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ENROLLMENT

General Content

Learn How to Enroll

Our ElderONE intake team is dedicated to helping prospective participants and their families determine their eligibility and guide them through the enrollment process.


Eligibility Requirements:

To be eligible for ElderONE, individuals must:

  • Be 55 years of age or older
  • Need community-based, long-term care for more than 120 days
  • Be able to live safely in the community with ElderONE assistance
  • Have Medicaid or be Medicaid eligible (unless paying privately)

If you are a Medicaid beneficiary (or are pending Medicaid) and wish to enroll in ElderONE, you must first contact Maximus to complete the Conflict-Free Evaluation And Enrollment Center (CFEEC) requirement on their toll-free number, 855-222-8350 to arrange for an evaluation.

CFEEC is a program of New York State Medicaid which determines your eligibility to join a Managed Long Term Care Plan (MLTC).


Participation Requirements:

ElderONE participants must agree to:

  • Receive all of their health care from ElderONE health care providers, other than emergency care
  • Pay for the costs of unauthorized or out-of-ElderONE program agreement services, other than emergency services

Participants may leave the program at any time.


Frequently Asked Questions:

  • How much does ElderONE care cost?

What you pay for ElderONE services depends on your eligibility under Medicare or Medicaid.

ElderONE services are financed by combined Medicare and Medicaid prospective capitation payments, and, in some instances, through a monthly cost share.

If you are eligible for Medicaid, or dually eligible for both Medicare and Medicaid, you won’t have a monthly premium for ElderONE services.

If you don’t qualify for Medicaid, but you have Medicare, you’ll be charged a monthly premium for ElderONE services; however, there are no deductibles or copayments for any drug, service, or care approved by your ElderONE health care team.

If you do not qualify for Medicare or Medicaid, you may receive ElderONE services through private pay.

  • What if I am not currently enrolled in Medicare or Medicaid?

If you are not currently enrolled in Medicaid, a financial assessment to help determine eligibility is completed; the potential participant will need to provide a summary of income and assets for this assessment. If the decision is made to apply for Medicaid, a list of documents needed for that process will be provided and an ElderONE social worker will help with the process.

  • What types of benefits do I receive?

The benefit package for all PACE participants includes: Primary Care, Hospital Care, Medical Specialty Services, Prescription Drugs (including Medicare Part D drugs), Nursing Home Services, Nursing Services, Personal Care Services, Emergency Services, Home Care, Physical Therapy, Occupational Therapy, Adult Day Health Care, Recreational Therapy, Meals, Dental Care, Nutritional Counseling, Social Services, Laboratory/X-Ray, Social Work Counseling, End of Life Care and Transportation.

  • How do I know if I am eligible for ElderONE?

The state and federal governments have set eligibility and enrollment criteria.

Once deemed eligible through the CFEEC, our ElderONE staff assesses the potential participant to ensure that he or she can be adequately cared for in a community setting. This involves an assessment of the individual’s care support network as well as the individual’s health condition to determine whether or not his or her health or safety would be jeopardized by living in a community setting.

  • Can I keep my primary care doctor?

Since our care is coordinated amongst our interdisciplinary team, participants that choose to enroll in ElderONE agree to forgo their usual sources of care and receive all their services through the ElderONE program. However, in some cases, your current primary care physician may continue to work with our ElderONE health care providers.

Please be assured that our ElderONE physicians are board-certified physicians who specialize in geriatric care. Our team of doctors focus solely on ElderONE participants.

  • Who may benefit from ElderONE?

The following are situations that may indicate a need for, or benefit from, enrollment in the ElderONE program:

  • In need of comprehensive care coordinated by a dedicated team of care professionals
  • Fragmented support services
  • Recent hospitalization due to illness or injury that has resulted in decreased functional ability
  • History of multiple or frequent emergency room visits, hospital admissions, or short-term nursing home stays
  • Frequent falls
  • Forgetting medications
  • Social isolation
  • Caregiver burnout
  • Wants to live at home but requires support of others to do so
  • Involved in an adult daycare program but frequently misses attendance due to medical frailty or inability to use or pay for transportation
  • How much aide service does a participant receive?

The number of days you attend the ElderONE PACE Center, amount of home care services and rehab services you receive are determined through your ElderONE team assessment. Each participant has a plan tailored to their specific needs. An individualized care plan is developed by the team and presented to you prior to enrollment.

  • Is a participant required to attend the Day Center?

While encouraged, it is not a requirement to attend the ElderONE PACE Center from week to week. Attendance is based on participant needs. However, regularly scheduled doctor appointments and therapy occur out of our ElderONE PACE Center facilities.

  • What hospital do you contract with for care?

Rochester General Hospital, Unity Hospital, Newark-Wayne Community Hospital, Clifton Springs Hospital

 

Interested in Learning More About ElderONE?

Contact Us

Phone: 585-922-2831
Toll-Free: 855-457-4636
Toll-Free TTY: 800-662-1220

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Enrollment Process
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(585) 922-2831

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Our Doctors

A comprehensive list of our healthcare professionals

As members of the interdisciplinary teams, our geriatricians take an integrated approach to care that allows seniors to maintain their independence for as long as possible. ElderONE provides extraordinary opportunities for people who would otherwise require long-term nursing home care.

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Our Services

Access to services made easy

Our ElderONE team works with seniors and their caregivers to arrange for and monitor all of their medical, social and daily living support services. When you enter the program, our interdisciplinary care team will develop your individualized care plan. We will carefully select the services you need to help you maintain your independence, dignity, and quality of life.

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ElderONE PACE Centers

Our centers are vibrant and active

We offer individual projects as well as small and large group activity programs. You'll find programs that are culturally diverse and that offer opportunities to pursue your interests while becoming part of the ElderONE community.

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