PACE Benefits, Coverage and Services | Sentara Healthcare
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Benefits, Coverage and Services 

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Benefits, Coverage and Services
Participants' Bill of Rights

Sentara PACE provides comprehensive medical care to minimize health problems and maximize levels of independence. Most services are provided at our PACE Centers, which combine the services of an adult day center with primary medical care provided in the clinic on site.

Services such as nursing, social work, physical, occupational and speech therapy and nutritional and personal care are all provided at the PACE Centers. There, participants enjoy meals, snacks, and recreational and social activities. Transportation is also provided. All care is monitored and coordinated by the IDT.

This program is different from any other kind of health care program. It offers participants a comprehensive health care program that is more personalized than ever and provides a full range of services 24 hours a day, 7 days a week, 365 days a year.

What kind of benefits and coverage do I receive with Sentara PACE?
As a participant in the PACE program, all necessary health services will be provided through PACE and your IDT. Most care is delivered at the PACE Center. Your IDT will determine with you and your family/caregiver on what is best for your needs. The IDT will develop a plan of care to address your service needs.

PACE provides all normally covered Medicaid and Medicare services as well as additional services if authorized by the Interdisciplinary Team (IDT).

Outpatient Health Services
Adult Day Center; Physician, clinic, specialty services and nursing. Specialty services may include:

Anesthesiology
Audiology
Behavioral Health services/mental health and substance abuse services including community psychiatric rehabilitation services
Cardiology
Dentistry
Dermatology
Gastroenterology
Gynecology
Internal Medicine
Nephrology
Neurosurgery
Oncology
Ophthalmology
Oral Surgery
Orthopedic Surgery
Otorhinolaryngology (ear, nose and throat)
Psychiatry
Pulmonary Disease
Radiology
Rheumatology
General Surgery and Ambulatory Surgery
Thoracic and Vascular Surgery
Urology
Nursing Care
Medical Social Services
Physical, Occupational and Speech Therapy
Podiatry
Help for you and your family on how to choose and cook healthy foods
Laboratory tests, X-rays and other tests used to find out what health problems you may have
Prescribed drugs and medicines.
Durable Medical Equipment (such as artificial limbs, hospital beds, wheelchairs, and walkers)
Vision care (examinations and treatment including eyeglasses)
Psychiatric Care including evaluation, consultation, diagnosis, and treatment
Hearing Services, including evaluation, hearing aids, repairs and maintenance

Hospital Inpatient Care

Semi-private room and meals
General Medical and Nursing services
Medical/Surgical, Intensive Care, Coronary Care units, as necessary
Laboratory tests, X-rays, and other necessary tests
Prescribed drugs and medicines
Blood and blood parts such as plasma
Surgical care including use of medicine that puts you to sleep during surgery
Use of oxygen
Physical, Speech, Occupational, and Respiratory Therapies
Medical Social Services
Emergency and Urgent Care
Ambulance Service
Treatment Room Services
Dentures and Repair and Maintenance

Not included under hospital care are private room and private duty nurse charges, unless your IDT feels it is necessary for your condition. Also not included are non-medical items such as telephone charges unless they are authorized by the IDT.

Nursing Facility Care

Semi-private room and meals
Doctor and nursing services
Custodial care
Personal care and assistance
Prescribed drugs and medicines
Physical, Speech, and Occupational Therapies
Medical Social Services
Medical supplies and appliances
Other services determined necessary by the IDT to improve and maintain the participant’s overall health status

Home Health Care

Skilled nursing services
Doctor's visits
Physical, Speech, and/or Occupational Therapies
Medical Social Services
Home Health Aide services
Homemaker/Chore service
Home delivered meals with special diets.
Respite Care
Personal Care Services

End of Life Care
End of Life services will be coordinated between the participant and their family/caregiver and the PACE IDT. End of Life services may include any combination of care in the hospital, care in a nursing facility, and/or care at home.

PLEASE NOTE: All content below this text and links above the title of this section are not affiliated with PACE. If you click on any of these outlying links, you will be leaving the PACE-specific web pages and content.

 


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