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Enrollment & Eligibility

Eligibility Requirements

PACE of West Baltimore can enroll individuals who meet the following eligibility requirements

  • Reside in the PACE approved service area upon enrollment;
  • Be 55 years old or older;
  • Be able to be maintained in a community-based setting with the assistance of PACE at the time of enrollment without jeopardizing the participant’s health or others’ health or safety;
  • Be determined to need the level of care required under the State Plan for coverage of nursing facility services for longer than 4 months; and
  • Be willing to abide by the provision that requires participants to receive all health and long-term care services exclusively from the PACE provider and its contracted or referred providers.

PACE of West Baltimore program staff must explain the following information in order for the potential participant or his/her representative to make an informed decision:

  • The PACE of West Baltimore program, using a copy of the enrollment agreement.
  • The requirement that the PACE of West Baltimore program would be the participant’s sole service provider and clarification that the PACE of West Baltimore program guarantees access to services, but not to a specific provider.
  • A list of employees of PACE of West Baltimore program who furnish care and the most current list of contracted health care providers.
  • Monthly premiums, if any.
  • Any Medicaid spend-down obligations.
  • Post-eligibility treatment of income.
  • A participant’s enrollment in the program is effective on the first day of the calendar month following the date that PACE of West Baltimore receives the signed enrollment agreement.
  • All participants will receive a PACE Membership Card that indicates that he or she is a PACE participant and that includes the phone number of PACE.
  • Emergency information will be posted in his or her home identifying the individual as a PACE participant and explaining how to access emergency services.
  • If there are changes in the enrollment agreement information at any time during the participant’s enrollment, PACE of West Baltimore must notify the participant.
  • Enrollment continues regardless of changes in health status until death, unless the participant is disenrolled voluntarily or involuntary or the participant no longer meets the Maryland PACE eligibility requirements.

The potential participant must sign a release to allow PACE of West Baltimore to obtain his or her medical and  financial information and eligibility status for Medicare and Medicaid.

The PACE of West Baltimore program interdisciplinary team will assess the potential participant to ensure that he or she can be cared for appropriately in a community setting.

After the participant signs the enrollment agreement, PACE of West Baltimore must give the participant the  following:

  • A copy of the enrollment agreement.
  • A PACE of West Baltimore membership card.
  • Emergency information to be posted in his or her home identifying the individual as a PACE of West Baltimore participant and explaining how to access emergency services.

We currently serve these zip codes in the Baltimore area:

21201; 21209; 21210; 21211; 21212; 21215; 21216; 21223; 21225; 21226; 21229; 21230; 21239; 21251; 21287; 21207; 21228

Costs of Service

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

All eligible individuals age 55 years of age and older are welcome to participate in PACE. We can help determine 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…you won’t pay a monthly premium for PACE.
  • IF YOU ARE ELIGIBLE FOR BOTH MEDICARE & MEDICAID…you won’t pay a monthly premium for PACE.
  • IF YOU DON’T QUALIFY FOR MEDICAID, BUT YOU HAVE MEDICARE…you’ll be charged a monthly premium for PACE.
  • IF YOU ARE NOT ELIGIBLE FOR MEDICARE OR MEDICAID…you can pay for PACE privately.
Learn More About PACE

Contact us to Learn more about Pace of West Baltimore, the program of all-inclusive care for the elderly