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More Prescription Drug Plan Choices for Medicare-Only PACE Participants

New rules allow individuals in the PACE program who only have Medicare, not Medicaid, to choose a prescription drug plan outside of their PACE program. This aims to provide more flexibility in selecting prescription drug coverage.
Key points
Individuals in the PACE (Program All-Inclusive Care for the Elderly) program with only Medicare can choose a prescription drug plan outside of their PACE program.
The chosen drug plan must meet specific conditions regarding out-of-pocket costs and federal subsidies.
PACE programs will be required to inform participants about this option and assist with plan selection.
PACE programs will monitor drug utilization for participants who choose an outside plan to coordinate care.
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Additional Information
Print number: 117_S_5106
Sponsor: Sen. Carper, Thomas R. [D-DE]
Process start date: 2022-11-16