Not every older adult who is eligible for nursing home care is ready to make that step. That is where the Program of All-Inclusive Care for the Elderly, also known as PACE, comes in. Whether enrolled in a benefit program like Medicare or not, PACE is an option for older adults who require wraparound services that meet all of their daily needs while remaining in their community.

What is a Program of All-Inclusive Care for the Elderly (PACE)?

PACE is a care program covering a variety of needs for older adults who may otherwise be enrolled in nursing home care.¹ The Centers for Medicare and Medicaid Services (CMS) regulate PACE programs run by public and private nonprofit organizations. In addition to regular meals, transportation and social services, PACE programs provide the following physical health and medical services for older adults who live at home or attend adult day health centers:² 

• Dental care
• Emergency services
• Hospital care
• Laboratory work
• Nutrition counseling
• Occupational therapy
• Physical therapy
• Prescription drugs
• Primary care nurses and doctors
• Recreational therapy
• Specialty care
• X-rays

Who is eligible for PACE?

Older adults qualify for PACE if they are all of the following:¹

• Age 55 or older
• Living near a PACE program
• Eligible for nursing home care (according to their state’s Medicaid agency)
• Living safely in their community

Older adults do not need to be enrolled in Medicare or Medicaid to be eligible for PACE services. But older adults enrolled in those programs are not allowed to be in PACE and also use the following benefits:³

• Medicaid Home and Community Based Services (HCBS) 1915(c) waivers
• Medicaid prepayment plan
• Medicare Advantage
• Medicare Hospice Benefit
• Medicare prescription drug plan other than Medicare Part D

Once enrolled, PACE will provide Medicare and Medicaid enrollees with all of their covered services.⁴ PACE is only available for Medicaid recipients in 33 states and the District of Columbia.⁵ There are nearly 180 PACE programs and over 300 PACE centers in the U.S.⁶ PACE programs commonly distinguish themselves by the enrollees that they serve; for example, a Dual Eligible PACE or a Medicare Only PACE. Use Medicare’s search tool to find a PACE program near you.    

How do I enroll in PACE?

There are limited spaces available in PACE programs. While PACE enrollment will differ dependingdepending on where you live, older adults should expect members of their local PACE program to meet with them and any caregivers in person to assess their health, social service needs and existing benefits.³ This helps PACE staff determine if they meet their state’s criteria for nursing home care and can safely live in their community. The assessment also helps PACE staff develop a personalized care plan and figure out how they’ll pay for services. Participants are free to leave the PACE program at any time.⁴

If you’re denied enrollment, your local PACE program is required to give you a written reason why and suggest other options for care.³

How much does PACE cost?

The average cost of PACE care can be $4,000 to $5,000 a month for older adults who aren’t enrolled in Medicare or Medicaid.⁷ However, if you’re enrolled in Medicare, then Medicare will cover the costs of its covered services under PACE.⁸

Medicare recipients who are not enrolled in Medicaid are responsible for monthly premiums for PACE services and a premium for Medicare Part D drug prescriptions.¹

Medicaid enrollees will pay either a small monthly fee or nothing at all for PACE’s long-term care benefit.⁸

Sources

1. Medicare.gov. PACE. Found on the Internet at https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE

2. Medicaid.gov. Programs of All-Inclusive Care for the Elderly Benefits. Found on the Internet at https://www.medicaid.gov/medicaid/long-term-services-supports/pace/programs-all-inclusive-care-elderly-benefits/index.html

3. CMS.gov. Programs of All-Inclusive Care for the Elderly (PACE) Chapter 4 – Enrollment and Disenrollment Table of Contents (Rev. 3, Issued: 12-05-23). Found on the Internet at https://www.cms.gov/files/document/pace-chapter-4-12-05-23.pdf

4. Medicaid.gov. Program of All-Inclusive Care for the Elderly. Found on the Internet at https://www.medicaid.gov/medicaid/long-term-services-supports/program-all-inclusive-care-elderly/index.html

5. Medicare.gov. Find a PACE Plan in your area. Found on the Internet at https://www.medicare.gov/plan-compare/#/pace?year=2025&lang=en

6. National Pace Association. Find a PACE Program Near You. Found on the Internet at https://www.npaonline.org/find-a-pace-program

7. MedicaidPlanningAssistance.org. PACE Programs as an Alternative to Nursing Homes for Medicaid Beneficiaries. Found on the Internet at https://www.medicaidplanningassistance.org/medicare-pace-programs/

8. CMS.gov. Quick Facts about Programs of All-inclusive Care for the Elderly (PACE). Found on the Internet at https://www.cms.gov/medicare/health-plans/pace/downloads/externalfactsheet.pdf