PACE
Program of All-inclusive Care for the Elderly (PACE) is a Medicare and/or Medicaid comprehensive medical and social services program available in some states. PACE helps eligible older adults who need nursing home-level care meet their health care needs in the community, by giving them coordinated care and support services (instead of having them go to a nursing home or other care facility)
If you join PACE, a team of health care professionals will work with you to help coordinate your care.
How does PACE work?
PACE covers all Medicare- and Medicaid-covered care and services, and anything else the health care professionals in your PACE team decide you need to improve and maintain your health, including your prescription drugs. The team personalizes your care based on your medical, physical, social, and emotional needs and preferences.
Here are some of the services PACE may cover:
- Adult day primary care (including meals/special dietary needs and recreational therapy)
- Dentistry
- Emergency services
- Home care
- Hospital care
- Laboratory/x-ray services
- Medical specialty services
- Mental health counseling
- Nursing home care
- Nutritional counseling
- Occupational therapy
- Personal care/support services
- Physical therapy
- Prescription drugs
- Preventive care
- Primary care (including doctor and nursing services)
- Social services
- Speech therapy
- Transportation to and from the PACE center and medical appointments
Who can get PACE?
The PACE program is only available in some states that offer PACE under Medicaid.
You can join PACE if you meet these 4 conditions:
- Are at least 55
- Live in the service area of a PACE organization
- Need a nursing home-level of care (as certified by your state)
- Are able to live safely in the community with help from PACE
What does PACE cost?
If you have Medicaid, you won't pay a monthly premium for PACE.
If you don't qualify for Medicaid but you have Medicare, the amount you pay will depend on whether you have Medicare Part A (Hospital Insurance) and/or Part B (Medical Insurance) and will also include:
- A monthly premium to cover the long-term care part of the PACE benefit
- A premium for Medicare Part D drugs
If you don’t have Medicare or Medicaid, you can pay the PACE premium yourself. Regardless of your financial situation, you won’t have a deductible, copayment, or co-insurance for any drug, service, or care your PACE team approves.
How do I apply for PACE?
To find out if you’re eligible and if there’s a PACE program near you, search for PACE plans in your area , or call your Medicaid office.