CMS Pub. 100-11, ch. 3, § 20

Materials

42 CFR 460.82(a)(1)

20.1 PACE Program Information

The following information must be included in marketing materials provided

to prospective participants, prior to an enrollment decision:

• An adequate description of the PO’s enrollment and disenrollment

policies and requirements;

• PACE enrollment procedures;

Note: Additional information on enrollment and disenrollment is

available in the PACE Manual at http://www.cms.gov/Regulations-and-

Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-

Items/CMS019036.html

• Description of benefits and services;

Programs of All-Inclusive Care for the

Elderly (PACE)

Chapter 3 – Marketing Guidelines

Rev. 5, Issued: 10/2/2018

• Premiums; e.g.,

• 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'll

be charged a monthly premium for PACE.

• There's no deductible or copayment for any drug, service, or

care approved by your health care team.

• If you don't have Medicare or Medicaid, you can pay for PACE

privately.

• Other information necessary for prospective participants to make an

informed decision about enrollment.

Note: POs do not have to include all of the information outlined in

section 20 in all marketing materials; rather the PO must ensure that

the aggregate of materials received by a prospective participant

contains the required information.