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Enrollment & Eligibility

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Eligibility Requirements

Rocky Mountain PACE can enroll individuals who meet the following eligibility requirements:

  • At least 55 years old
  • Living in our PACE service area
  • Certified by the State of Colorado as needing nursing home-level care
  • Able to live safely in the community with PACE services at the time of enrollment

We currently serve these zip codes in El Paso county and continue to add more as we receive requests to serve new areas.

80817, 80829, 80903, 80904, 80905, 80906, 80907, 80909, 80910, 80911, 80914, 80915, 80916, 80917, 80918, 80919, 80920, 80922, 80923, 80924, 80925, 80927, 80939, 80951

6-Step Enrollment Process

Step 1: Contact Rocky Mountain PACE

  • When you call our center (translation services available), we will explain our program services, program eligibility requirements and any costs of Rocky Mountain PACE. We can help you see if Rocky Mountain PACE would be a good fit for you or a loved one. We will schedule an in-home visit with our enrollment specialist.
  • If you do not currently receive Medicaid benefits, you may be eligible. PACE staff can assist with your Medicaid application.

Step 2: Home Visit

  • Our Enrollment Specialist will meet with you and a loved one in your home to discuss your needs and Rocky Mountain PACE. We will discuss PACE financial coverage and begin paperwork for our program. We will need documents signed, such as a release of your medical records from your current care provider. Our Enrollment Specialist will schedule a second visit, called an in-home assessment, with a few members of our healthcare team. Paperwork will also be submitted to El Paso County, and they will contact you about a functional assessment (they assess whether you meet the Skilled Nursing Level of Care).

Step 3: In-Home Assessment

  • Our healthcare team members will come and visit you in your home. They will ask you more questions about your healthcare needs, medical history, and your living situation. This will help us determine what type of care plan you will need. They will also ask you questions about your medications and how you are feeling physically. During this visit, they will schedule your Rocky Mountain PACE Center visit, if you desire.

Step 4: Rocky Mountain PACE Center Visit

  • We would like you to come and visit our PACE Center, if you desire. You will have lunch, get a tour, and visit with additional members of our healthcare team.

Step 5: Meet at Your Home

  • Once all of the assessments, paperwork and financial applications have been completed, the Enrollment Specialist will meet with you in your home. They will present to you and your loved ones your personalized plan of care as a PACE participant. If you agree, you will sign your Enrollment Agreement.

Step 6: Welcome to Rocky Mountain PACE

  • You are now a Rocky Mountain PACE participant, and you will start on the first day of the following month. WELCOME!
  • Rocky Mountain PACE participants may disenroll at the end of any month.

Costs of Service

Rocky Mountain PACE is designed to provide coordinated healthcare, social engagement, medication management, transportation, in-home assistance, and other specialty care options.

All eligible individuals over 55 years of age are welcome to participate and we can assist in determining your qualifications for Medicare and Medicaid and assist in the application process. A private pay option is also available.

IF YOU ARE ELIGIBLE FOR MEDICAID

…no cost to the participant.

IF YOU ARE ELIGIBLE FOR MEDICARE & MEDICAID

…no cost to the participant.

IF YOU ARE ELIGIBLE FOR MEDICARE ONLY

…participants pay the Medicaid portion plus Medicare Part D.

IF YOU ARE NOT ELIGIBLE FOR MEDICARE OR MEDICAID

…participants pay the self-pay rate.

WHILE IT IS OUR GOAL TO KEEP PACE PARTICIPANTS IN THEIR RESIDENCE

…the only exception is if the individual lives in or moves to supportive housing (assisted living or nursing home), in which case there is a co-pay to that facility.

Rocky Mountain PACE participants must receive all needed healthcare, including primary care and specialty physician services (other than emergency services) from Rocky Mountain PACE contracted providers.

Rocky Mountain PACE participants may be fully and/or personally responsible for costs of any unauthorized out-of-network services.

Learn More about our PACE Program