All of the medical care and long-term services that you need are provided through Total Senior Care. One call connects you to all the services of the program that are medically necessary. Your Care Team (including your physician) will work with you and your family to develop a plan of care that uses services to best meet your individual needs.
COVERED SERVICES INCLUDE:
TSC Center Services
–Team-based care management
–Physician services, specializing in care for the elderly
–Social Work services
–Recreational and educational activities
–Round-trip transport to and from the Center
Outpatient Medical Services
–Medical specialty services
–Mental health services
–Eye care including exams and glasses
–Hearing exams and hearing aids
–Alcohol and substance abuse services
–Diagnostic tests and lab services
Comprehensive Hospital Inpatient and Emergency Services
Comprehensive Home Health Care
–Including nursing, rehabilitation therapies, social work and home health aides services
–Durable medical equipment and all needed supplies
–Consumer Directed Personal Assistance Services
–No Part D donut hole, no co-pays
–All authorized medications covered
–Over the counter medication coverage
Transportation to and from Medical Appointments
–Social and environmental supports (such as home modification)
–Personal Emergency Response System
WHO PROVIDES THE SERVICES?
All services of Total Senior Care are provided by the staff of the program and the carefully chosen, reliable providers of the Total Senior Care Network.* As a participant, you will have a choice of providers in your neighborhood for many of the program’s services. To obtain a list of our Provider Network, or to find out if your provider is in the network, simply call us at 716-379-8474 or 1-866-939-8613 (TTY/TDD:1-800-662-1220) 8:30 a.m. to 4:30 p.m. Monday through Friday. If you are currently receiving services from someone who is not part of our network, we will coordinate any changes that need to be made so that you can continue to receive the care you need.
WHO WILL BE MY DOCTOR IF I JOIN THIS PROGRAM?
As a Total Senior Care PACE participant, you will receive primary care services at the Total Senior Care Center or from one of the community-based primary care physicians in our network. If you need care in a hospital or from a specialist, you will also be required to use a physician or hospital in the Total Senior Care provider network. Our physicians work closely with the network specialists to be sure that your care is closely coordinated, in order to meet your specific needs. Members must accept Total Senior Care as their managed long-term care program.
* It is important to note that, as stated in Total Senior Care’s Participant Agreement Lock-In Clause, participants may be fully and personally liable for the costs of unauthorized or out-of-PACE program agreement services.
For more information on Medicare go to https://www.medicare.gov/