PACE Program Explained: All-Inclusive Medicare and Medicaid Care for Seniors Who Want to Stay Home

Who Should Read This

This publication is written for adults aged 55 and older who need ongoing medical and personal care but want to continue living at home rather than moving to a nursing facility. It is also highly relevant for family members, caregivers, and loved ones who help make healthcare decisions for seniors with chronic conditions or complex health needs.

If you or someone you love has multiple health conditions, needs daily support, and wants to stay in the community, this publication is especially important. Social workers, elder care coordinators, and healthcare providers helping seniors navigate Medicare and Medicaid options will also find this information valuable.

Quick Overview

This publication provides a clear and straightforward summary of the Program of All-Inclusive Care for the Elderly, commonly known as PACE. It explains what PACE is, who can join, what services are covered, and how costs are handled under Medicare and Medicaid. The publication is a concise quick-facts format designed to help seniors and their families quickly understand this important care option.

Key Takeaways

• PACE is a special program that provides all-in-one medical and personal care for people aged 55 and older who need nursing home-level care but prefer to live at home.
• To qualify for PACE, you must be 55 or older, live in a PACE service area, need nursing home-level care, and be able to safely live in the community with PACE support.
• PACE covers a wide range of services including doctor visits, hospital care, prescription drugs, dental care, vision, hearing, home care, and transportation.
• If you have both Medicare and Medicaid, you typically pay nothing out of pocket for PACE services covered by those programs.
• PACE participants receive coordinated care through a team of healthcare professionals who work together to meet each person's unique needs.
• The PACE day center is a central part of the program where participants receive health services, social activities, and meals.
• PACE is not available everywhere, so checking whether a PACE program exists in your area is an important first step.

Publication Summary

What Is PACE?

PACE stands for Program of All-Inclusive Care for the Elderly. It is a Medicare and Medicaid program designed to help seniors with serious health needs continue to live at home and in their communities. Instead of moving to a nursing home, PACE participants receive comprehensive care that addresses both their medical and personal needs in one coordinated program.

PACE is built around the idea that older adults with complex health conditions can live better lives when they receive the right support in a familiar setting. The program brings together doctors, nurses, social workers, therapists, and other care professionals into one team that works together to manage a participant's health.

Who Is Eligible for PACE?

To join PACE, a person must meet all of the following requirements:

• Be 55 years of age or older
• Live in the geographic area served by a PACE organization
• Be certified by the state as needing nursing home-level care
• Be able to live safely in the community at the time of enrollment with help from PACE

Most PACE participants are enrolled in both Medicare and Medicaid, but people with only Medicare or only Medicaid may also be eligible in some cases.

What Services Does PACE Cover?

One of the biggest advantages of PACE is the broad range of services it covers. All care is coordinated through the PACE team and may include:

• Primary care and specialist doctor visits
• Hospital and emergency care
• Prescription drugs
• Nursing home care when necessary
• Home health and personal care services
• Physical, occupational, and speech therapy
• Dental, vision, and hearing care
• Nutritional counseling and meals
• Social services and mental health care
• Transportation to and from the PACE center and medical appointments

All of these services are managed and delivered through the PACE organization, making it much easier for participants and their families to navigate care.

The PACE Day Center

The PACE day center is a core part of how the program works. Participants visit the center regularly to receive health services, participate in social activities, and share meals with others. The center provides a place where the PACE care team can monitor each person's health, make adjustments to care plans, and offer both medical and social support.

Transportation to and from the PACE center is provided as part of the program, which removes a common barrier for seniors who no longer drive or have limited mobility.

How Does PACE Handle Costs?

For people who have both Medicare and Medicaid, PACE services are typically covered at no out-of-pocket cost. Medicare and Medicaid pay a set monthly amount to the PACE organization, which then takes on full responsibility for all covered care.

People who have Medicare but not Medicaid may pay a monthly premium for the long-term care portion of PACE. People who have neither Medicare nor Medicaid may still be able to join PACE but would pay privately. It is important to contact your local PACE organization to understand the specific costs that may apply to your situation.

How PACE Is Different from Other Medicare Plans

Unlike traditional Medicare or Medicare Advantage plans, PACE is not just an insurance plan. It is a fully integrated care delivery system. The PACE organization is responsible not only for paying for care but also for providing and coordinating all of that care directly. This means participants work with the same team of professionals who know them well and understand their full health picture.

PACE also requires that participants use the PACE organization for all of their care needs, except in emergency situations. This is different from other Medicare options where you may have more flexibility in choosing providers.

How to Find a PACE Program

PACE programs are not available in every part of the country. To find out if there is a PACE program in your area, you can visit Medicare.gov or call 1-800-MEDICARE. Your State Health Insurance Assistance Program, known as SHIP, can also help you learn more about PACE and whether it might be a good fit for your needs.

Frequently Asked Questions

Can I join PACE if I only have Medicare and not Medicaid?

Yes, it is possible to join PACE with Medicare alone. However, you may be responsible for paying a monthly premium to cover the long-term care portion of services that would otherwise be covered by Medicaid. Contact your local PACE organization to learn about costs that may apply to you.

What happens if I need to go to a hospital or specialist outside of PACE?

In an emergency, you can receive care outside of the PACE network. However, for non-emergency care, PACE participants are generally required to use providers and services arranged by their PACE organization. The PACE team coordinates all referrals and specialty care as part of your overall care plan.

Can I leave the PACE program if I change my mind?

Yes. Enrollment in PACE is voluntary and you can leave the program at any time. If you leave PACE, you will return to Original Medicare or you may choose to join a Medicare Advantage plan or other coverage option. It is a good idea to review your coverage options before leaving to make sure you have the care you need.

Does PACE cover prescription drugs?

Yes. Prescription drugs are included as part of PACE coverage. Because PACE provides all-inclusive care, there is no need for a separate Medicare Part D prescription drug plan when you are enrolled in PACE.

Do I have to go to the PACE day center every day?

The number of days you attend the PACE day center depends on your individual care plan. Your PACE care team will work with you to determine how often you need to visit the center based on your health needs and personal circumstances. Some participants attend several days a week while others may go less frequently.

Access the Full Publication

Publication Number: 11341
Publication Date: December 2025
Length: 4 pages