AllCARE for Seniors is a Program of All-Inclusive Care for the Elderly

PACE is a program of the Commonwealth of Virginia, the Federal Government & Appalachian Agency for Senior Citizens (AASC)

Serving the Counties of Buchanan, Dickenson, Russell, and Tazewell of Virginia

AllCARE for Seniors provides all normally covered Medicaid and Medicare services as well as additional services if needed.

Following are lists of examples of services AllCARE for Seniors provides:

  • Outpatient Health Services

    • Adult Day Care
    • Physician, clinic, and specialist services, which may include advanced practice nurses. Female participants are entitled to choose a qualified specialist for women's health services from an AllCARE for Seniors provider network to furnish routine and preventive care. Specialty services may include:
      • Anesthesiology
      • Audiology
      • Behavioral Health services/mental health and substance abuse services including community psychiatric rehabilitation services
      • Cardiology
      • Dermatology
      • Gastroenterology
      • Gynecology
      • Internal Medicine
      • Nephrology
      • Neurosurgery
      • Oncology
      • Ophthalmology
      • Oral Surgery
      • Orthopedic Surgery
      • Otorhinolaryngology(Ear, Nose and Throat)
      • Plastic Surgery
      • Pulmonary Disease
      • Radiology
      • Rheumatology
      • General Surgery and Ambulatory Surgery
      • Thoracic and Vascular Surgery
      • Urology
    • Nursing Care
    • Medical Social Services
    • Physical, Occupational and Speech Therapy
    • Podiatry
    • Help for you and your family on how to choose and cook healthy foods
    • Laboratory tests, X-rays and other tests used to find out what health problems you may have.
    • Prescribed drugs and medicines. You must get these through the AllCARE for Seniors Center. Most local pharmacies do participate with our prescription drug card SeniorScript.
    • Durable Medical Equipment (such as artificial limbs, hospital beds, wheelchairs, and walkers).
    • Vision care (examinations and treatment including eyeglasses).
    • Psychiatric Care including evaluation, consultation, diagnosis, and treatment.
    • Hearing Services, including evaluation, hearing devices, repairs and maintenance.
  • Hospital Inpatient Care

    • Semi-private room and meals.
    • General Medical and Nursing Services.
    • Medical/Surgical, Intensive Care, Coronary Care units, as necessary.
    • Laboratory tests, X-rays, and other necessary tests.
    • Prescribed drugs and medicines.
    • Blood and blood parts such as plasma.
    • Surgical care including use of medicine that puts you to sleep during surgery.
    • Use of oxygen.
    • Physical, Speech, Occupational and Respiratory Therapies.
    • Medical Social Services.
    • Emergency and Urgent Care.
    • Ambulance Service.
    • Treatment Room Services.

    Not included under hospital care are private room and private duty nurse charges, unless your Interdisciplinary Team feels it is necessary for your condition. Also not included are non-medical items such as telephone charges, unless the Interdisciplinary Team feels they are medically necessary.

  • Long-Term Care Facility

    • Semi-private room and meals.
    • Doctor and nursing services.
    • Custodial care.
    • Personal care and assistance.
    • Prescribed drugs and medicines.
    • Physical, Speech and Occupational Therapies.
    • Social Work Services.
    • Medical supplies and appliances.
  • Home Health Care

    • Skilled nursing services.
    • Doctor's visits.
    • Physical, Speech and/or Occupational Therapies.
    • Social Work Services.
    • Home Health Aide services.
    • Homemaker/Chore services.
    • Home delivered meals.
    • Respite Care.
  • End of Life Care

    End of Life services will be coordinated between the participant and their family/caregiver and the AllCARE for Seniors Interdisciplinary Team. End of Life services may include any combination of care in the hospital, care in a nursing facility and/or care at home.

  • Health-Related Services

    Health related services include transportation, homemaker/chore services, home delivered meals, help in getting around your community, and help in handling your money and paying your bills. Health related services will be coordinated and provided based on your plan of care.

  • Dental Care

    Dental care will be given to you according to your needs. Your Interdisciplinary Team will approve of the dentist who will care for your teeth and gums and will schedule any necessary appointments.

    Dental services may include:

    • Diagnostic services - examinations and tests, or X-rays, to see what your needs are.
    • Preventive services - cleaning and instructions in keeping your teeth and gums as healthy as possible.
    • Restorative dentistry – fillings, temporary or permanent crown(s).
    • Prosthetic appliances - complete or partial dentures.
    • Oral surgery - pulling teeth (called “extracting”) or the removal or repair of soft and hard gum tissue.
  • Appointment of Representative for Medicare

    CMS permits individuals or entitiesto appoint representatives to exercise their rights to appeal an initial determination.

    An Appointment of representative must:

    • Be in Writing.
    • Be signed and dated by both the party and the individual agreeing to be the representative.
    • Provide a statement appointing the representative to act on behalf of the party, and in the case of a beneficiary, authorize the adjudicator to release persanally identifiable health information.
    • Include in written explanation of the purpose and scope of the representation.
    • Contain the party's amd appointed representative's name, phone number, and address.
    • Provide the beneficiary's Medicare health insurance claim number, if applicable. When the represented party is not a beneficiary, a unique identifier (such as the National Provider Identifier or Plan Number) is requested)
    • Include the appointed representative's professional status or relationship to the party.
    • Also be filed with the entity processing the party's initial determination or appeal.
    • CMS Form 1696 must be completed. (Click here to go to printable PDF of CMS 1696 form)

What kind of benefits and coverage do I receive with AllCARE for Seniors?

As a participant in the AllCARE for Seniors program, all necessary health services will be provided through AllCARE for Seniors and your Interdisciplinary Team. Most care is delivered at the AllCARE for Seniors Center. Your Interdisciplinary Team will decide with you and your family/caregiver on what is best for your needs. All services, except for emergency services, must be approved in advance by your Interdisciplinary Team.

Second Medical Opinion

You and/or your family/caregiver are entitled to the opinion of a different health care provider if you so choose. If you and/or your family/caregiver would like a second opinion, you must forward your request to the AllCARE for Seniors IDT to authorize and then coordinate and schedule this second opinion for you.

You always have the right to appeal an AllCARE for Seniors care decision. (See IDT tab: Appeal Procedure)