June 12, 2025 • 24 mins
In this episode of 'Advice From Your Advocates', hosts Bob Mannor and Savannah Meksto delve into the PACE program, a transformative initiative for elder care. They discuss the eligibility criteria, financial aspects, and the comprehensive care provided under the program. The conversation emphasizes the importance of understanding Medicaid qualifications and the benefits of receiving care at home. Listeners are encouraged to explore the PACE program as a viable option for their loved ones, highlighting the supportive community and medical resources available.
Host: Attorney Bob Mannor
Co-Host: Savannah Meksto
Executive Producer: Savannah Meksto
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Mannor Law Group helps clients in all matters of estate planning and elder law including special needs planning, veterans’ benefits, Medicaid planning, estate administration, and more. We offer guidance through all stages of life.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
You're listening to Advice from your Advocates, a
show where we provide elder lawadvice to professionals who work
with the elderly and theirfamilies.
Speaker 2 (00:07):
Welcome to Advice from your Advocates.
I'm your host, Bob Manor.
I am a board-certified elderlaw attorney and certified
dementia practitioner.
Joining me, as always, is myco-host, Savannah Mexico, who is
also a certified dementiapractitioner.
Savannah, great to have youhere.
Speaker 1 (00:22):
Thanks, bob.
I'm happy to be here Now.
Today's topic is one that cantruly transform how families
approach elder care the PACEprogram in Michigan.
So, bob, for those who areunfamiliar with the PACE program
, can you explain that to us?
Speaker 2 (00:37):
Absolutely so.
This is something that it's allover the country.
We have the PACE program as anational program, but it's
really underutilized and underunknown.
So PACE, p-a-c-e what does thatstand for?
That stands for the Program forAll-Inclusive Care for the
(00:57):
Elderly.
Now, all right, just the namesounds encouraging right, yeah,
right.
Yeah, so it is a Medicare andMedicaid program.
So generally I mean you canprivate pay and it will be
supplemented by Medicare for theprogram.
But very few people are goingto probably private pay for this
PACE program.
It's generally going to be forfolks that can qualify for
(01:19):
Medicaid Now we have Medicareand Medicaid and it is generally
going to be folks that are overage 55 then qualify for
Medicaid Now we have Medicareand Medicaid and it is generally
going to be folks that are overage 55, then qualify for
Medicaid.
Now, what we do at Manor LawGroup is we help people figure
out how to qualify for Medicaidand still keep your money.
So if this is the first timeyou're listening, you might not
(01:40):
know that there's ways toqualify for Medicaid and not
lose all your money.
But if you've listened before,you probably should know that
that's an option.
Speaker 1 (01:47):
So, bob, how about we dive deeper into that financial
side of the PACE program?
Now we know that you have to be55 to qualify, but what other
markers are they looking for?
And really, how does Medicaidmake this program accessible for
families who really need thecare?
Speaker 2 (02:02):
Well, first of all, I'm a little bit upset about the
qualifications, because 2025,I'm going to be 55.
So I will qualify for PACEbased on the age ranking, and
that doesn't make me reallyhappy.
Speaker 1 (02:16):
We'll have fun reminding you of that every day.
Speaker 2 (02:18):
Exactly so okay, so right.
So you have to be at least 55.
That's just.
You know the starting point.
You can't qualify for this ifyou're under 55.
There are other Medicaidprograms that you can qualify
for if you're under 55, but PACEis not one of them.
So the program forall-inclusive care for the
elderly is.
We'll get into what you getfrom that.
(02:40):
But let's talk about thequalification process first, and
there is both an income and anasset limit for that.
Now, assets is where Manor LawGroup can come in and help you
out to make sure that we canprotect assets and still qualify
for PACE Income.
We can also potentially qualify, but that gets a little bit
(03:02):
stickier if you're over theincome limit.
It's an individual income limit, meaning it doesn't matter what
your spouse makes as income.
It matters what you make.
An income, and I want toclarify what I mean by income.
Income is going to be yourpension and your social security
, and that's it.
Any other income is somethingthat we can work with you on,
(03:23):
the law office can work with youon to protect, but the one
thing that is just what it is isyour pension and social
security.
Speaker 1 (03:31):
So for those families who do qualify and they need
help with care, what kinds ofthings can the PACE program help
with?
Speaker 2 (03:40):
So it is the program for all-inclusive care for the
elderly, right.
So it's all-inclusive care.
So it is partially designed tobe where you're staying in your
home.
And you know, I've been doingthis for almost 30 years now.
This is probably why I'mgetting to the age where I
qualify for PACE, but I've beendoing this for almost 30 years
now, and almost always I ask ifyou get to the point where you
(04:03):
need help, where you can'tprovide all the care, you're not
completely independent anymore.
You need help from other people.
Would you rather get that helpin your house or would you
rather move into someplace thatprovides that care?
And about 99% of the timepeople say I'd rather get care
in my home, right, and so thisis one of those programs that
(04:23):
can help with that.
It is designed to keep you inyour home.
Now they can.
If they feel like you're notsafe in your home, they're
probably not going to accept youinto that program, Right?
But if they feel like withfamily support and other support
that they can provide, they canprovide the necessary help for
you, then it creates an optionfor you to stay in your home,
(04:47):
get some home care options, butalso go to the PACE program.
You know PACE Center In GeneseeCounty.
Here we have a really reallynice PACE Center right next door
to the Flint Farmer's Market.
So if you've ever been to theFlint Farmer's Market I know
you've been there Savannah, ohyeah, it's just really nice.
And then right next door is thePACE program.
It used to be the InternationalCenter but it's a great
(05:11):
building.
So they've got a nice pavilion,they've got concerts there
sometimes.
It's just a really great placeand you can go there as part of
the PACE program and they willprovide you with sort of your
daycare and then they'llsupplement that with some home
care.
Speaker 1 (05:27):
So you and I actually had the opportunity to tour the
Pace Center together, and thiswas like years ago that I went
to this facility with you tojust to check it out, and I
still, to this day, just thinkabout how cool it was there.
There was so much to do.
Speaker 2 (05:42):
Right.
Speaker 1 (05:42):
Just the.
You know I'm going to soundlike a hippie, but the vibe I
loved the vibe there.
Just everyone was in such agood mood.
Everyone was so friendly.
The staff was just above andbeyond friendly and everyone
staff and PACE participant alikejust seemed happy to be there.
Speaker 2 (05:57):
Absolutely, and so that's one of the things that I
really like about PACE is that,you know, there's a lot of good
care centers, places thatprovide 24-hour care, and you
live there, but it can be verydifficult in those settings to
provide 24-hour care, andsometimes you walk in and it's a
little bit depressing, right, Imean, and even the best places,
(06:18):
there's going to be days whereyou know it's just not the most
upbeat place in the world tolive, and the Pace Center is.
Every time I've ever been there, I think you said the right
word vibe.
The vibe has been very positiveand one of the things I love
about this, you know.
I'll tell you this quick story.
We have a bunch of clients thatare part of, you know,
(06:38):
participate in this Pace program, and a lot of them have some
kind of memory issue, have somekind of dementia.
You know they're not, theydon't have complete connection
to the world around them.
However, they still have someskill sets, right.
So, and I remember there areone of our clients was a really
(06:59):
great seamstress.
She was just a really greatseamstress and could sew.
We have another client thatdoes crochet and both of them
teach classes.
They're participants in theprogram and they have a little
circle of people that they'llteach them seamstress and you
know sewing and they'll teachthem.
The other one teaches crochet,where they're actively
(07:19):
participating in helping theother people that are part of
the PACE program and make itinteresting and unique and fun.
That's just something you don'tsee very often.
Speaker 1 (07:28):
No, absolutely not, and just so meaningful for the
people that are learning thatnew skill, but also for our
client, who got to share thatand make connections in that way
.
That's really cool.
I hadn't heard that story yet,but I love that.
Speaker 2 (07:40):
It's, you know, and it does give meaning.
You know we've had this in anynumber of settings where
somebody who's not really fullyunderstanding their surroundings
and that they often there'sbeen multiple clients that we've
had that they go to the settingand they feel like they're
going to work, which is great.
I mean.
I know you and I sometimesprobably show up on Monday
(08:01):
morning and we're like, oh, it'sMonday morning and I want to go
to work.
But work provides meaning,right, Work provides purpose in
life and to have that forsomebody who might be 85 years
old with memory issues, and thatyou're giving them some meaning
, you're giving them somepurpose, that really improves
the quality of life of theperson and the people around
(08:21):
them.
Speaker 1 (08:22):
Absolutely.
So we talked about how, ifsomeone feels like they might be
interested in the PACE program,they're 55, they need long-term
care, but they're not quiteready for you know skilled
nursing care or anything likethat yet and they think this
might be for me, you know howcan they go about that.
Speaker 2 (08:39):
All right.
So let's break that down.
That's really a great questionbecause we've got to say, okay,
how does this fit in?
So let's talk about the medicalrequirement, because it is a
Medicaid program, so you've gotto meet a medical eligibility
and with Medicaid, they havethese eight categories or
(09:02):
classifications.
They call them DOORS, d-o-o-r-sDOORS.
It's kind of weird that theycall them DOORS, but they're
basically categories and you'vegot to be eligible based on one
of those DOORS or categories,one of those eight DOORS or
categories.
In my experience, these DOORS orcategories to be medically
(09:22):
eligible is very subjective,meaning that whoever is making
that determination can be verystrict about it or be a little
bit less strict about it.
And in my experience, the folksthat you know are eligible for
PACE are probably going to be onthe lower end of the scale of
whether they're medicallyeligible.
(09:43):
You know they don't.
They're not bed bound, they'renot going to be where they need
somebody to.
You know, lift them out oftheir bed, or two people to lift
them out of their bed, to putthem into a chair.
That's not appropriate for PACE, right?
And so what I'm getting at isthe PACE folks that make this
determination are probably goingto be a little bit more lenient
(10:04):
in whether or not you aremedically eligible.
But that's the first requirement.
It can't just be hey, thissounds like fun, let's do that.
No, that's, you know.
Go visit your senior centerbecause they have some stuff at
your local senior center thatcan keep you entertained.
But if you're not medicallyeligible, then you know you're
not medically eligible.
So there is a medical part ofthat.
(10:25):
But you know, one of themedical eligibility things would
be dementia, like memory issues, right?
So if you're listening and youhave a mom or dad that has, is
you know.
So if you're listening and youhave a mom or dad that has, you
know, short-term memory loss,frequently asking the same
question over and over again,they might be eligible medically
at least for this PACE program.
So that's the first requirement.
(10:47):
You have to have a medicaleligibility.
The second requirement is we'vegot to be, you know we got to
get eligible for Medicaid and sofortunately, the folks over at
Pace will sometimes, you know,they'll say, well, I don't see
that you're eligible financiallyright now, but you know, maybe
go see one of these lawyers thatwe work with and so that's what
(11:09):
we can help people with.
So if you think, oh, I'll neverqualify for Medicaid.
Well, that's probably wrong.
You probably could qualify forMedicaid under the right
circumstances, regardless ofyour income or assets.
There's different strategies ortechniques that we have that
could get you eligible.
So I say Medicaid versusMedicare, which, if you're over
(11:29):
65, you probably already haveMedicare, and what our law
office does is we can help youqualify for Medicaid and that
would help you get eligible forPACE program.
Speaker 1 (11:40):
That's awesome and that must be such a huge relief
for families who just feel stuckbetween not qualifying for
Medicaid but also not being ableto afford the private care that
they need at home.
Speaker 2 (11:51):
That can be very difficult With PACE.
There is a income limit andthere's not a whole lot I can do
about the income limit, so it'sabout $2,900 a month.
If you individually not as amarried couple, but you
individually your gross incomemeaning your social security
before deductions, your pensionbefore deductions more than 20,
(12:15):
about $2,900 a month, you aren'tgoing to be eligible for this
particular program.
You can be eligible for otherMedicaid programs, but not this
PACE program.
And now you know that's notgreat.
I'd love to change that ruleand we actually are working
aggressively on changing thatrule.
So stay tuned to see if thatmight change next year or three
(12:38):
years from now or whatever,because several other states
have figured out a workaround sothat we're not disqualifying
people from the PACE programsimply because they get a GM
pension or something like that.
Speaker 1 (12:49):
Yeah, that's incredibly important.
Now, if you're just tuning in,today you are listening to
advice from your advocates andtoday we are talking about the
PACE program, or the Program ofAll-Inclusive Care for the
Elderly.
Now, bob, beyond the financialrelief of the PACE program,
there are a lot of benefits tobelonging to the program and
going to the center.
You know it's like youmentioned a little bit.
(13:11):
It's not just a communitycenter, it's not a senior center
, there's actually a medicalcomponent to that.
Can you tell us a little bitabout what PACE covers?
Speaker 2 (13:20):
Yeah, perfect.
So that's a great question andthat's sort of the two-sided
coin right.
Part of it is really great andpart of it is something that
some people won't be thrilledabout, and that is that once
you're on PACE, once you acceptthe PACE program, you have to
use the PACE doctors, you haveto use the PACE specialists.
That's what the program is.
(13:41):
It's all-inclusive care,meaning that you are likely not
going to continue with yourexisting doctor.
I really want people to take abreath and not discount that
they shouldn't consider thisoption simply because they'd
have to work with a differentdoctor.
I fully understand howimportant it is to have that
(14:02):
trust and faith in your doctorand you know the people that,
the professionals that you use.
But it is one of those thingswhere you're going to get all of
your medical help physicaltherapy, occupational therapy,
speech therapy, exercise, youknow therapy all of those things
would happen through the PACECenter and the point of it is
(14:25):
that's kind of what is necessaryto make it all inclusive, and
my experience dealing with themedical industry is that it's
really important that thedifferent doctors, the different
medical professionals allreally work very close together,
very hand in hand, to try tosolve the problem.
And if they're all like littleislands where you have your home
(14:47):
, you know, you have yourpersonal doctor or your family
doctor, and then you have thecardiologist, and then you have
the oncologist or whatever it is, they're probably not
communicating, they're probablynot, all you know, coming up
with a plan of care.
Unfortunately, that's just theway the healthcare industry
works.
With PACE they are.
(15:08):
They're coordinating all of ittogether and so, yes, you might
be giving up your existingdoctor to participate in the
PACE program, but the advantageof it is they come up with a
plan of care.
They've got 11 differentspecialties that they put as
part of your plan of care team,including making sure that you
have the proper transportation,so you don't have to get back
(15:29):
and forth to the PACE center.
They will pick you up.
And when I say they pick you up, that doesn't mean they get to
your driveway and honk the horn.
They're supposed to come intoyour house, get you situated,
help you out, get you into thevan, drive you to the Pace
Center, get you inside the PaceCenter, get by them, but then
there's going to be a doctor, asocial worker, a nurse, you know
(15:59):
, a physical therapist One ofthe things about PACE that I
really really like is that youdon't have to rely on your
insurance company to decide howmuch care you get or how much
physical therapy you get or howmuch occupational therapy you
get.
So they've got the caregiversthere.
You could continue physicaltherapy for years, whereas under
(16:20):
Medicare and Blue Cross orwhatever insurance, they're
probably going to cut that offafter about seven weeks.
With PACE, you might meet withyour physical therapist for
multiple years and there's nocutoff because it's part of that
all-inclusive care program.
Speaker 1 (16:36):
And that's just amazing and I remember during
our tour they talked about itwas just an interdisciplinary
team and they all work together.
And one of the things thatstuck out to me, you mentioned
the driver.
Even the driver they consider apart of that interdisciplinary
team and I just thought thatthat was so cool.
It really is all-inclusive care.
Speaker 2 (17:00):
Yeah, and I really do like so we're.
You know we're broadcastinghere in Genesee County and
there's PACE programs all overthe country and all over
Michigan.
But I really do appreciate theGenesee County PACE program
which is through.
I guess it's Henry Ford now,but it's the you know the
Genesis PACE through.
I guess Henry Ford took overthat.
But yeah, I think they do agreat job.
I really do.
I think that they havecontracts with different
(17:25):
assisted livings, they havecontracts with different doctors
and things like that, and I dothink that they make really good
decisions.
Sometimes I think people worryabout if you get on one of these
programs, you're going to getthe lowest quality, you're going
to get the least doctor.
Speaker 1 (17:42):
I don't feel like that's the issue with Pace at
all.
No, I completely disagree withthat myth, especially after just
doing the tour.
I mean just that in itself andI think they're really cool and
we'll talk about this in aminute.
But if you're interested inPace, they're really open about
stuff like that.
They want you to call, theywant to talk to you and answer
your questions.
Speaker 2 (18:01):
One thing I want to point out and you ask about.
You know what are the benefitsof PACE?
They're probably not going toadmit you to the program, and I
know that this isn't 100% true,because I've seen some examples
where they were able to do aplacement in a memory care from
the very beginning, in a memorycare from the very beginning.
(18:24):
But for the most part, we wantto start PACE before it gets to
the point where you can't liveat home anymore or you can't
live with your daughter anymore.
That is the better situation.
And if it advances to the pointwhere that you can't stay home
or you can't stay with yourdaughter, it's just too much of
a burden.
Pace will cover that cost.
Now, at that point, the onething I want to point out about
PACE is that there's actually nocost to it.
(18:45):
There's no copay.
You get eligible and it's $0.
Now if PACE decides, if thatteam of 11, your specialty comes
up with a plan of care and theysay, well, you know, it's
really not safe for you to behome anymore, or it's really not
safe for you to live with yourdaughter anymore because she
works, you know, 40 hours a weekor whatever it is, then they
(19:07):
will provide placement and theplacement places that they've
chosen for placement they havecontracts with, I think are good
places I would independentlyrecommend outside of PACE and so
.
But typically they're not goingto and there's exceptions to
this rule but typically they'renot going to and there's
exceptions to this rule, buttypically they're not going to
want to accept you into the PACEprogram if you already need to
(19:29):
be admitted into memory care orassisted living.
If you are admitted into memorycare, assisted living as part of
the PACE program, you could besubject to a copay based on your
income.
But that's OK.
Yeah, absolutely.
You know, if these places cost$6,000 or $7,000 a month and the
biggest obligation you wouldhave is based on your Social
Security check, that's fair,right and so there's no cost to
(19:53):
it if you're living at home orliving with your daughter or son
or whatever.
But there could be a copaybased on the fact that you are
placed now in a living settingand the maximum copay would be
based on the fact that you areplaced now in a living setting
and the maximum copay would bebased on your monthly income.
Speaker 1 (20:07):
So the point there, I think, is don't wait.
Speaker 2 (20:09):
Exactly, don't wait.
Speaker 1 (20:10):
So, before we wrap up today, bob, what advice do you
have for families who areexploring the PACE program but
might feel intimidated by thewhole Medicaid process?
Speaker 2 (20:21):
Yeah, absolutely.
That's a great, great, greatquestion.
So the first thing is check itout.
Go and visit.
You know I've visited Pace manytimes, often where it's a
scheduled thing and I'm meetingwith people.
But I've also just stopped byand my experience has been the
same both when they knew I wascoming and when they didn't know
I was coming.
I've got the same vibe as faras the quality of care that
(20:43):
they're providing.
But that's the first thingCheck it out, because you know,
whenever I'm talking to a clientabout this, maybe they knew
about PACE.
A lot of times they didn't knowabout PACE.
I never have them commit to theprocess in my office before
they go and at least you know,get the tour.
Speaker 1 (21:02):
That's smart.
Speaker 2 (21:03):
Yeah, exactly, we need to have them check it out,
make sure they're comfortablewith it, and then the next step
is, if it appears that you'renot financially eligible, come
see us at Manor Law Group.
And what we do is we work veryclosely with PACE we will you
know if you are eligible, if youbasically don't have any assets
and have you know minimalincome are eligible.
(21:23):
If you basically don't have anyassets and have you know
minimal income, then they willsubmit the application for you.
You don't need a lawyer forthat.
What you need the lawyer forand particularly a lawyer that
does Medicaid, which is there'svery few of those in this area
is making sure that we can getapproved for Medicaid without
having to spend down all of theassets.
And so that's what I recommendis that first check it out.
(21:46):
Once you think this is probablya good idea and that you should
do this, then come see us andwe will help you with the
financial part of it to get youfinancially eligible for
Medicaid.
Speaker 1 (21:56):
So for families who are listening right now, who
maybe have already applied forthe PACE program and were told
no or they were denied, whatshould they do?
Should they try again?
Speaker 2 (22:06):
Absolutely Come see us.
So a lot of times if it's afinancial eligibility issue, you
know, sometimes the people atPACE will say, hey, you know, go
see a lawyer.
Speaker 1 (22:15):
We know a guy.
Yeah, we know a guy.
Speaker 2 (22:18):
So come see us, we can help you out.
And you know, the other thingthat we always think about is OK
, maybe PACE isn't the answer,Maybe it's Veterans Benefits,
Maybe it's other Medicaidprograms, Maybe there's other
you know options for you.
We're certainly going to lookat PACE as one of the strong
options.
Speaker 1 (22:35):
So if you are listening today and you have
questions about Medicaid or youhave questions about the PACE
program, we strongly encourageyou to reach out to our team.
You can call us at1-800-990-6030.
You can also call us at ourlocal number, which is
810-694-9000.
You can even visit us on ourwebsite, which is
(22:58):
wwwmannerlawgroupcom, andthere's two N's in Manner
M-A-N-N-O-R-L-A-W groupcom, andwe'd love to answer those
questions for you.
Bob, is there anything that youjust feel is really important,
any lasting words about the PACEprogram that you just wish
people would know?
Speaker 2 (23:15):
I just wish that they would consider it more often.
You know, when I bring this upto families, sometimes when I
tell them that they aren't goingto be able to continue with
their doctor, they'll just say,oh, absolutely not.
And I think sometimes we haveto make hard decisions,
especially when there's dementiainvolved or things like that.
We've got to get the best carethat we can for our parents, for
our spouse, for our loved ones,and sometimes that means we
(23:38):
have to make hard decisions anddon't reject it out of hand just
because of one issue or anotherissue.
I think that we have to reallykind of look at the big picture.
Speaker 1 (23:46):
Yeah, absolutely, and in that case you could be
trading one doctor for a wholeteam of 11 or 12 specialists, so
I think that's a pretty goodtradeoff, in my opinion.
Well, bob, thank you so muchfor another informative episode
of Advice from your Advocates,and thank you to our listeners
for joining us.
I would love to talk to younext month when we're back again
on 103.9 the Fox, but if youdon't want to wait a whole
(24:09):
nother month to listen to us,you can find us wherever you get
your podcasts, so you canactually just look for Advice
From your Advocates.
We are on Apple Podcasts,spotify, literally anywhere you
get your podcasts, and you caneven watch videos on YouTube.
We interview guests from allover the country and actually
the world who are experts inleading the way in elder
(24:29):
advocacy and elder care, so wehope that you find us there, and
thanks again for listening.
Thanks for listening.
To learn more, visitManorLawGroupcom.
You're listening to Advice from your Advocates, a
show where we provide elder lawadvice to professionals who work
with the elderly and theirfamilies.
Speaker 2 (00:07):
Welcome to Advice from your Advocates.
I'm your host, Bob Manor.
I am a board-certified elderlaw attorney and certified
dementia practitioner.
Joining me, as always, is myco-host, Savannah Mexico, who is
also a certified dementiapractitioner.
Savannah, great to have youhere.
Speaker 1 (00:22):
Thanks, bob.
I'm happy to be here Now.
Today's topic is one that cantruly transform how families
approach elder care the PACEprogram in Michigan.
So, bob, for those who areunfamiliar with the PACE program
, can you explain that to us?
Speaker 2 (00:37):
Absolutely so.
This is something that it's allover the country.
We have the PACE program as anational program, but it's
really underutilized and underunknown.
So PACE, p-a-c-e what does thatstand for?
That stands for the Program forAll-Inclusive Care for the
(00:57):
Elderly.
Now, all right, just the namesounds encouraging right, yeah,
right.
Yeah, so it is a Medicare andMedicaid program.
So generally I mean you canprivate pay and it will be
supplemented by Medicare for theprogram.
But very few people are goingto probably private pay for this
PACE program.
It's generally going to be forfolks that can qualify for
(01:19):
Medicaid Now we have Medicareand Medicaid and it is generally
going to be folks that are overage 55 then qualify for
Medicaid Now we have Medicareand Medicaid and it is generally
going to be folks that are overage 55, then qualify for
Medicaid.
Now, what we do at Manor LawGroup is we help people figure
out how to qualify for Medicaidand still keep your money.
So if this is the first timeyou're listening, you might not
(01:40):
know that there's ways toqualify for Medicaid and not
lose all your money.
But if you've listened before,you probably should know that
that's an option.
Speaker 1 (01:47):
So, bob, how about we dive deeper into that financial
side of the PACE program?
Now we know that you have to be55 to qualify, but what other
markers are they looking for?
And really, how does Medicaidmake this program accessible for
families who really need thecare?
Speaker 2 (02:02):
Well, first of all, I'm a little bit upset about the
qualifications, because 2025,I'm going to be 55.
So I will qualify for PACEbased on the age ranking, and
that doesn't make me reallyhappy.
Speaker 1 (02:16):
We'll have fun reminding you of that every day.
Speaker 2 (02:18):
Exactly so okay, so right.
So you have to be at least 55.
That's just.
You know the starting point.
You can't qualify for this ifyou're under 55.
There are other Medicaidprograms that you can qualify
for if you're under 55, but PACEis not one of them.
So the program forall-inclusive care for the
elderly is.
We'll get into what you getfrom that.
(02:40):
But let's talk about thequalification process first, and
there is both an income and anasset limit for that.
Now, assets is where Manor LawGroup can come in and help you
out to make sure that we canprotect assets and still qualify
for PACE Income.
We can also potentially qualify, but that gets a little bit
(03:02):
stickier if you're over theincome limit.
It's an individual income limit, meaning it doesn't matter what
your spouse makes as income.
It matters what you make.
An income, and I want toclarify what I mean by income.
Income is going to be yourpension and your social security
, and that's it.
Any other income is somethingthat we can work with you on,
(03:23):
the law office can work with youon to protect, but the one
thing that is just what it is isyour pension and social
security.
Speaker 1 (03:31):
So for those families who do qualify and they need
help with care, what kinds ofthings can the PACE program help
with?
Speaker 2 (03:40):
So it is the program for all-inclusive care for the
elderly, right.
So it's all-inclusive care.
So it is partially designed tobe where you're staying in your
home.
And you know, I've been doingthis for almost 30 years now.
This is probably why I'mgetting to the age where I
qualify for PACE, but I've beendoing this for almost 30 years
now, and almost always I ask ifyou get to the point where you
(04:03):
need help, where you can'tprovide all the care, you're not
completely independent anymore.
You need help from other people.
Would you rather get that helpin your house or would you
rather move into someplace thatprovides that care?
And about 99% of the timepeople say I'd rather get care
in my home, right, and so thisis one of those programs that
(04:23):
can help with that.
It is designed to keep you inyour home.
Now they can.
If they feel like you're notsafe in your home, they're
probably not going to accept youinto that program, Right?
But if they feel like withfamily support and other support
that they can provide, they canprovide the necessary help for
you, then it creates an optionfor you to stay in your home,
(04:47):
get some home care options, butalso go to the PACE program.
You know PACE Center In GeneseeCounty.
Here we have a really reallynice PACE Center right next door
to the Flint Farmer's Market.
So if you've ever been to theFlint Farmer's Market I know
you've been there Savannah, ohyeah, it's just really nice.
And then right next door is thePACE program.
It used to be the InternationalCenter but it's a great
(05:11):
building.
So they've got a nice pavilion,they've got concerts there
sometimes.
It's just a really great placeand you can go there as part of
the PACE program and they willprovide you with sort of your
daycare and then they'llsupplement that with some home
care.
Speaker 1 (05:27):
So you and I actually had the opportunity to tour the
Pace Center together, and thiswas like years ago that I went
to this facility with you tojust to check it out, and I
still, to this day, just thinkabout how cool it was there.
There was so much to do.
Speaker 2 (05:42):
Right.
Speaker 1 (05:42):
Just the.
You know I'm going to soundlike a hippie, but the vibe I
loved the vibe there.
Just everyone was in such agood mood.
Everyone was so friendly.
The staff was just above andbeyond friendly and everyone
staff and PACE participant alikejust seemed happy to be there.
Speaker 2 (05:57):
Absolutely, and so that's one of the things that I
really like about PACE is that,you know, there's a lot of good
care centers, places thatprovide 24-hour care, and you
live there, but it can be verydifficult in those settings to
provide 24-hour care, andsometimes you walk in and it's a
little bit depressing, right, Imean, and even the best places,
(06:18):
there's going to be days whereyou know it's just not the most
upbeat place in the world tolive, and the Pace Center is.
Every time I've ever been there, I think you said the right
word vibe.
The vibe has been very positiveand one of the things I love
about this, you know.
I'll tell you this quick story.
We have a bunch of clients thatare part of, you know,
(06:38):
participate in this Pace program, and a lot of them have some
kind of memory issue, have somekind of dementia.
You know they're not, theydon't have complete connection
to the world around them.
However, they still have someskill sets, right.
So, and I remember there areone of our clients was a really
(06:59):
great seamstress.
She was just a really greatseamstress and could sew.
We have another client thatdoes crochet and both of them
teach classes.
They're participants in theprogram and they have a little
circle of people that they'llteach them seamstress and you
know sewing and they'll teachthem.
The other one teaches crochet,where they're actively
(07:19):
participating in helping theother people that are part of
the PACE program and make itinteresting and unique and fun.
That's just something you don'tsee very often.
Speaker 1 (07:28):
No, absolutely not, and just so meaningful for the
people that are learning thatnew skill, but also for our
client, who got to share thatand make connections in that way
.
That's really cool.
I hadn't heard that story yet,but I love that.
Speaker 2 (07:40):
It's, you know, and it does give meaning.
You know we've had this in anynumber of settings where
somebody who's not really fullyunderstanding their surroundings
and that they often there'sbeen multiple clients that we've
had that they go to the settingand they feel like they're
going to work, which is great.
I mean.
I know you and I sometimesprobably show up on Monday
(08:01):
morning and we're like, oh, it'sMonday morning and I want to go
to work.
But work provides meaning,right, Work provides purpose in
life and to have that forsomebody who might be 85 years
old with memory issues, and thatyou're giving them some meaning
, you're giving them somepurpose, that really improves
the quality of life of theperson and the people around
(08:21):
them.
Speaker 1 (08:22):
Absolutely.
So we talked about how, ifsomeone feels like they might be
interested in the PACE program,they're 55, they need long-term
care, but they're not quiteready for you know skilled
nursing care or anything likethat yet and they think this
might be for me, you know howcan they go about that.
Speaker 2 (08:39):
All right.
So let's break that down.
That's really a great questionbecause we've got to say, okay,
how does this fit in?
So let's talk about the medicalrequirement, because it is a
Medicaid program, so you've gotto meet a medical eligibility
and with Medicaid, they havethese eight categories or
(09:02):
classifications.
They call them DOORS, d-o-o-r-sDOORS.
It's kind of weird that theycall them DOORS, but they're
basically categories and you'vegot to be eligible based on one
of those DOORS or categories,one of those eight DOORS or
categories.
In my experience, these DOORS orcategories to be medically
(09:22):
eligible is very subjective,meaning that whoever is making
that determination can be verystrict about it or be a little
bit less strict about it.
And in my experience, the folksthat you know are eligible for
PACE are probably going to be onthe lower end of the scale of
whether they're medicallyeligible.
(09:43):
You know they don't.
They're not bed bound, they'renot going to be where they need
somebody to.
You know, lift them out oftheir bed, or two people to lift
them out of their bed, to putthem into a chair.
That's not appropriate for PACE, right?
And so what I'm getting at isthe PACE folks that make this
determination are probably goingto be a little bit more lenient
(10:04):
in whether or not you aremedically eligible.
But that's the first requirement.
It can't just be hey, thissounds like fun, let's do that.
No, that's, you know.
Go visit your senior centerbecause they have some stuff at
your local senior center thatcan keep you entertained.
But if you're not medicallyeligible, then you know you're
not medically eligible.
So there is a medical part ofthat.
(10:25):
But you know, one of themedical eligibility things would
be dementia, like memory issues, right?
So if you're listening and youhave a mom or dad that has, is
you know.
So if you're listening and youhave a mom or dad that has, you
know, short-term memory loss,frequently asking the same
question over and over again,they might be eligible medically
at least for this PACE program.
So that's the first requirement.
(10:47):
You have to have a medicaleligibility.
The second requirement is we'vegot to be, you know we got to
get eligible for Medicaid and sofortunately, the folks over at
Pace will sometimes, you know,they'll say, well, I don't see
that you're eligible financiallyright now, but you know, maybe
go see one of these lawyers thatwe work with and so that's what
(11:09):
we can help people with.
So if you think, oh, I'll neverqualify for Medicaid.
Well, that's probably wrong.
You probably could qualify forMedicaid under the right
circumstances, regardless ofyour income or assets.
There's different strategies ortechniques that we have that
could get you eligible.
So I say Medicaid versusMedicare, which, if you're over
(11:29):
65, you probably already haveMedicare, and what our law
office does is we can help youqualify for Medicaid and that
would help you get eligible forPACE program.
Speaker 1 (11:40):
That's awesome and that must be such a huge relief
for families who just feel stuckbetween not qualifying for
Medicaid but also not being ableto afford the private care that
they need at home.
Speaker 2 (11:51):
That can be very difficult With PACE.
There is a income limit andthere's not a whole lot I can do
about the income limit, so it'sabout $2,900 a month.
If you individually not as amarried couple, but you
individually your gross incomemeaning your social security
before deductions, your pensionbefore deductions more than 20,
(12:15):
about $2,900 a month, you aren'tgoing to be eligible for this
particular program.
You can be eligible for otherMedicaid programs, but not this
PACE program.
And now you know that's notgreat.
I'd love to change that ruleand we actually are working
aggressively on changing thatrule.
So stay tuned to see if thatmight change next year or three
(12:38):
years from now or whatever,because several other states
have figured out a workaround sothat we're not disqualifying
people from the PACE programsimply because they get a GM
pension or something like that.
Speaker 1 (12:49):
Yeah, that's incredibly important.
Now, if you're just tuning in,today you are listening to
advice from your advocates andtoday we are talking about the
PACE program, or the Program ofAll-Inclusive Care for the
Elderly.
Now, bob, beyond the financialrelief of the PACE program,
there are a lot of benefits tobelonging to the program and
going to the center.
You know it's like youmentioned a little bit.
(13:11):
It's not just a communitycenter, it's not a senior center
, there's actually a medicalcomponent to that.
Can you tell us a little bitabout what PACE covers?
Speaker 2 (13:20):
Yeah, perfect.
So that's a great question andthat's sort of the two-sided
coin right.
Part of it is really great andpart of it is something that
some people won't be thrilledabout, and that is that once
you're on PACE, once you acceptthe PACE program, you have to
use the PACE doctors, you haveto use the PACE specialists.
That's what the program is.
(13:41):
It's all-inclusive care,meaning that you are likely not
going to continue with yourexisting doctor.
I really want people to take abreath and not discount that
they shouldn't consider thisoption simply because they'd
have to work with a differentdoctor.
I fully understand howimportant it is to have that
(14:02):
trust and faith in your doctorand you know the people that,
the professionals that you use.
But it is one of those thingswhere you're going to get all of
your medical help physicaltherapy, occupational therapy,
speech therapy, exercise, youknow therapy all of those things
would happen through the PACECenter and the point of it is
(14:25):
that's kind of what is necessaryto make it all inclusive, and
my experience dealing with themedical industry is that it's
really important that thedifferent doctors, the different
medical professionals allreally work very close together,
very hand in hand, to try tosolve the problem.
And if they're all like littleislands where you have your home
(14:47):
, you know, you have yourpersonal doctor or your family
doctor, and then you have thecardiologist, and then you have
the oncologist or whatever it is, they're probably not
communicating, they're probablynot, all you know, coming up
with a plan of care.
Unfortunately, that's just theway the healthcare industry
works.
With PACE they are.
(15:08):
They're coordinating all of ittogether and so, yes, you might
be giving up your existingdoctor to participate in the
PACE program, but the advantageof it is they come up with a
plan of care.
They've got 11 differentspecialties that they put as
part of your plan of care team,including making sure that you
have the proper transportation,so you don't have to get back
(15:29):
and forth to the PACE center.
They will pick you up.
And when I say they pick you up, that doesn't mean they get to
your driveway and honk the horn.
They're supposed to come intoyour house, get you situated,
help you out, get you into thevan, drive you to the Pace
Center, get you inside the PaceCenter, get by them, but then
there's going to be a doctor, asocial worker, a nurse, you know
(15:59):
, a physical therapist One ofthe things about PACE that I
really really like is that youdon't have to rely on your
insurance company to decide howmuch care you get or how much
physical therapy you get or howmuch occupational therapy you
get.
So they've got the caregiversthere.
You could continue physicaltherapy for years, whereas under
(16:20):
Medicare and Blue Cross orwhatever insurance, they're
probably going to cut that offafter about seven weeks.
With PACE, you might meet withyour physical therapist for
multiple years and there's nocutoff because it's part of that
all-inclusive care program.
Speaker 1 (16:36):
And that's just amazing and I remember during
our tour they talked about itwas just an interdisciplinary
team and they all work together.
And one of the things thatstuck out to me, you mentioned
the driver.
Even the driver they consider apart of that interdisciplinary
team and I just thought thatthat was so cool.
It really is all-inclusive care.
Speaker 2 (17:00):
Yeah, and I really do like so we're.
You know we're broadcastinghere in Genesee County and
there's PACE programs all overthe country and all over
Michigan.
But I really do appreciate theGenesee County PACE program
which is through.
I guess it's Henry Ford now,but it's the you know the
Genesis PACE through.
I guess Henry Ford took overthat.
But yeah, I think they do agreat job.
I really do.
I think that they havecontracts with different
(17:25):
assisted livings, they havecontracts with different doctors
and things like that, and I dothink that they make really good
decisions.
Sometimes I think people worryabout if you get on one of these
programs, you're going to getthe lowest quality, you're going
to get the least doctor.
Speaker 1 (17:42):
I don't feel like that's the issue with Pace at
all.
No, I completely disagree withthat myth, especially after just
doing the tour.
I mean just that in itself andI think they're really cool and
we'll talk about this in aminute.
But if you're interested inPace, they're really open about
stuff like that.
They want you to call, theywant to talk to you and answer
your questions.
Speaker 2 (18:01):
One thing I want to point out and you ask about.
You know what are the benefitsof PACE?
They're probably not going toadmit you to the program, and I
know that this isn't 100% true,because I've seen some examples
where they were able to do aplacement in a memory care from
the very beginning, in a memorycare from the very beginning.
(18:24):
But for the most part, we wantto start PACE before it gets to
the point where you can't liveat home anymore or you can't
live with your daughter anymore.
That is the better situation.
And if it advances to the pointwhere that you can't stay home
or you can't stay with yourdaughter, it's just too much of
a burden.
Pace will cover that cost.
Now, at that point, the onething I want to point out about
PACE is that there's actually nocost to it.
(18:45):
There's no copay.
You get eligible and it's $0.
Now if PACE decides, if thatteam of 11, your specialty comes
up with a plan of care and theysay, well, you know, it's
really not safe for you to behome anymore, or it's really not
safe for you to live with yourdaughter anymore because she
works, you know, 40 hours a weekor whatever it is, then they
(19:07):
will provide placement and theplacement places that they've
chosen for placement they havecontracts with, I think are good
places I would independentlyrecommend outside of PACE and so
.
But typically they're not goingto and there's exceptions to
this rule but typically they'renot going to and there's
exceptions to this rule, buttypically they're not going to
want to accept you into the PACEprogram if you already need to
(19:29):
be admitted into memory care orassisted living.
If you are admitted into memorycare, assisted living as part of
the PACE program, you could besubject to a copay based on your
income.
But that's OK.
Yeah, absolutely.
You know, if these places cost$6,000 or $7,000 a month and the
biggest obligation you wouldhave is based on your Social
Security check, that's fair,right and so there's no cost to
(19:53):
it if you're living at home orliving with your daughter or son
or whatever.
But there could be a copaybased on the fact that you are
placed now in a living settingand the maximum copay would be
based on the fact that you areplaced now in a living setting
and the maximum copay would bebased on your monthly income.
Speaker 1 (20:07):
So the point there, I think, is don't wait.
Speaker 2 (20:09):
Exactly, don't wait.
Speaker 1 (20:10):
So, before we wrap up today, bob, what advice do you
have for families who areexploring the PACE program but
might feel intimidated by thewhole Medicaid process?
Speaker 2 (20:21):
Yeah, absolutely.
That's a great, great, greatquestion.
So the first thing is check itout.
Go and visit.
You know I've visited Pace manytimes, often where it's a
scheduled thing and I'm meetingwith people.
But I've also just stopped byand my experience has been the
same both when they knew I wascoming and when they didn't know
I was coming.
I've got the same vibe as faras the quality of care that
(20:43):
they're providing.
But that's the first thingCheck it out, because you know,
whenever I'm talking to a clientabout this, maybe they knew
about PACE.
A lot of times they didn't knowabout PACE.
I never have them commit to theprocess in my office before
they go and at least you know,get the tour.
Speaker 1 (21:02):
That's smart.
Speaker 2 (21:03):
Yeah, exactly, we need to have them check it out,
make sure they're comfortablewith it, and then the next step
is, if it appears that you'renot financially eligible, come
see us at Manor Law Group.
And what we do is we work veryclosely with PACE we will you
know if you are eligible, if youbasically don't have any assets
and have you know minimalincome are eligible.
(21:23):
If you basically don't have anyassets and have you know
minimal income, then they willsubmit the application for you.
You don't need a lawyer forthat.
What you need the lawyer forand particularly a lawyer that
does Medicaid, which is there'svery few of those in this area
is making sure that we can getapproved for Medicaid without
having to spend down all of theassets.
And so that's what I recommendis that first check it out.
(21:46):
Once you think this is probablya good idea and that you should
do this, then come see us andwe will help you with the
financial part of it to get youfinancially eligible for
Medicaid.
Speaker 1 (21:56):
So for families who are listening right now, who
maybe have already applied forthe PACE program and were told
no or they were denied, whatshould they do?
Should they try again?
Speaker 2 (22:06):
Absolutely Come see us.
So a lot of times if it's afinancial eligibility issue, you
know, sometimes the people atPACE will say, hey, you know, go
see a lawyer.
Speaker 1 (22:15):
We know a guy.
Yeah, we know a guy.
Speaker 2 (22:18):
So come see us, we can help you out.
And you know, the other thingthat we always think about is OK
, maybe PACE isn't the answer,Maybe it's Veterans Benefits,
Maybe it's other Medicaidprograms, Maybe there's other
you know options for you.
We're certainly going to lookat PACE as one of the strong
options.
Speaker 1 (22:35):
So if you are listening today and you have
questions about Medicaid or youhave questions about the PACE
program, we strongly encourageyou to reach out to our team.
You can call us at1-800-990-6030.
You can also call us at ourlocal number, which is
810-694-9000.
You can even visit us on ourwebsite, which is
(22:58):
wwwmannerlawgroupcom, andthere's two N's in Manner
M-A-N-N-O-R-L-A-W groupcom, andwe'd love to answer those
questions for you.
Bob, is there anything that youjust feel is really important,
any lasting words about the PACEprogram that you just wish
people would know?
Speaker 2 (23:15):
I just wish that they would consider it more often.
You know, when I bring this upto families, sometimes when I
tell them that they aren't goingto be able to continue with
their doctor, they'll just say,oh, absolutely not.
And I think sometimes we haveto make hard decisions,
especially when there's dementiainvolved or things like that.
We've got to get the best carethat we can for our parents, for
our spouse, for our loved ones,and sometimes that means we
(23:38):
have to make hard decisions anddon't reject it out of hand just
because of one issue or anotherissue.
I think that we have to reallykind of look at the big picture.
Speaker 1 (23:46):
Yeah, absolutely, and in that case you could be
trading one doctor for a wholeteam of 11 or 12 specialists, so
I think that's a pretty goodtradeoff, in my opinion.
Well, bob, thank you so muchfor another informative episode
of Advice from your Advocates,and thank you to our listeners
for joining us.
I would love to talk to younext month when we're back again
on 103.9 the Fox, but if youdon't want to wait a whole
(24:09):
nother month to listen to us,you can find us wherever you get
your podcasts, so you canactually just look for Advice
From your Advocates.
We are on Apple Podcasts,spotify, literally anywhere you
get your podcasts, and you caneven watch videos on YouTube.
We interview guests from allover the country and actually
the world who are experts inleading the way in elder
(24:29):
advocacy and elder care, so wehope that you find us there, and
thanks again for listening.
Thanks for listening.
To learn more, visitManorLawGroupcom.
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