Eligibility Requirements
Prospective participants must meet the following criteria to be eligible to participate in the PACE Program:
- 55+ years of age;
- State certified as needing nursing home care;
- Living within the service area of Bienvivir (please see the Service Area Map); and
- Can safely live within the community.
Bienvivir assists applicants with the application process, but approval of application and enrollment are determined by the State of Texas. If you’d like to learn more about eligibility or want to start the enrollment process, please fill out this form or call the Intake Department at (915) 562-3444 ext. 1442.
The PACE Enrollment Process
Enrollment in the PACE Program is voluntary and the application is free. Below is an overview of the enrollment process.
Interested participant requests enrollment information and assistance.
Bienvivir sends a nurse to the applicant’s home to provide additional information, answer questions and verify eligibility. The applicant and family are invited to visit the nearest Bienvivir day health center for a tour.
If eligible, the application process includes a physical evaluation, medical history and financial evaluation.
The application is submitted to the State for approval. On average, the state may take 30-60 days to make a decision.
If approved, Bienvivir will work with the participant and his/her family to enroll the participant into the PACE Program.
Cost of the PACE Program
It is free to submit an enrollment application for the PACE program. The services provided by Bienvivir and the PACE Program are fully covered by Medicare and Medicaid. There are no copays or out-of-pocket expenses for participants who are eligible for both Medicare and Medicaid. A participant is required to pay a premium if:
- He/she is not eligible for Medicaid.
- He/she is not eligible for Medicare and Medicaid; the participant will pay a premium equal to the Medicare and Medicaid premium.
All healthcare services needed by the participant, and approved by the Interdisciplinary Team are covered by the PACE Program. Participants are responsible for the cost of unauthorized, out-of-program services. Bienvivir offers participants Medicare Part D coverage for prescription medication.
Participants who enroll in a separate Medicare Advantage Plan will become ineligible for continued enrollment in Bienvivir.
Am I Eligible?
If you’re interested in the services offered by Bienvivir, please take the following survey to determine if you meet the PACE Program eligibility requirements.
