Community Care s PACE Program (PACE)
Community Care s PACE Program (PACE) is a Medicare Advantage Plan by Community Care.
Community Care s PACE Program (PACE) is a Medicare Advantage PACE plan by Community Care.
IMPORTANT: Community Care s PACE Program (PACE) is a PACE plan. Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program for people who are 55 or older, live in the service area of a PACE organization, need a nursing home-level of care (as certified by your state), and are able to live safely in the community with help from PACE.
This page features plan details for 2024 Community Care s PACE Program (PACE) H5212 – 002 – 0.
IMPORTANT: This page features the 2024 version of this plan. See the 2025 version using the link below:
Locations
Community Care s PACE Program (PACE) is offered in the following locations.
Plan Overview
Community Care s PACE Program (PACE) offers the following coverage and cost-sharing.
| Insurer: | Community Care |
| Health Plan Deductible: | $0.00 |
| MOOP: | Not Applicable |
| Drugs Covered: | Yes |
Ready to sign up for Community Care s PACE Program (PACE) ?
Get help from a licensed insurance agent.
Call 1-877-354-4611 / TTY 711.
M-F: 8:00 am – 10:00 pm EST
Sat-Sun: 8:00 am – 9:00 pm EST
Premium Breakdown
Community Care s PACE Program (PACE) has a monthly premium of $714.90. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.| Part B | Part C | Part D | Part B Give Back | Total |
|---|---|---|---|---|
| $174.70 | $0.00 | $714.90 | $0.00 | $ |
- Your Part B premium may differ based on factors including late enrollment, income, and disability status.
- You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.
Drug Info
Community Care s PACE Program (PACE) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
| Drug Deductible: | $ |
| Initial Coverage Limit: | $ |
| Catastrophic Coverage Limit: | $8,000.00 |
| Drug Benefit Type: | |
| Additional Gap Coverage: | |
| Formulary Link: | Formulary Link |
Part D Premium Reduction
The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.
The table below shows how the LIS impacts the Part D premium of this plan.
| Part D | LIS Full |
|---|---|
| $714.90 | $666.80 |
Initial Coverage Phase
After you pay your $ drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $. Once you reach that amount, you will enter the next coverage phase.
Gap Coverage Phase
| Tier | Cost |
|---|---|
| All other tiers (Generic) | 25% |
| All other tiers (Brand-name) | 25% |
Catastrophic Coverage Phase
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $8,000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
Community Care s PACE Program (PACE) also provides the following benefits.
| $0 |
| In-network | No |
| Not Applicable |
| No |
| In-network | No |
| Not Applicable (Not applicable.) (Not applicable.) |
| Primary | Not Applicable (Not applicable.) (Not applicable.) |
| Specialist | Not Applicable (Not applicable.) (Not applicable.) |
| $0 copay (Not applicable.) (Not applicable.) |
| Emergency | Not Applicable (Not applicable.) (Not applicable.) |
| Urgent care | Not Applicable (Not applicable.) (Not applicable.) |
| Diagnostic tests and procedures | Not Applicable (Not applicable.) (Not applicable.) |
| Lab services | Not Applicable (Not applicable.) (Not applicable.) |
| Diagnostic radiology services (e.g., MRI) | Not Applicable (Not applicable.) (Not applicable.) |
| Outpatient x-rays | Not Applicable (Not applicable.) (Not applicable.) |
| Hearing exam | Not Applicable (Not applicable.) (Not applicable.) |
| Fitting/evaluation | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Hearing aids – inner ear | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Hearing aids – outer ear | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Hearing aids – over the ear | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Oral exam | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Cleaning | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Fluoride treatment | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Dental x-ray(s) | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Non-routine services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Diagnostic services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Restorative services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Endodontics | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Periodontics | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Extractions | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Prosthodontics, other oral/maxillofacial surgery, other services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Routine eye exam | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Other | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Contact lenses | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Eyeglasses (frames and lenses) | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Eyeglass frames | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Eyeglass lenses | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Upgrades | Not covered (Not applicable.) (Not applicable.) |
| Occupational therapy visit | Not Applicable (Not applicable.) (Not applicable.) |
| Physical therapy and speech and language therapy visit | Not Applicable (Not applicable.) (Not applicable.) |
| Not Applicable (Not applicable.) (Not applicable.) |
| Not covered (Not applicable.) (Not applicable.) |
| Foot exams and treatment | Not Applicable (Not applicable.) (Not applicable.) |
| Routine foot care | Not covered (Not applicable.) (Not applicable.) |
| Durable medical equipment (e.g., wheelchairs, oxygen) | Not Applicable (Not applicable.) (Not applicable.) |
| Prosthetics (e.g., braces, artificial limbs) | Not Applicable (Not applicable.) (Not applicable.) |
| Diabetes supplies | Not Applicable (Not applicable.) (Not applicable.) |
| Not covered (Not applicable.) (Not applicable.) |
| Chemotherapy | Not Applicable (Not applicable.) (Not applicable.) |
| Other Part B drugs | Not Applicable (Not applicable.) (Not applicable.) |
| Part B Insulin drugs | Not Applicable (Not applicable.) (Not applicable.) |
| Not Applicable (Not applicable.) (Not applicable.) |
| Inpatient hospital – psychiatric | Not Applicable (Not applicable.) (Not applicable.) |
| Outpatient group therapy visit with a psychiatrist | Not Applicable (Not applicable.) (Not applicable.) |
| Outpatient individual therapy visit with a psychiatrist | Not Applicable (Not applicable.) (Not applicable.) |
| Outpatient group therapy visit | Not Applicable (Not applicable.) (Not applicable.) |
| Outpatient individual therapy visit | Not Applicable (Not applicable.) (Not applicable.) |
| $0 copay per stay (Not applicable.) (Not applicable.) |
Ready to sign up for Community Care s PACE Program (PACE) ?
Get help from a licensed insurance agent.
Call 1-877-354-4611 / TTY 711.
M-F: 8:00 am – 10:00 pm EST
Sat-Sun: 8:00 am – 9:00 pm EST