Complete Guide to PACE (Program of All-Inclusive Care for the Elderly)
1. Introduction to PACE
The Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program designed to help older adults remain in their homes and communities instead of moving into nursing homes or other long-term care facilities.
PACE coordinates medical care, social services, and long-term support for seniors who have significant health needs. The goal is to provide a comprehensive, team-based approach to health care, allowing participants to maintain independence while still receiving high-quality support.
2. Why PACE Was Created
PACE was developed in the 1970s in California as a way to care for older adults in the community. It became a permanent part of Medicare in the 1990s. The idea is simple: many seniors want to stay in their homes as long as possible, but they need extensive medical and personal care.
PACE integrates:
- Medical care
- Long-term services
- Social support
into one coordinated program, reducing hospitalizations and nursing home admissions.
3. Who Qualifies for PACE
To qualify for PACE, you must:
- Be 55 years or older.
- Live in a PACE service area (availability varies by state).
- Be certified by your state as needing a nursing home level of care.
- Be able to live safely in the community with PACE support.
Enrollment is voluntary, and once you join, PACE becomes your primary source of health coverage.
4. What Services PACE Provides
PACE covers all care and services covered by Medicare and Medicaid, plus additional services as needed. Examples include:
- Primary and specialty medical care
- Prescription drugs
- Adult day health care
- Dental, vision, and hearing care
- Home care and personal care assistance
- Transportation to medical appointments
- Nutritional counseling and meals
- Physical, occupational, and recreational therapy
- Hospital and nursing home care, if needed
The goal is holistic care — everything from medical treatment to social activities is managed by one coordinated team.
5. How PACE Works (Care Model Explained)
PACE uses an interdisciplinary team approach. This team typically includes doctors, nurses, social workers, therapists, dietitians, and drivers.
Participants usually receive services at a PACE center, which functions as both a health clinic and adult day center. Transportation to and from the center is included. Care is individualized — your team creates a plan that meets your unique needs and adjusts it regularly.
6. Costs of PACE and How It’s Covered
- If you have Medicare and Medicaid, most PACE services are free.
- If you have Medicare only, you may pay a monthly premium.
- If you have neither, you can still pay privately, but costs vary by state and program.
PACE participants never pay deductibles or copayments for services approved by the PACE team.
7. How to Apply for PACE
- Check if PACE is available in your area using Medicare’s PACE search tool.
- Contact your local PACE program.
- Schedule an eligibility assessment — the state will determine if you meet the nursing home level of care requirement.
- If approved, you’ll be enrolled and assigned a care team.
8. Benefits of PACE for Participants and Families
- Stay at home longer instead of moving into a nursing home.
- One-stop care coordination — no need to juggle multiple doctors or insurance.
- Transportation included, reducing stress for families.
- Family involvement in care planning.
- Preventative care reduces hospital visits and health complications.
9. PACE vs. Nursing Homes vs. Home Health Care
- PACE: Community-based, team-managed, covers all care needs, focused on independence.
- Nursing Homes: Provide 24/7 medical and personal care but require leaving home.
- Home Health Care: Limited services, usually medical care provided at home, but not as comprehensive as PACE.
PACE is often a middle ground — it allows people to remain at home while still receiving extensive support.
10. Common Misconceptions About PACE
- “PACE is only for very sick people.”
Not true. It’s for anyone certified as needing a nursing home level of care, but many participants live independently with support. - “PACE replaces my doctor.”
Not exactly — your PACE team becomes your primary care provider, but they may coordinate with your existing specialists. - “PACE is too expensive.”
Most participants pay little or nothing if they qualify for Medicare and Medicaid.
11. Limitations of PACE
- Not available everywhere — only certain states and regions offer PACE.
- Requires enrollment in a specific network of providers — you can’t keep your old doctor if they’re not part of PACE.
- Some participants may prefer more flexibility than PACE provides.
12. Tips for Getting the Most from PACE
- Involve family in care planning meetings.
- Use transportation services to reduce stress.
- Participate in adult day programs to stay active and engaged.
- Communicate openly with your care team about needs and changes.
13. Frequently Asked Questions (FAQ)
Q: Can I keep my Medicare and Medicaid if I join PACE?
A: Yes. PACE coordinates both, and you continue to receive the same coverage — just managed through PACE.
Q: Do I have to change doctors?
A: Usually yes, since care is managed by PACE’s own medical team.
Q: Does PACE provide nursing home care if I eventually need it?
A: Yes. If you require nursing home placement, PACE covers and coordinates that care.
Q: What if I don’t like the program?
A: Enrollment is voluntary — you can disenroll at any time and return to regular Medicare/Medicaid coverage.
Q: Can people under 55 join PACE?
A: In most cases, no. PACE is designed for those 55 and older.
14. Helpful Resources & Links
- Medicare – PACE Program Overview
- National PACE Association
- Find a PACE Program Near You
- Medicaid and PACE Information
Important Disclaimers:
- Timeliness: Information current as of 09/04/2025. Government programs and eligibility rules change frequently. Verify with official sources.
- No Government Affiliation: AssistanceGuide360.com is independent and not endorsed by any government agency.
- Individual Circumstances: This guide is general. Your situation may differ — consult professionals or official agencies.
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