Frequently Asked Questions
We Are Here to Help
We know you might have a few questions about WelbeHealth and what we offer. That’s why we created a list of the most frequently asked questions. If there’s anything else we can help you with, feel free to call us at 800-734-8041 (TTY: 800-735-2922).
Program of All-Inclusive Care for the Elderly (PACE)
What is PACE?
PACE (The Program of All-Inclusive Care for the Elderly) individually coordinates the care of each participant enrolled in the program based on his or her needs with the goal of enabling them to remain living in their community. PACE is both a primary care provider and a health insurer. Currently, there are more than 240 PACE centers operating in more than 30 states.
What is the main goal of PACE?
PACE helps participants meet their health care needs in their homes and community, keeping them healthy and preventing hospital and nursing home admissions.
What services are covered by PACE?
PACE provides coordinated medical and social services. This includes a range of services from transportation, dentistry, eye care, ER visits, meals, nutritional counseling, prescription drugs and social work. For a complete list of services that we cover, visit the PACE Services page.
Is transportation provided to and from the WelbeHealth Coastline PACE center?
Yes, we provide transportation to and from your house to the PACE center and to appointments outside the center.
Do I need to go to the WelbeHealth Coastline PACE center daily?
No, the frequency of visits to the center will depend on the schedule that your care team creates for you. But you don’t want to miss out on all the fun! We host a variety of activities and socializing events each day at the WelbeHealth center, along with free meals and snacks.
What activities can I get involved with at the WelbeHealth Coastlie PACE center?
Games, arts and crafts, music therapy, gardening, puzzles, movies, exercise, socializing, walking, and so much more.
Will meals be available at the center? What if my doctor recommends a special diet?
Yes, we provide breakfast, lunch and dinner, along with snacks. If your doctor recommends a special diet, we can create a meal plan that works for you.
How do I schedule a tour of the WelbeHealth Coastline PACE center?
Please call us at 800-734-8041 (TTY: 800-735-2922) or email us and we’ll be happy to schedule a tour of the center.
Can I get in-home care, or do I have to visit a PACE center?
Yes, in-home care is available if a person needs it for medical reasons and can’t come to the center. Your medical needs will be assessed and a personal care plan will be created for your situation.
Eligibility
Am I eligible for PACE?
To qualify for PACE, you need to meet the following criteria:
- 55 years of age or older
- Live in the designated service area
- Certified by the state as eligible for nursing facility level of care
- Live safely in your home and the community
Is there anything I need to do to maintain my eligibility, after I enroll?
No, enrollment in the PACE program is voluntary. A person will stay enrolled for as long as they want to be, regardless of changes in health status.
What does it mean to meet nursing home level of care?
This varies by state. In California, a doctor will determine if there’s a need for nursing home care. People might need nursing home care if they can’t self-administer medications, feed themselves, need help dressing/bathing or suffer from a mental illness or Alzheimer’s.
Insurance / Costs
Does my insurance cover PACE?
Medicare and Medi-Cal reimburse WelbeHealth for care. If you are enrolled in Medicare and Medi-Cal, you will pay nothing, or you will pay your Medi-Cal “share of cost.”
Does my insurance change if I join PACE?
Once you join PACE, we become your health insurer. We coordinate and pay for all your medical care, becoming both your provider and insurer.
I don’t know if I’m covered by Medicare or Medi-Cal. Can someone help me find out?
Yes, please call us at 800-734-8041 (TTY: 800-735-2922) or email us and we’ll be happy to help you.
Do I notify my insurance company that I’m enrolled with PACE?
No. We can do this for you on your behalf.
How much will PACE cost me?
The cost for PACE depends on your financial situation. Most participants receive PACE services at no cost to them. If you have Medi-Cal or a combination of Medicare and Medi-Cal with no share of cost, then PACE services are free. If you are eligible for Medicare but not Medi-Cal, you pay Medi-Cal and Medicare Part D premiums. If you are not eligible for Medicare or Medi-Cal, you pay the self-pay rate for PACE.
Do I lose my Medicare/Medi-Cal when I enroll in PACE?
When you enroll in PACE, you keep the benefits offered by Medicare and/or Medi-Cal, along with becoming eligible for additional benefits offered by WelbeHealth.
Enrollment
How do I enroll?
First, we’ll schedule a time to talk with you over the phone to discuss basic information, questions and concerns. Next, a home care assessment is scheduled with a registered nurse. We’ll also sign you up for a tour of our WelbeHealth Coastline PACE center.
If I’m a caregiver, how do I refer a loved one?
We’re here to help serve your loved ones. Please call us at 800-734-8041 (TTY: 800-735-2922) or email us and we’ll be happy to discuss the next steps.
Do I live in the service area?
Refer to the map on the Day center page to see if you live in the service area.
What happens if I move?
If you move to a new city or outside of our WelbeHealth Coastline PACE service area, we’ll be happy to see if we can transfer you to a different PACE center in your new location.
If I enroll, can I keep my current doctor?
No. We will help you choose a primary care physician within the WelbeHealth Coastline PACE network. Even though you won’t be able to keep your current doctor, you will now have an entire dedicated PACE team to provide you with top-quality services.
After I submit my application, how long does it take for PACE services to start?
It usually takes about 2 weeks to apply, sometimes longer. Once the application is approved, the participant can start at the beginning of the following month.
If I’m not satisfied, what is the process for leaving PACE?
If you’re not satisfied, you can leave at the end of the month, so you can be enrolled in Medicare and Medicaid programs. Please notify us and we can take care of it for you.
