Intro PACE stands for the Program of All-Inclusive Care for the Elderly. It is a program that helps older adults who need nursing-home-level care stay in their homes and communities. PACE brings medical, social, and support services together under one team. This article explains what PACE is, who can join, what it covers, how it works, and how to find a program near you.
What is PACE?
PACE is a coordinated care program for older adults. It is run through Medicare and Medicaid in states that offer it. A PACE organization uses an interdisciplinary team. The team makes a personalized care plan for each participant. The goal is to help people remain as independent as possible and avoid long stays in nursing homes.
PACE covers all Medicare- and Medicaid-covered services. It also covers other services the PACE team thinks are needed to keep someone healthy and safe. That can include medical care, therapies, social services, transportation, and help in the home.
Who is eligible for PACE?
You may be eligible for PACE if you meet these four conditions:
- You are 55 years old or older.
- You live in a PACE service area. PACE is not available everywhere.
- A state assessment shows you need a nursing home level of care.
- You can live safely in the community with help from PACE.
Each state that offers PACE may have its own process to confirm the nursing-home-level-of-care requirement. If you are unsure, contact your local PACE program or your state Medicaid office for details.
What services does PACE cover?
PACE provides a wide range of services. The exact mix depends on the person’s needs. Services commonly included are:
- Primary care and regular medical visits at a PACE center.
- Prescription drugs (PACE usually provides Part D drugs).
- Hospital and emergency care when needed.
- Home health care and personal care services.
- Physical, occupational, and speech therapy.
- Mental health counseling and social work.
- Dental care.
- Laboratory and imaging tests.
- Transportation to and from the PACE center and medical appointments.
- Meals, recreational activities, and adult day services.
Importantly, PACE covers any other care the PACE team decides is necessary to keep the participant healthy and living safely in the community.
How does PACE work day-to-day?
When someone joins PACE, they meet with an interdisciplinary team. The team typically includes doctors, nurses, social workers, therapists, nutritionists, and care coordinators. They do a full assessment of medical, social, and emotional needs. Then they create a single care plan.
Many participants attend a PACE center for primary care, meals, therapy, and social activities. PACE also provides services in the home as needed. The team coordinates all care and specialists. That coordination reduces the need for multiple appointments and confusion about who is managing care.
Family caregivers often find PACE helpful. The PACE team supports family members and offers training and counseling when needed.
What does PACE cost?
Costs depend on your situation and the state rules:
- If you have Medicaid, you generally will not pay a monthly premium for PACE.
- If you have Medicare but not Medicaid, you may pay a premium for the long-term care portion of PACE. Costs also depend on whether you have Medicare Part A and Part B.
- If you have neither Medicare nor Medicaid, you can pay the PACE premium yourself.
One important point: for services and drugs the PACE team approves, participants generally do not have deductibles, copayments, or coinsurance. Also, if you join PACE with Medicare, PACE usually covers your Part D prescription drugs. If you try to join a separate Medicare drug plan while in PACE, you may be disenrolled from PACE.
Because rules vary by state and situation, ask the PACE program about costs before enrolling.
Where is PACE available?
PACE is available only in some states. The number of programs grows over time. The National PACE Association lists PACE programs and an interactive map you can use to find a local program. Medicare.gov also offers a way to search for PACE plans in your area. If you can’t find PACE in your area, check your state Medicaid website. Some states may have special rules or limits on new programs.
How do I apply or learn more?
Start with these steps:
- Search for PACE programs on Medicare.gov or the National PACE Association website.
- Call the local PACE organization and ask about eligibility, services, and costs.
- Contact your state Medicaid office if you need help with the nursing-home-level-of-care assessment.
- Visit a PACE center, if possible, to meet staff and see services in person.
A PACE representative can walk you through the enrollment process and help you get the state assessment you need.
Questions to ask a PACE program
When you call or visit, ask:
- What services are provided at the PACE center?
- How do you coordinate care with outside specialists?
- What are the costs for my situation?
- How do you support family caregivers?
- How do you handle emergencies and hospital stays?
- What are the hours and transportation options?
Answers to these questions will help you decide if PACE fits your parent’s needs.
Final note
PACE is a strong option for older adults who need nursing-home-level care but want to remain in their home and community. It brings medical, social, and support services together under one team. Availability and costs vary by state, so check local program details and talk with the PACE team. If you want coordinated care and support for your parent, PACE is worth considering.
