Resources

Dual Eligible Strategy Documents

Model Options for Dual Eligibles - Key Learnings, 2019 Stakeholder Discussions

Consumer Notices- ICI Phase 2

 List of Notices and why they are sent



Notice 32, Application  FAQ : Opt-In Enrollment Letter, Application



Notice 32 Spanish, Notice 32 Portuguese- Opt-In Enrollment Letter



Notice 31 and FAQ: Passive Enrollment Letter #1



Notice 31 Spanish, Notice 31 Portuguese -Passive Enrollment Letter #1



Notice 5: Passive Enrollment Letter #2



Notice 5 Spanish, Notice 5 Portuguese- Passive Enrollment Letter #2



Notice 4: Receipt of Completed Enrollment Request and Confirm Enrollment



Notice 6: Notice for Requesting Information



Notice 8: Member Has Employer or Union Retiree Drug Subsidy



Notice 9: Denial of Enrollment



Notice 11: Acknowledgement of Request to Cancel Enrollment



Notice 16: Notice to Confirm Voluntary Disenrollment



Notice 17: Denial of Disenrollment



Notice 19: Disenrollment Due to Out of Area Status



Notice 21: Disenrollment Due to Loss of Medicaid Status



Notice 23: Disenrollment Due to Death



Notice 24: Disenrollment Due to Part A or B Ending



Notice 25: Disenrollment Due to Incarceration



Notice 27: Acknowledgement of Reinstatement



Notice 28: Acknowledgement of Request to Opt-Out of MMP



Translation insert (included with all notices)



Appeals Instructions and Form (Eng)



Appeals Instructions and Form (Span)



Appeals Instructions and Form (Port)







FAQs



Cancelling vs. Disenrollment Fact Sheet, 2/4/2020

PACE

PACE-RI is a health plan for adults 55 and older who have chronic health needs and want to live at home.  PACE provides health care, insurance, and support services including primary care, access to specialists, prescription drugs, durable medical equipment, dental care, 24-hour emergency services, home care, transportation to all medical appointments, day center services, meals, and physical, speech, occupational and respiratory therapies.  PACE-RI serves the entire state (except Block Island and Prudence Island).  For more information, call 401-654-4176, 877-781-7223 (toll-free) or visit Website:  www.pace-ri.org

PACE Brochure

 

Background Documents