PACE: The All-Inclusive Program Most Families Miss
If your parent needs nursing home level care but wants to stay home, pace eligibility is worth checking before you sign a facility contract. You are not choosing between doing everything yourself and moving your parent out. You are checking whether one team can take on the medical care, the home help, and the rides, while your parent keeps living at home.
Sources: Medicare.gov PACE guidance; National PACE Association state count, April 2026; Massachusetts PACE common questions; accessed October 2026.
What PACE is
PACE stands for Program of All-Inclusive Care for the Elderly. One PACE organization coordinates all of a participant's care through an interdisciplinary team, a team of doctors, nurses, therapists, social workers, aides, and drivers who plan care together. The team works from a PACE center and in the participant's home, and its goal is to keep the participant living in the community instead of moving into a nursing home.
That single-team design means fewer handoffs between a clinic, a home aide agency, and a pharmacy. Availability is the first limit to check. The National PACE Association reported 202 programs operating in 33 states and the District of Columbia in April 2026, so a family in one of the remaining states cannot enroll. Check the service area by your parent's address, not yours.
The 4 eligibility requirements
All four requirements must be true at the same time. Meeting three out of four is not enough, and no local program can waive one of them.
- Age 55 or older. The age floor is 55, not 65, which surprises many families who assume PACE follows the usual Medicare age.
- State-certified as needing nursing home level of care. The state, not the PACE organization, makes this call, and each state writes its own standard.
- Lives in a PACE service area. PACE is tied to a local organization and its center. If no organization covers your parent's address, enrollment is not possible there.
- Can live safely in the community with PACE support. The test is safety with help, not safety alone. A parent who needs daily help can still qualify if PACE services close the gap.
Medicaid is not a requirement for pace eligibility. People without Medicaid can enroll and pay privately, and people without Medicare can also enroll on a private-pay basis. Ask the local program to explain the payment route separately from the eligibility decision, and get both answers in writing.
What PACE covers
PACE covers all care covered by Medicare and Medicaid when the team authorizes it, plus any other service the team decides a participant needs to stay in the community. Covered services include medical care, prescriptions, adult day care, home care, dental care, vision care, meals, transportation to the center and to medical appointments, therapy, social services, and nursing home care if it becomes necessary. Caregiver training, support groups, and respite care for family caregivers are also part of the model.
One limit matters for budgeting: PACE does not pay room and board in a residential facility. A participant who lives in assisted living still pays the housing cost, while PACE covers the medical and support services in the plan. For housing costs, read assisted living alternatives and assisted living costs.
What PACE costs
Cost follows payment status, not care need. The table below uses Medicare.gov guidance, accessed October 2026. No single national premium figure applies to everyone, so treat any quoted premium as program-specific until your local program confirms it in writing.
| Payment status | Monthly premium for the long-term care part | Other costs |
|---|---|---|
| Both Medicare and Medicaid | No monthly premium for the long-term care part | No deductible or copayment for approved care |
| Medicare only, no Medicaid | Monthly premium for the long-term care part, set by the program | Plus a Medicare Part D premium; still no deductible or copayment for approved care |
| Neither Medicare nor Medicaid | Private pay for the full PACE cost | Medicaid Planning Assistance reports a private-pay range of $4,000 to $7,000 per month, varying by program |
The private-pay range above is a reported range, not a price promise. Programs set their own private-pay rates, so two programs in different cities can quote very different amounts. PACE is separate from a Medicaid waiver, the state program that pays for care at home and in the community instead of a nursing home. A waiver waitlist does not by itself block PACE, so ask the state Medicaid agency which route your parent is actually on. For Medicaid rules, read does Medicaid pay for assisted living.
PACE vs nursing home vs assisted living
Use this table to compare the shape of each option, not just a monthly price. Facility prices vary by state and care level, so a national price comparison would mislead more than it helps.
| Option | Where your parent lives | Who coordinates care | Best fit |
|---|---|---|---|
| PACE | At home or in the community | One PACE team | Needs nursing home level care but can live safely at home with support |
| Assisted living | In a facility, with help for daily tasks | Facility staff plus outside doctors | Needs daily help and a staffed building, day and night |
| Nursing home | In a facility, with skilled nursing care | Facility medical team | Needs round-the-clock skilled care that home support cannot safely cover |
The deciding question is whether your parent can live safely at home with the specific services the local PACE team will put in the care plan. If the team cannot cover nights, or if your parent needs supervision every hour, a facility may be the safer answer even when pace eligibility is met. For facility prices, read nursing home costs and adult day care cost.
How to enroll
Start with the National PACE Association directory or the Medicare.gov plan finder, and search by your parent's address. Contact the local PACE organization directly and ask for an intake visit. The state then certifies nursing home level of care, and the PACE team completes its own assessment and writes a care plan with your parent.
Enrollment is voluntary, and participants may leave PACE at any time for any reason. People with Medicare or Medicaid who leave are helped back to their former coverage. Before you enroll, ask which services the draft care plan covers, how many days per week your parent will attend the center, and how transport works from your parent's address. If no program covers your parent's address, read home care costs to price the home route while you wait.
PACE is not PACENET
Two different programs share a similar name, and mixing them up wastes weeks. The PACE in this page is the national Program of All-Inclusive Care for the Elderly, a full care program for people age 55 or older who need nursing home level care. PACENET is a Pennsylvania-only prescription help program. PACENET stands for PACE Needs Enhancement Tier, and it helps Pennsylvania residents age 65 or older pay for prescription drugs alongside Medicare drug coverage.
PACENET does not coordinate doctors, home care, meals, or transport, and it does not replace a nursing home stay. If a search result talks about drug copays and Pennsylvania residency, it is talking about PACENET. If it talks about a care team, a PACE center, and nursing home level of care, it is talking about the national PACE program.
Frequently asked questions
Can you keep your own doctor in PACE?
Typically no. The PACE physician becomes your parent's primary care doctor, and care outside the PACE team that the team has not approved may be billed to the participant. A program may contract with a specialist your parent already sees, but the PACE physician prescribes and authorizes care.
What if my parent needs to move out of the service area?
Tell the PACE organization before the move, not after it. Moving out of the service area can end eligibility with that organization, and a move to a new area means a fresh check: a new program, a new service area test, and a new assessment. Ask the current program to put the move rules and the last covered date in writing, and check for an opening in the new area before you sign a lease.
Can you disenroll from PACE?
Yes, at any time and for any reason, and the program must help restore former Medicare or Medicaid coverage. Before the switch takes effect, confirm the exact last day of PACE coverage in writing, and do not join a separate Medicare Part D drug plan while still enrolled, since joining one can end PACE drug benefits.
Does PACE cover 24-hour home care?
No, PACE does not promise a round-the-clock aide at home. The team decides how many home care hours the care plan covers, based on what keeps your parent safe in the community, and it covers nursing home care through PACE if community living stops being safe. Ask the team in writing what overnight cover the draft plan includes. If nights are the main gap, price overnight help separately.
Your next step is to check the service area first. Search the National PACE Association directory or Medicare.gov by your parent's address, ask for the four-test decision and a premium quote, and read assisted living alternatives to compare PACE with the facility route side by side.