# Understanding the PACE Part D Choice Act of 2021

Right now, if you're enrolled in a PACE program (Programs of All-Inclusive Care for the Elderly), you're stuck with whatever prescription drug plan your PACE provider offers. This bill changes that by letting certain seniors choose their own standalone prescription drug plan instead, starting in 2023. Essentially, it's about giving people more control over which company handles their medications and how much they pay for drugs.

Here's who this affects: You qualify if you're on Medicare, enrolled in a PACE program, and don't receive Medicaid benefits. The bill specifically excludes people on Medicaid because they already have different protections. If you fit this description, you'd be allowed to switch to a different prescription drug plan—but only if that new plan meets specific requirements. The alternative plan has to cost you the same or less in out-of-pocket expenses (premiums, deductibles, and copays) compared to what your PACE program charges, and it can't cost the federal government more in subsidies either.

Your PACE program would have new responsibilities under this bill. They'd have to tell you about your option to switch plans and help you understand which plans might work better for you if you ask. They'd also need to keep track of your medications and spending throughout the year, work with your new drug plan to make sure your medications are covered properly, and help you file complaints if something goes wrong. If you switch plans and your medications change or your costs unexpectedly jump, you'd be allowed to switch back or try a different plan during the year.

The practical effect is that seniors in PACE programs would gain the same kind of prescription drug plan flexibility that other Medicare beneficiaries already have, potentially saving money or getting better drug coverage if they find a better deal elsewhere.

PACE Part D Choice Act of 2021

Blumenauer, Earl

PACE Part D Choice Act of 2021 This bill allows Medicare-only beneficiaries who are enrolled in Programs of All-Inclusive Care for the Elderly (PACE) to choose prescription drug plans that are not operated by PACE. (PACE is a program under Medicare and Medicaid that provides in-home and community services for certain individuals as an alternative to nursing home care.) Specifically, the bill allows PACE enrollees who are Medicare (but not Medicaid) beneficiaries to choose a prescription drug plan that is not a Medicare Advantage plan or operated by PACE and for which annual out-of-pocket costs and federal subsidies are equal to or less than that under the applicable PACE prescription drug plan. The bill also allows for disenrollment from a chosen plan upon a change in medication or demonstration of an unexpected increase in out-of-pocket costs. PACE programs must conduct outreach, monitor data, and coordinate benefits with respect to such options.