The Horizon PACE philosophy is centered on the belief that it is better for frail individuals and their families to be served in the community whenever possible, allowing patients to remain in their home and in control of their lives.
PACE programs coordinate and provide all needed preventive, primary, acute and long-term care services so that their participants can continue living in the community.
The result is higher quality of care and better results compared to traditional care options.
Participants
The average participant is 76 years old and has multiple, complex medical conditions, cognitive and/or functional impairments, and significant health and long-term care needs. However, people as young as 55 may be eligible.
Approximately 90 percent are dually eligible for Medicare and Medicaid.
Participants must live in a Horizon PACE service area and be able to live safely in the community with PACE services at the time of enrollment. See more on eligibility.
Team Approach
The PACE team is made up of doctors, nurse practitioners, nurses, social workers, health aides, transportation staff, physical therapists, occupational therapists, dietitians, speech therapists and others who meet regularly to exchange information and solve problems as the conditions and needs of PACE participants change.
Upon enrollment in Horizon PACE, participants and their caregivers meet with that team. Their needs are assessed, and an individualized care plan is developed to respond to all of the participant’s needs – 24 hours a day, seven days a week, 365 days a year.
Services are primarily provided in the Horizon PACE Center but may also be provided in the participant’s home or within the Horizon PACE community network.
In the home, PACE offers skilled care, personal care supportive services, and tools and materials such as ramps and grab bars to improve safety.In the community, PACE offers access to specialists and other providers.
Cost of PACE Services
What you pay for PACE depends on your eligibility under Medicare and Medicaid. If you are eligible for Medicaid, or dually eligible for both Medicare and Medicaid, you won’t pay a monthly premium for PACE. If you don’t qualify for Medicaid, but you have Medicare, you will be charged a monthly premium for PACE. There is no deductible or copayment for any drug, services or care approved by your health care team. If you don’t have Medicare or Medicaid, you can pay for PACE privately.
Grievance
It is important to us at Horizon PACE that you are satisfied with your services and the quality of care you receive. If you have any concerns we encourage you to share those by filing a grievance. A grievance is defined as a complaint, either written or oral, expressing dissatisfaction with the services provided or the quality of your care that is provided by Horizon PACE. You have the right to file a grievance about any concerns.
You may file a grievance with any PACE staff member at any time, either verbally or in writing. You may mail or fax your written grievance to the PACE site. In addition, you may also contact us to discuss the status of your grievance.
Appeal
You may file an appeal if PACE refuses to provide or pay for a service that you feel is necessary, or if your PACE team denies a request for a service or payment, or reduces, or stops a service you have been receiving. If you would like to file an appeal, Horizon PACE staff can help you complete this process. You may request help from any staff member directly or you can contact the PACE center.
Appointment of a representative: If you need someone to file a complaint or appeal for you, you may appoint a representative by completing the following form: CMS-1696. This document allows you to name someone to make decisions for you. (Clicking on the form will take you to the CMS website).
PACE Centers
The PACE Center includes a health clinic with an on-site physician and/or nurse practitioner, nursing services, physical and occupational therapy facilities, and at least one common room for social and recreational activities. The PACE centers are located in Bowling Green, Monticello and Richmond, and serve 11 counties as specified below:
Horizon PACE Bowling Green (serves Barren and Warren counties)
1110 Wilkinson Trace, Bowling Green, KY 42103
Phone: (877) 676-8581
Fax: (270) 599-0703
TTY: (270) 599-0780
Horizon PACE Monticello (serves Clinton, Laurel, McCreary, Pulaski, and Wayne counties)
939 W Columbia Ave, Monticello, KY 42633
Phone: (877) 249-8545
Fax: (606) 348-0114
TTY: (606) 348-7160
Horizon PACE Richmond (serves Estill, Jackson, Madison, and Rockcastle counties)
5008 Atwood Dr Suite 1, Richmond, KY 40475
Phone: (877) 676-8583
Fax: (859) 575-4118
TTY: (859) 353-8287
Translation services are available.
(Last modified November 7, 2022)