Benefits, Coverage and Services

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, 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.

Last updated 11/20/18