Cost to you
- If you are Medicaid eligible or have Medicare and Medicaid, there is no cost.
- if you are eligible for Medicare only, there will be a fee involved.
- Those without Medicare or Medicaid may pay privately.
Once an individual enrolls in ConcertoPACE, all services including medical care are provided by the
program. All services that participants receive must be approved by the PACE Interdisciplinary Team.
PACE participants may be financially responsible for care and services not authorized by the PACE
program.
If at any time you are permanently placed in a nursing home, you may be responsible for a portion of the cost.
Participant rights and responsibilities
At ConcertoPACE we are committed to your care.
Our services are developed and provided to each participant based on their needs. If you feel that you are not pleased, please let us know immediately so that we can
take the necessary steps to address your concerns.
Filing a grievance
If you are not happy or satisfied with any of the services offered through ConcertoPACE, you can let any staff person know.
Click on the link for instructions on how to file a grievance, which will include contact information.
Click on the link for instructions on how to file an appeal which will include contact information,
Filing an appeal
If ConcertoPACE decides not to provide or pay for a service you feel you need, you may ask us to change our decision. This is called an appeal. If you
wish to file an appeal we are available to assist you.
Read this guide for instructions on how to file an appeal. including contact information.
Rights and responsibilities upon disenrollment
If you choose to leave the program, click on this link for the helpful guide. It will assist you to understand the process
with information and instructions for disenrollment.
Click on this link to learn how to appoint a representative CMS Form 1696
(Selecting this link above may take you to another website outside of the website that you are currently on.)
Send this form to the same location where you are sending (or have already sent) your appeal if you are filing an appeal. grievance or complaint if you are filing a
grievance or complaint, or an initial determination or decision if you are requesting an initial determination or decision.
If you are in need of additional assistance, contact either 1-800-MEDICARE (1-800-633-4227) or your Medicare plan. TTY users please call 1-877-486-2048.
Please note:
By chosing to enroll in ConcertoPACE participants must receive all needed healthcare services. including primary care and specialist physician
services (other than emergency services) from ConcertoPACE or a person or company pre-authorized by
ConcertoPACE of Los Angeles. ConcertoPACE
guarantees access to services, but not to a specific provider.
ConcertoPACE participants may be fully and personally responsible for the costs of any out-of-network services.
