How is AllCARE For Seniors Unique?
Interdisciplinary Team – An Interdisciplinary Team will create a care plan with you and your family and/or caregiver. Your team includes,
at a minimum, a primary care physician, a registered nurse, a social worker, a dietitian, a physical therapist, an occupational therapist,
a recreational coordinator, PACE Center Manager, a homecare coordinator, a certified nurse assistant, and a driver. Each Team member will evaluate
your medical and social needs. The Team may also call on other specialists.
Authorization of Care - You will get to know each of your Team members very well. They will help you to be as healthy and independent as possible.
Your choices for health care, except for emergency services, must be approved in advance by your Team in order for those services to be paid for by
AllCARE for Seniors. About three times a year, your Team will re-evaluate your needs. They will talk with you and your family to see if your needs
have changed. They will meet more often with you and your family if your health needs require it, or at the request of you or your family.
If your Interdisciplinary Team finds it necessary for you to receive additional services from other doctors or specialists, then the Team will
approve these services, make the appointment for you, and take you to and from the appointment with the outside provider. If you make appointments
without the knowledge or consent of the Team, you may be responsible for payment of those services.
PACE Center - You will receive most of your health care services from our PACE Center, a multi-purpose center that provides you with health care,
nutritious meals, activities, and opportunities to socialize and make new friends.
PACE Center Attendance – Your Interdisciplinary Team will decide the best way of caring for you after talking with you and your family. This includes
determining the appropriate number of attendance days at the PACE Center.
“Lock-In” Provisions - As a AllCARE for Seniors participant, all health care services are provided and arranged by your Interdisicplinary Team. If a
PACE participant receives medical services from an out-of network provider and/or without prior authorization (with the exception of emergency
services), the participant may be liable for the full cost of those services.
Special Payment – If you are eligible for Medicare and/or Medicaid, AllCARE for Seniors takes the place of standard Medicare and/or Medicaid
programs. The only payment made by Medicare and/or Medicaid for the care you need will be one payment each month to AllCARE for Seniors.
AllCARE for Seniors will provide all of your care. You will receive all the services you normally receive through Medicare and Medicaid and may,
in fact, even receive more services.
Financial Consent Form – If you are eligible for Medicare and not Medicaid, you will be asked to pay what is equal to the payment AllCARE for Seniors
gets from Medicaid each month. You will be asked to sign a financial consent form acknowledging your agreement to pay the monthly premium.
After paying the monthly premium you will owe nothing else to AllCARE for Seniors in the form of co-insurance, deductibles, co-pays, etc., for any of
the services AllCARE for Seniors provides.