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Randolph Health StayWell Senior Care accepts Medicaid, Medicare or private payment for care. If a person does not qualify for Medicare, a monthly premium will be charged to cover services. There is no out-of-pocket cost for Medicaid-eligible participants. If the individual wants Medicaid to assist with coverage, the Department of Social Services determines the cost during the Medicaid application process. Other insurance plans are contracted on a case by case basis. Enrolling in another plan will cancel PACE enrollment. Coverage is determined by the insurer. Once an individual is enrolled, StayWell becomes the primary care provider and covers all healthcare services. Participants with Medicaid and Medicare may receive services at no cost if dually eligible for Medicaid and Medicare. With the exception of life threatening emergency services, all services delivered must be approved in advance by StayWell. Participants may be charged for the full cost of services from an out-of-network provider or for services received that are not approved by StayWell in advance.

Who Pays for PACE?

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