What PACE Is and Who It Serves

PACE (Programs of All-Inclusive Care for the Elderly) is a Medicare and Medicaid program that lets older adults stay in their own homes while receiving medical care, therapy, meals, and transportation — all coordinated through one organization. Instead of moving to a nursing home, you get a care team that comes to you and manages your health in one place.

PACE is designed for people age 55 and older who live in a PACE service area and meet medical requirements — usually meaning you need the level of care a nursing home would provide, but you want to remain at home. You must be able to live safely in your community with PACE support. The program covers both Medicare and Medicaid costs, so you do not pay separately for each service.

PACE operates in about 30 states, with programs in urban and rural areas. Each PACE organization serves a specific geographic region, so whether PACE is an option depends on where you live.

Key Takeaways

  • PACE combines medical care, therapy, meals, transportation, and social activities into one program you access through a single organization in your area.
  • You must be 55 or older, live in a PACE service area, and need nursing home-level care to be considered for the program.
  • PACE is paid for through Medicare and Medicaid, so there are no separate bills for individual services.
  • A PACE team includes doctors, nurses, therapists, and social workers who coordinate your care and meet with you regularly at an adult day center.
  • You can leave PACE at any time, and the program can end if you move out of the service area or no longer meet medical requirements.

How PACE Services Work in Practice

When you enroll in PACE, you become part of a team-based care model. You visit an adult day center several days per week — the exact schedule depends on your health needs and what your care team recommends. At the center, you see doctors, nurses, physical therapists, occupational therapists, and social workers. They monitor your health, adjust medications, provide therapy, and help you stay active.

Between day center visits, PACE sends home health aides to your house for personal care, nurses for medical needs, and therapists for ongoing treatment. The program also arranges transportation to appointments, delivers meals, provides prescription medications, and covers hospital and emergency care if you need it. One care coordinator stays in touch with you and your family, making sure everything is working and adjusting the plan when your needs change.

The goal is to prevent unnecessary hospital stays and nursing home placement by catching health problems early and managing them at home. If you do need to go to the hospital, PACE coordinates your discharge and brings you back into the home care plan.

What PACE Covers and What It Costs

PACE covers a wide range of services under one monthly capitated payment — meaning the PACE organization receives a fixed amount per month from Medicare and Medicaid to provide all your care. This includes primary care and specialist visits, hospital and emergency care, prescription drugs, therapy and rehabilitation, medical equipment and supplies, transportation, adult day services, meals, and social activities.

If you are may be able to access for both Medicare and Medicaid, PACE is free to you. If you have Medicare only, you may have a monthly premium, which varies by program and state. Some PACE programs charge copayments for certain services, though many waive them for low-income participants. You should ask the specific PACE program in your area what costs explore to your situation.

PACE does not cover services outside the program's network, so you cannot use your own doctors unless they work with PACE or the program authorizes it. This is different from traditional Medicare, where you can see any provider. Before enrolling, confirm that your current doctors are part of the PACE network or that you are comfortable switching.

How to Find and Enroll in PACE in Your Area

Start by finding out whether PACE operates where you live. The National PACE Association maintains a directory of all PACE programs by state and region. You can search online or call your local Area Agency on Aging, which can tell you if PACE is available in your community and connect you to the program.

To enroll, you will need to contact the PACE organization directly. They will ask about your medical history, current health needs, and living situation. A nurse or social worker will visit your home to assess whether you meet the program's medical requirements — this is called a level-of-care information. If you may have access to, you will sign an enrollment agreement and choose your primary care doctor within the PACE network.

Enrollment typically takes two to four weeks from your first contact. You can enroll in PACE during any month of the year; there is no annual enrollment period like traditional Medicare. Once enrolled, you can start using services right away.

Medical Requirements and Who Does Not may have access to

PACE is not for everyone. You must need the level of care a nursing home would provide — this means you have significant difficulty with daily activities like bathing, dressing, or taking medications, or you have complex medical conditions that require frequent monitoring. If you are generally healthy and only need occasional doctor visits, PACE is not the right fit.

You also must be able to live safely in your community with PACE support. If you have severe dementia and cannot be left alone, or if your home is unsafe and cannot be modified, PACE may not work. The program requires that you have a caregiver or support system at home, though PACE can supplement that support.

Additionally, you must live in a PACE service area and be willing to receive care through that organization's network. If you move outside the service area, your enrollment ends. Some PACE programs have waiting lists during periods of high demand, so availability can vary.

How PACE Differs from Nursing Homes and Traditional Medicare

The main difference between PACE and a nursing home is location: PACE keeps you at home while a nursing home moves you into a facility. PACE also coordinates all your care through one team, whereas in a nursing home you might see different doctors and staff. PACE is typically less expensive than nursing home care because it prevents complications and hospital stays.

Compared to traditional Medicare, PACE is more restrictive — you must use PACE doctors and providers, and you cannot see outside specialists without authorization. However, PACE includes services Medicare does not cover, such as adult day care, meals, and transportation. If you have Medicaid, PACE eliminates the need to navigate separate programs for different services.

PACE is also different from home health care alone. Home health typically covers skilled nursing and therapy for a limited time after an illness or injury. PACE is ongoing, comprehensive care for people with chronic conditions who need support to stay home long-term.

What Happens If Your Health Changes or You Want to Leave

PACE is flexible. You can leave the program at any time without penalty — you straightforward notify the PACE organization and return to traditional Medicare or Medicaid. If your health improves and you no longer need nursing home-level care, PACE may determine you no longer meet medical requirements and end your enrollment, though this is uncommon.

If your health declines significantly and you need 24-hour care that PACE cannot provide at home, the program will help you transition to a nursing home or other facility. PACE does not provide overnight care in your home, so if you reach a point where you need round-the-clock supervision, PACE will coordinate your move and may support continuity of care.

If you move out of the PACE service area, your enrollment automatically ends. You will need to re-enroll in traditional Medicare or find another PACE program in your new location if one exists.

Frequently Asked Questions

Do I have to go to the adult day center if I am in PACE?

Most PACE programs require regular day center attendance as part of the care plan, typically two to five days per week depending on your needs. However, if you are temporarily ill or hospitalized, the requirement may be waived. Talk to your care coordinator about what schedule works for your situation.

Can I keep my current doctor if I join PACE?

Only if your doctor is part of the PACE network or the program authorizes an exception. Before enrolling, ask the PACE organization whether your doctor participates. If not, you will need to choose a primary care doctor from the PACE panel.

What if I need to go to the hospital while in PACE?

PACE covers all hospital care, including emergency visits. The PACE organization will coordinate your hospital stay and arrange your discharge. You do not need to call your insurance or worry about authorization — PACE handles it all.

Is PACE the same in every state?

PACE is a federal program, so the basic structure is the same everywhere, but individual programs vary in services offered, costs, and quality. Some programs are larger and have more specialists; others are smaller and more community-focused. Research the specific PACE program in your area before enrolling.

What if I cannot afford the monthly premium?

If you have Medicaid, PACE is free. If you have Medicare only, ask the PACE program about financial hardship waivers or reduced premiums. Some programs offer information based on income, though this varies by organization and state.