pathways Pace

A person qualifies if she or he:

• Is 55 years of age or older.
• Meets the requirement for skilled nursing home care as determined by Pathways PACE’s interdisciplinary team (IDT) assessment and certified by the Colorado Department of Human Services.
• Lives in a service area (county and zip code) served by the Pathways PACE program.
• Can live in the community without jeopardizing his/her health or safety.

Yes. If a person meets the income and assets limits to qualify for Medicaid, the program pays for a portion of the monthly Pathways PACE premium. Medicare pays for the rest. If a person does not qualify for Medicaid, he or she is responsible for the portion of the monthly premium Medicaid would pay. Pathways PACE staff can help determine a person’s Medicaid eligibility.

Pathways PACE participants agree to receive all health care services defined in a participant’s individualized care plan developed by the Pathways PACE program’s Interdisciplinary Team (IDT). Pathways PACE IDT members include the primary care provider, registered nurse, social worker, physical, occupational, and recreational therapists, dietitian, home care coordinator, personal care attendant, transportation driver, and center director.

If you have a specialist that is part of the Pathways PACE network of contracted providers, you may be able to keep your current specialty care physician. When a participant enrolls in a Pathways PACE health plan, she/he is assigned a primary care physician (PCP) who is a member of the Pathways PACE Day Center’s Interdisciplinary Team (IDT) skilled in treating the healthcare needs of seniors.

Pathways PACE participants may be fully and personally liable for the costs of unauthorized or out of Pathways PACE program agreement services.