19-05-2025
What Is Medicare's PACE Program?
The PACE provides medical and social services for people with significant needs who want to continue living at home. It's a combined effort between Medicare and Medicaid.
The Program of All-Inclusive Care for the Elderly (PACE) offers support for people who wish to live at home but require a certain level of consistent medical care.
Many of those enrolled in PACE are eligible for both Medicare and Medicaid, and these organizations work together to offer this program.
PACE covers several services as long as you live within one of its service areas and meet specific criteria to qualify. Keep reading to discover what services are covered, how to qualify, and more.
What is pace, and how does it work?
PACE was created for people who need help managing their health but live in a private residence rather than a skilled nursing facility. You must have specific needs to qualify for the program, and most PACE participants are already dual eligible for both Medicare and Medicaid.
Medicare and Medicaid work together to offer PACE services, which are provided across the country by local care teams. The PACE team assesses the needs that can be met within your community.
PACE is a public program that can help you get the medical and social support you need without a lot of extra costs and without leaving home. The program covers all the services available under Medicare, Medicaid, and more.
A few examples of these services include:
adult day care
dental care
help with meals and nutrition
home care
occupational and physical therapy
prescription medications
social services and social work counseling
transportation
A specialized team of professionals is brought together to provide the necessary services for your care. This team may include the following:
dietitian
driver
home care liaison
nurse
occupational therapist
PACE center supervisor
personal caregiver
physical therapist
primary care physician
recreational therapist
social worker
Services are mainly provided at adult day health centers participating in the PACE program. Those services are supplemented by in-home care and other referral services. These are based on your needs and as directed by the PACE healthcare team.
When you need end-of-life care, the PACE program provides medical, prescription drug, and counseling services. The exception is if you elect to use hospice benefits.
At that point, you're required to disenroll from the PACE program. You can choose to end your participation in the PACE program at any time for other reasons as well.
Am I eligible for this program?
Enrollment in the PACE program is voluntary. If you'd like to enroll, you must meet specific criteria to be eligible. You must:
be age 55 or older
live in a PACE service area
be certified by your state (through Medicaid) as needing nursing home–level care
be able to continue living in the community safely with the help of PACE services
As long as you meet these criteria and want to enroll in the PACE program, you
to be enrolled in Medicare or Medicaid. Plus, financial criteria are not considered when determining your eligibility for a PACE program.
To enroll in a PACE program, however, you can't already be enrolled in any of the following:
a Medicare Advantage (Part C) plan
a Medicare prepayment plan
a Medicare prescription drug plan
hospice services
certain other programs
How much does the PACE program cost?
A monthly premium covers the long-term care portion of the PACE benefit. If you don't have Medicare or Medicaid, you'll be responsible for paying this premium. The premium amount will depend on the services you need and your PACE service area.
If you don't qualify for Medicaid, you'll also pay a premium for your Medicare Part D medications. But you won't have to pay any deductibles or copayments for services your PACE care team provides.
What are the income limits for PACE?
In order to qualify for PACE without having to pay a premium, you need to qualify for Medicare or Medicaid. Medicare eligibility is determined by age or having certain disabilities. To qualify for Medicaid, you need to earn under certain income limits and below certain thresholds for assets.
In 2025, 185 PACE programs operated in 33 states and the District of Columbia. Most states follow the federal Medicaid income limit of three times the SSI benefit level of $967 per individual monthly, or $2,901. The asset limit i $2,000 per person, and both incomes are higher if you are a couple.
A number of states, however, have alternative limits. The following limits are based on available information and may change slightly depending on the state and the calendar year.
PACE programs by state Monthly individual income limit Individual asset limit
Arkansas $2,829 $2,000
California $1,732 none
Delaware $2,417.5 $2,000
Illinois $1,304 $17,500
Louisiana $2,901 $2,000
Missouri $1,109 $5,909
Nebraska $2,609 $4,000
North Carolina $1,305 $2,000
North Dakota $1,174 $3,000
What are the pros and cons of the pace program?
One advantage of PACE is its interdisciplinary healthcare team, which includes both professional and paraprofessional staff.
A 2022 review of six studies compared PACE with other U.S. caregiving programs for older adults, focusing on economic, clinical, and functional outcomes. Some studies demonstrated better results for PACE participants, such as fewer and shorter hospital stays.
However, among the potential disadvantages of the PACE program, the study also found higher nursing home use among PACE enrollees. In addition, clinical outcomes and survival rates varied. Some studies indicated longer survival for PACE participants, while others showed higher mortality.
The review, therefore, highlighted limited research and a lack of thorough bias assessments, emphasizing the need for more comprehensive studies on the effectiveness of the PACE program.
How do I enroll?
To enroll in a PACE program, you must meet the criteria mentioned above and any other requirements from your local program. If you decide to enroll, you must agree to provide medical and other personal information that'll allow your care team to assess your needs and determine which services are required.
Once you sign an enrollment agreement for a PACE program, you'll receive additional information on what the program covers, how to get services, and plans for emergency care.
When enrolled in PACE, you don't need to reenroll annually as long as you meet the program's criteria. You can disenroll from the PACE program at any time.
It's possible to be dropped from the program as well. Some of the reasons you may be dropped include:
not paying your PACE premiums
engaging in disruptive, dangerous, or threatening behaviors that could harm yourself or a caregiver
moving outside of a PACE service area
the state no longer contracts your PACE provider to provide care under the program
you are no longer eligible for services, as determined by the state
Takeaway
PACE is a program for people who need extra medical services in their home or community. You'll need to meet specific criteria to qualify, continue to prove these needs, and follow any rules set by your local program.
If you qualify for Medicare or Medicaid, these agencies will help pay for the cost of PACE services. You can enroll or disenroll from PACE at any time, regardless of Medicare enrollment periods.-=[';
