What is PACE?
PACE stands for Program of All-Inclusive Care for the Elderly. It’s a Medicare and Medicaid program that helps people meet their health needs in the community instead of going to a nursing home or other care facility.
Who is eligible for PACE?
To qualify for PACE, you must:
- Be 55 or older
- Live in a PACE service area
- Be certified by your state as needing a nursing-home level of care
- Be able to live safely in the community with PACE services at the time of enrollment
What services does PACE provide?
PACE covers comprehensive medical and social services, including:
- Primary and specialty medical care
- Prescription drugs
- Adult day care
- Transportation
- Home care services
- Meals and nutrition counseling
- Physical, occupational, and speech therapy
- Dental and vision care
- Hospital and nursing facility care if needed
How much does PACE cost?
- If you have Medicaid, you do not have to pay anything.
- If you don’t qualify for Medicaid, you may pay a monthly premium for the long-term care portion and the Medicare Part D drug plan.
- There are no deductibles or co-pays for PACE-covered services.
Can I keep my current doctor if I join PACE?
No, PACE participants receive care from a team of doctors and specialists affiliated with the PACE organization. These providers are trained in caring for older adults and work together to coordinate your care.
Is PACE only for people with serious health conditions?
PACE is designed for individuals who are certified to need nursing-home level care but can still live safely at home with support. This includes many people with chronic conditions or disabilities.
Does PACE replace my Medicare or Medicaid?
Yes. When you enroll in PACE, PACE becomes your Medicare and/or Medicaid provider. You receive all your health care services through the PACE organization.
Do I have to live in a nursing home to join PACE?
No. PACE is designed to help people remain in their homes and communities for as long as possible.
What happens if my health declines after joining PACE?
PACE continues to provide care and support. If nursing home care becomes necessary, PACE covers it and continues managing your services.
Can I leave the PACE program if I change my mind?
Yes. You can disenroll at any time and return to traditional Medicare or Medicaid coverage.
Participant Resources
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How to Appoint a Representative:
• Use this form to appoint a representative to act on your behalf for your claim, appeal, grievance or request. By signing this form and appointing this representative, you agree that the representative will be the main contact and have authority to make requests, present evidence, get information, and receive all communication about your action. This person may see your personal medical information.
• CMS 1696 Form attached for download. - How to File a Grievance
- Appeals Information
- Notice of Privacy Practices
- Title VI Nondiscrimination Notices