service Plan, all care and services, with the exception of emergency care must be approved by the PACE health care team, and provided through the Elder Service Plan. These provisions are known as “lock-in,” remain in effect while enrolled. Participants may disenroll from the Elder Service Plan at any time.
The UESP program is covered by both state and federal institutions.
Many participants are enrolled with both MassHealth and Medicaid. PACE programs are covered by Medicare and Medicaid for eligible individuals. Some participants have a monthly share of cost premium based on income. A participant’s monthly premium responsibility depends upon his or her eligibility under Medicare and Medicaid. PACE services are also available on a private pay basis. Many participants qualify for zero monthly cost share or zero premium based on income. Call the Enrollment and Income Coordinator at 617-288-0970, extension 16, to find out more about income requirements.