The PACE program, explained

This guide explains what PACE is, who qualifies, what it covers, how much it costs, and the one big limitation families run into.

What PACE actually is

PACE is a joint Medicare and Medicaid program that delivers comprehensive care to frail older adults through a single local organization. Instead of juggling a primary doctor, specialists, a pharmacy, home aides, and transportation separately, a participant gets an interdisciplinary care team — doctors, nurses, therapists, social workers, aides, and drivers — who plan and provide all of it together, usually anchored by a PACE center the person attends.

The defining idea is in the name: all-inclusive. PACE is responsible for the whole picture of a participant's care.

Who qualifies for PACE

A person generally must meet all of these:

• Be 55 or older.
• Live in the service area of a PACE organization.
• Be certified by the state as needing a nursing-home level of care.
• Be able to live safely in the community with PACE support at the time of enrollment.

The key reframe: needing a “nursing-home level of care” is the qualification for PACE — not a sentence to live in one. PACE exists precisely so people who meet that bar can stay home instead.

What PACE covers

Coverage is broad — everything Medicare and Medicaid cover, plus whatever else the care team determines a participant needs. In practice that commonly includes:

• Primary, specialty, and hospital care.
• Prescription drugs.
• Adult day care and in-home personal care.
• Nursing, physical, occupational, and speech therapy.
• Social work and counseling.
• Meals and nutrition.
• Transportation to the PACE center and to medical appointments.
• Nursing-home care if and when it becomes necessary.

How much PACE costs

This is where PACE surprises families in a good way. Cost depends on coverage:

• Medicare and Medicaid (dual-eligible): generally no cost for covered care — no deductibles, no copays.
• Medicare only (no Medicaid): typically a monthly premium for the long-term-care portion, plus a premium for Medicare Part D-level drug coverage.
• Neither: a person can pay for PACE privately.

Why Medicaid matters here: because dual-eligibles usually pay nothing, qualifying for Medicaid can make PACE essentially free. If a parent is close to Medicaid eligibility, it may be worth understanding the spend-down and your state's Medicaid rules as part of exploring PACE.

The one big limitation: availability

PACE is excellent, but it is not everywhere. A PACE organization has to operate in your area, and you have to live within its specific service area, for it to be an option — and many communities simply do not have one yet. That is why the very first practical step is to check whether a PACE program serves your location and has room to enroll.

How families usually explore PACE

• Check whether a PACE organization serves your community and has openings.
• Confirm the level-of-care and age requirements for the person.
• Sort out coverage — Medicare, Medicaid, or both — and what (if anything) it would cost.
• Compare PACE's provider network with the person's current doctors.
• If Medicaid eligibility is the missing piece, talk to an elder law attorney about the path.

Where this fits in the bigger picture

PACE is one of the strongest options for aging in place when care needs are high, and it sits alongside the broader Medicaid questions families face — nursing home costs, the spend-down, and overall eligibility. Because Medicaid often makes PACE free, the two are worth exploring together. If you are weighing how to care for a parent who needs a lot of help but wants to stay home, an elder law attorney or your local Area Agency on Aging can help you map the options. Find an elder law attorney in your state to start.

Frequently asked questions

What is the PACE program?

PACE — the Program of All-Inclusive Care for the Elderly — is a Medicare and Medicaid program that provides comprehensive medical and social services to frail older adults who need nursing-home-level care but want to keep living in their community. A local PACE organization coordinates all of a person's care through one interdisciplinary team.

Who qualifies for PACE?

A person generally must be 55 or older, live in the service area of a PACE organization, be certified by the state as needing a nursing-home level of care, and be able to live safely in the community with PACE services at enrollment. Meeting the nursing-home level-of-care standard does not mean a person has to live in a nursing home.

How much does PACE cost?

It depends on coverage. People with both Medicare and Medicaid generally pay nothing for covered care, with no deductibles or copays. People with Medicare but not Medicaid typically pay a monthly premium for the long-term-care portion plus a drug-coverage premium. People with neither can pay privately.

What does PACE cover?

PACE covers everything Medicare and Medicaid cover and more, as determined by the care team — doctor and specialty care, prescription drugs, adult day care, in-home care, nursing, therapy, social services, meals, transportation, and hospital and nursing-home care when needed.

Is PACE available everywhere?

No. PACE is only available where a PACE organization operates, and many areas do not have one. Availability also depends on living within a specific service area, so the first step is checking whether a PACE program serves your community and has capacity.

How is PACE different from a nursing home?

PACE is built to help people who would otherwise qualify for a nursing home keep living at home instead. Participants live in their own homes and receive coordinated care through a PACE center and in-home services. If a participant later needs nursing-home care, PACE covers that too.