Greenville Senior AdvisorIs PACE available in Greenville, SC?
Yes. Prisma Health SeniorCare PACE-Upstate serves Greenville, Pickens and Anderson counties, according to SCDHHS's PACE program data, and its day center in Greenville holds a DPH adult day care license; SCDHHS's enrollment snapshot lists 212 members for the Upstate program.
Laurens County is not in the Upstate program's service area, so Laurens families rely on the Community Choices waiver, OSS and Medicaid nursing home coverage instead. PACE service areas are defined by county and sometimes by ZIP code, so confirm an address before planning around it.
What does PACE cover?
PACE takes over all of a participant's Medicare- and Medicaid-covered care, including primary care, specialists, prescriptions, hospital and nursing home care, therapy, home care, transportation and day center attendance, coordinated by its own interdisciplinary team.
The trade-off is choice of doctors: participants use PACE's own physicians and its contracted network. In return, families get one team responsible for everything, which can keep a frail person at home much longer. If nursing home care becomes necessary, PACE continues to pay for it.
Who qualifies for PACE in South Carolina?
PACE is for people 55 and older who live in the program's service area, meet South Carolina's nursing facility level of care, and can live safely in the community with PACE's help at the time of enrollment.
Most participants have both Medicare and Medicaid, and for them PACE has no premium. Someone who has Medicare but not Medicaid can enroll by paying a monthly premium for the Medicaid portion, which makes PACE expensive for middle-income families. Enrollment is voluntary and a participant can leave.
How is PACE different from the Community Choices waiver?
Community Choices pays for home and community services while the participant keeps their own doctors and Medicare coverage, whereas PACE replaces the participant's Medicare and Medicaid coverage with one program that provides and coordinates all care, centered on a day center.
A parent who values a long relationship with a particular physician may prefer Community Choices; a parent with many conditions, frequent hospital visits and a family stretched thin may do better with PACE's single team. Both require nursing facility level of care.
How do we enroll in PACE-Upstate?
Contact Prisma Health SeniorCare PACE-Upstate directly to schedule an intake visit; the program assesses the applicant at home and at the center, SCDHHS confirms nursing facility level of care and Medicaid eligibility, and enrollment starts on the first of a month.
Ask about transportation from your parent's address, how often participants attend the center, after-hours medical coverage, and which hospitals and nursing homes PACE uses. The Appalachian Council of Governments Area Agency on Aging can also explain how PACE compares with other options for your situation.
At a glance
| PACE in the Upstate is | PACE in the Upstate is not | |
|---|---|---|
| Where | Greenville, Pickens and Anderson counties | Available in Laurens County |
| Coverage | All Medicare and Medicaid services, coordinated by one team | A supplement to your current doctors |
| Who | Age 55+, nursing facility level of care, safe at home with help | For anyone over 55 |
| Cost | No premium for people with Medicare and Medicaid | Free for Medicare-only enrollees |
Sources include S.C. Code Regs. 60-84, DPH Healthcare Quality and SCDHHS pages and bulletins, CareScout, CMS and VA rate tables as cited above; see our editorial standards.
