In Their Own Words
Linda and Tom’s Story:
Linda discovered PACE when considering long-term care options for her husband, Tom, who is covered by Medicare and living with early-onset Alzheimer’s. She was drawn to PACE’s personalized and coordinated model that would meet her husband’s needs and support her as a caregiver. It felt like a perfect fit for their family.
But Linda hasn’t enrolled Tom in the program because the PACE Medicare Part D penalty would raise his prescription drug premium from $11 a month to $800. Eager to connect her husband with the care he needs, Linda is frustrated that the financial penalty—which would mean an extra $9,500 a year for Tom’s prescriptions—makes PACE care unaffordable.
If Congress passes the PACE Part D Choice Act, Tom could keep his current, less-expensive Part D plan and afford to enroll in PACE.
Eleanor’s Story:
Eleanor wanted to return home as soon as possible after a fall that caused a dislocated shoulder, followed by a hospital stay and five-week rehabilitation. Fortunately, her children could ensure she received all necessary medical and long-term services and support at home and in her community by enrolling her in the local PACE program. Eleanor’s care includes two daily home visits from health care aides, physical therapy, occupational therapy, and other supports.
Unfortunately, Eleanor’s prescription drug coverage costs her nearly $13,000 a year because of the PACE Part D penalty, making it stressful to focus on her health and recovery. The PACE-provided care she receives helps her regain the independence she had before her accident, such as going to her weekly bridge games on her own. But managing the costly Part D premiums continues to hold her back and limits her spending on what could help improve her overall quality of life.
If Congress passes the PACE Part D Choice Act, Eleanor can enroll in a less expensive Medicare Part D drug plan, saving her money and giving her peace of mind to focus on the care she needs to thrive.
Names have been changed for privacy.
