PACE and PACENET are a Pennsylvania funded and run program that helps Medicare eligible beneficiaries save money on their prescription drug costs. PACE stands for Pharmaceutical Assistance Contract for the Elderly while PACENET stands for PACE Needs Enhancement Tier. These programs are run by Pennsylvania’s Department of Aging.

In order to qualify for PACE, you need to meet the following eligibility requirements:

• You must be 65 years of age or older.
• A Pennsylvania resident for at least 90 days prior to the date of application.
• You cannot be enrolled in the Department of Human Service’s Medicaid prescription benefit.
• For a single person, total income must be $14,500 or less.
• For a married couple, combined total income must be $17,700 or less.

In order to qualify for PACENET, you need to meet the following eligibility requirements:

• You must be 65 years of age or older.
• A Pennsylvania resident for at least 90 days prior to the date of application.
• You cannot be enrolled in the Department of Human Service’s Medicaid prescription benefit.
• PACENET income limits are slightly higher than those for PACE
• For a single person, total income can be between $14,500 and $27,500
• For a married couple, combined total income can be between $17,700 and $35,500

HOW PACE/PACENET WORKS WITH MEDICARE

PACE/PACENET is designed to help people that are 65 or older to qualify for pharmaceutical assistance. Unlike most state pharmaceutical programs, PA does not require the person to be enrolled into a Medicare Part D plan. PACENET members are encouraged to sign-up for a Part D plan as they will incur a $37.03 premium at the pharmacy each month if they do not have one. The generic copayments for PACE beneficiaries are $6 and $9 for brand name drugs. The beneficiaries for PACENET will have a $8 copayment for generic and $15 for brand name drugs.

Beneficiaries that are enrolled into the PACE/PACENET program are granted a one-time special election period (SEP) outside of the annual election period (AEP) or open enrollment period (OEP)during that year. This gives agents another opportunity to help get these beneficiaries into another plan that may best suit their needs. Pinnacle Financial Services has plenty of lead opportunities for this market which makes them an excellent lead source throughout the year.

How to Enroll in PACE/PACENET