Program of All-Inclusive Care for the Elderly (PACE) in Virginia

The Program of All-Inclusive Care for the Elderly (PACE) in Virginia provides independent living flexibility to senior citizens who are frail enough to require nursing home-level care but wish to remain in their own homes and communities. Virginia’s PACE program includes 12 PACE center locations across the state and participants must live within the service area of one of these locations. PACE services are all-inclusive and tailored to meet the individual needs of each participant. Even though the PACE program exists to keep disabled or chronically ill senior citizens in their own communities for as long as possible, PACE participants must be eligible for nursing home-level care. Applicants must meet all other VA PACE eligibility requirements and be dually eligible for Medicare and Medicaid benefits, or Medicaid alone. Learn more about how to apply for PACE and learn PACE benefits when you review the sections below.

What are the benefits of participating in the Virginia PACE program?

Virginia PACE participants enjoy a wide range of benefits when they sign up for PACE. All who qualify for PACE will have their health and social service needs managed by a primary care provider who is part of an Interdisciplinary Team (IDT) of professionals committed to providing comprehensive elder care. PACE services are designed to help senior citizens retain their independence and remain living in their own homes, alone or with family members or other caregivers, for as long as possible. PACE programs include services geared toward helping caregivers and family members, such as caregiver training and respite care. Those who are eligible for PACE in VA may receive services at a PACE center, adult day care center, in their own home or at an inpatient facility.

Services Provided by PACE in Virginia

PACE services in Virginia include all Medicare and Medicaid health care services and many additional social and wellness benefits. Seniors receiving PACE services should note that specific services may vary somewhat by location and even between each person enrolled in the program. This is because PACE programs are individually tailored to meet each participant’s personal preferences and goals. PACE program services include medical care provided by primary care providers and specialists. PACE medical services also provide prescription medication coverage, necessary over-the-counter drugs and transportation to and from medical and social appointments. VA PACE services include various therapy programs and nutritional help, which can include providing meals if that service is included in the care plan. PACE program social services include adult day care, counseling and mental health care and personal care services. Download our comprehensive guide to obtain more detailed information about PACE services and benefits.

Eligibility Requirements for Virginia PACE Participation

PACE helps senior citizens with disabilities or chronic physical and mental conditions live independently in their community for as long as possible. PACE eligibility in Virginia is determined by the applicant meeting all PACE participation requirements. To enroll in PACE, you must meet the following requirements:

  • Be 55 years of age or older
  • Live within a Virginia PACE service area
  • Have a verified need for nursing home-level care
  • Be physically well enough to live safely in the community with PACE program support.
  • Be eligible for both Medicaid and Medicare benefits, or Medicaid only.

Seniors can participate in a VA PACE program even if they do not meet the Medicaid requirement. PACE services include a self-pay option for those who meet all other qualifications.

How to Enroll in PACE in Virginia

The PACE application process in VA is lengthy, with several steps involved. To apply for PACE, you must first find out if you are within a PACE center’s area of service. Each center has a slightly different process to enroll in PACE, although they all must follow guidelines set by the National PACE Association. The Virginia PACE application process requires several visits between the applicant’s home and the PACE center. This is to ensure that applicants fully understand PACE services and how the PACE program will contribute to their well-being. A PACE staff member must fully explain all aspects of PACE participation and have the applicant or his or her caregiver sign a release allowing PACE access to enrollment-related medical and financial records.

The next step in the VA PACE application process involves a comprehensive assessment conducted by the IDT. The purpose of this PACE program assessment is to see which services the applicant will need and to make sure that he or she can continue living in their own home safely. If it is determined that the Virginia PACE program applicant can safely reside in the community, the IDT creates a personalized care plan and PACE services begin. To obtain more specific information to help you apply for the PACE program, you can download our complimentary guide.

Virginia Department of Social Services