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 (FAQs). If there’s anything else we can help you with, feel free to call us at 888-530-4415.
Program of All-Inclusive Care for the Elderly (PACE)
What is WelbeHealth?
WelbeHealth provides and coordinates your care based on medical, functional and social needs, with the goal helping you remain living independently in the community, rather than a nursing home.
PACE is both a care provider and a health insurer. Currently, there are more than 240 PACE centers operating in more than 30 states.
What services are covered by WelbeHealth?
WelbeHealth provides comprehensive medical and social services coordinated by a dedicated PACE care team. This includes a range of benefits such as primary and specialty medical care, dental, prescription drugs, transportation, physical therapy, nutritional support, social services, and much more. For a complete list of services that we cover, please visit the PACE Services page.
What transportation is provided?
We provide transportation to and from your home to the PACE center and to scheduled medical specialty appointments within our service area.
What is a PACE Center?
- A medical clinic where you can see doctors, nurses and specialists.
- A social environment where you can spend time with friends, enjoy a nutritious meal and participate in engaging activities.
- A supportive place where a dedicated PACE care team partners with you to live as independently as possible.
What about my personal doctors?
Once enrolled, WelbeHealth becomes your primary care provider. You will have a dedicated PACE care team and network of primary and specialty physicians to care for you.
What if I need help during the night or weekends?
As a participant of WelbeHealth, you will have access to medical care 24 hours a day, 7 days a week, 365 days a year.
How often do I go to the WelbeHealth PACE Center?
The schedule of center visits will depend on the plan that you and your care team create to meet your individual needs and preferences. Please note that due to the COVID-19 pandemic, we are providing participants with internet-connected tablets so that many of the services that they would normally receive at the center can now be received at home.
What activities can I get involved with at the WelbeHealth Sierra PACE Center?
The Engagement Program at the WelbeHealth Sierra PACE Center is varied to provide individualized ways to get involved. Wellness, exercise and art classes; professional entertainment; outings; and activities such as games, puzzles and gardening are just some of the experiences you may enjoy at WelbeHealth.
Will meals be available at the WelbeHealth Sierra PACE Center?
Yes. We provide a nutritious lunch, along with snacks.
What if my Doctor recommends a special diet?
If your Doctor recommends a special diet, our Registered Dietitian with work with the Doctor to create a nutrition program that meets your healthcare needs.
Can I get care in my home?
In-home care is available and will be provided for those who need it. Your needs will be assessed by the PACE care team, including a Home Care Registered Nurse, who will determine any assistance needed in the home.
Please note that due to the COVID-19 pandemic, we are providing participants with internet-connected tablets so that many of the services that they would normally receive at the center can now be received at home.
Eligibility
Am I eligible for WelbeHealth?
To qualify for PACE, you need to meet the following criteria:
- 55 years of age or older
- Live in the WelbeHealth designated service area
- Certified by the state as eligible for nursing facility level of care
- Live safely in your home and the community
Do I live in the service area?
Refer to the map on the About page to see if you live in the WelbeHealth service area.
Insurance / Costs
How much will WelbeHealth cost?
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 have Medi-Cal with a share of cost, you will pay this monthly. If you are eligible for Medicare but not Medi-Cal, you will pay Medi-Cal and Medicare Part D premiums. If you are not eligible for Medicare or Medi-Cal, you may pay the self-pay rate for PACE.
There is never a deducible or co-payment for any drug, service or care approved by the PACE team. PACE participants can only access medical services through the PACE network with prior approval from the WelbeHealth Interdisciplinary Team except in an emergency. PACE participants may be fully and personally liable for the costs of unauthorized or out-of PACE program agreement services.
Does my insurance change if I join WelbeHealth?
Yes. Once you join PACE, we become your health insurer.
Do I lose my Medicare and or Medi-Cal benefits when I enroll in WelbeHealth?
No. WelbeHealth provides all the care and services covered by Medicare and Medicaid, as authorized by the interdisciplinary team, as well as additional medically-necessary care and services not covered by Medicare and Medicaid.
Enrollment
How do I schedule a tour of the WelbeHealth Sierra PACE Center?
Please call us at 888-530-4415 and we’ll be happy to schedule a tour of the WelbeHealth Sierra PACE Center.
How do I enroll?
First, we’ll schedule a time to talk with you over the phone to discuss information about the program and address your questions. Next, one or more home visits will be scheduled with the enrollment team, including a Registered Nurse. Once we confirm your eligibility (which may involve additional healthcare assessments) and the State of California approves the enrollment, we will discuss your PACE care plan and you can sign the Enrollment Agreement to become a PACE participant (effective the following month).
If I’m a caregiver or a provider, how do I refer a patient or a loved one?
We’re here to help serve your loved ones. Please complete the Referral Form online, call us at 888-530-4415, or email us at and we’ll be happy to discuss the next steps.
