As people age, they may require more healthcare yet become less equipped to care for themselves. If this is true of one of your loved ones, it could be time to help them transition to a senior living community or nursing home. However, some people are uncomfortable with the idea of moving into a senior living facility and may prefer to receive care and social support nearby — or in their home.
One solution is the Program of All-Inclusive Care for the Elderly (PACE). This joint Medicare and Medicaid program, which offers customized services under a single care team, supports older adults’ health and wellness while they age in place.
If you’re considering whether PACE is a good fit for your loved one, start by familiarizing yourself with the program’s offerings, talking to your loved one and their doctor about their needs and preferences and checking to see if there is a PACE location near you.
[READ: Navigating Medicare Deductibles and Premiums in 2026]
How the PACE Healthcare Model Works
PACE acts as both the primary insurance plan and the provider for nursing home-eligible older adults.
“It’s all under one roof — literally under one pay center,” says Dr. Esiquio Casillas, the executive vice president and chief clinical operations officer at AltaMed Health Services Program of All-Inclusive Care for the Elderly, based in Los Angeles. “There’s a real benefit in colocation of all the services in one place, where normally if you’re in a traditional Medicare plan, it is really piecemeal.”
The program’s all-inclusive approach offers centralized services in two primary ways:
— Local PACE centers: These neighborhood centers serve patients who live within designated boundaries.
— In-home care services: A PACE worker tends to a patient in their house or apartment.
[READ: Senior Home Care: Services, Costs and Tips for Aging in Place]
What Services and Benefits Does PACE Cover?
PACE covers all of the same services as Medicaid and Medicare, plus other services that your care team decides will benefit your health.
Services may include:
— Visits to the doctor and dentist, including for preventive care
— Physical and occupational therapy
— Hospital care
— Mental health counseling
— Imaging and diagnostic tests
— Meals and nutritional counseling
— Social services
— Transportation to the PACE center for activities or medical appointments
Who is on the PACE interdisciplinary care team?
The PACE interdisciplinary team includes a comprehensive, highly coordinated group of healthcare professionals who create individualized care plans
for PACE patients. Patients start working with their team upon admission into PACE and continue working with them throughout their time in the program.
Members of the PACE interdisciplinary team include but are not limited to:
— Doctors
— Nurses
— Therapists
— Social workers
— Dietitians
— Personal care aides
— Transportation drivers
[Read: Solo Aging: A Complete Guide to Living Independently and Safely]
Who Qualifies for PACE? Eligibility Requirements
Adults must meet the following requirements to be eligible for PACE:
— Be age 55 or older
— Be certified by their state as needing a nursing home-level of care, which may require them to display certain chronic conditions and/or dysfunctional limitations, such as having trouble walking or opening medications
— Be able to safely live in their community (with PACE’s assistance)
— Be located within a PACE service area (currently available in the District of Columbia and 33 states)
— Not be enrolled in certain other programs, including hospice services
How PACE Replaces Medicare Advantage Plans and Medigap Policies
PACE becomes your insurance provider when you enroll. It replaces your existing Medicare coverage, Medicare Advantage plan, Medigap plan
or Medicare Part D prescription drug plan.
— Medicare Advantage plan replacement: If you currently have a Medicare Advantage plan and want to join PACE, you must switch to original Medicare, which PACE then manages.
— Medigap policy cancellation: Because PACE covers Medicare-approved cost-sharing, your Medigap plan (which would otherwise cover any remaining costs) becomes redundant. To avoid paying monthly Medigap premiums, you should consider canceling your Medigap policy once you’re enrolled in PACE. However, if you elect to leave PACE, return to original Medicare and reenroll in a Medigap policy, you may face medical underwriting.
— Integrated prescription drug coverage: When you join PACE, you’ll get your Part D-covered drugs and all other necessary medication from PACE.
— Automatic program disenrollment: If you join a separate Medicare drug plan while you’re in the PACE program, you’ll be disenrolled from PACE.
PACE Program Cost and Payments: Understanding Premiums and Copays
How much you pay for PACE will depend on which insurance plan you are eligible for or enrolled in. Three typical payment protocols and cost methods for PACE include:
| Coverage scenario | Monthly Long-Term Care Premium | Medicare Part D Premium | Copays and Deductibles |
| Dual eligibility for Medicare and Medicaid | $0 (unless a state Medicaid share-of-cost applies) | $0 | $0 for all PACE-approved services |
| Medicare only | Set monthly PACE long-term care premium | $38.99 (2026 national base beneficiary premium; estimated to increase to $41.33 for 2027) | $0 for PACE-approved care; out-of-pocket copays apply for non-approved care |
| Private pay | $4,000 to $7,000, according to the American Council on Aging | Included in private plan rate or billed separately | $0 for PACE-approved services |
Does PACE have income limits?
No, there are no income limits for joining PACE. However, there are income limits to Medicaid, which can be used to pay for PACE. Exact limits can vary based on the state you live in and may change over time.
How to Find a PACE Center and Enroll
Before signing up for a PACE program, you’ll want to ensure that you have access to a PACE center nearby, and that you are eligible for PACE services.
Finding a PACE center
You can find a PACE center near you by using the National PACE Association’s online navigation tool. Here, you can search for centers by typing in your ZIP code, county or state. You can also click on a state on a digital map provided, and search that way. If you’d rather not use an online tool to find a center, ask your doctor for advice or talk to friends and family with experience using PACE.
Enrollment checklist: Steps to take before signing up for PACE
Some enrollment steps to check off your list include:
— Confirm that you are of eligibility age — meaning 55 or older.
— Verify that your residential address is within a PACE service area by using tools such as the PACE center navigation tool.
— Obtain any necessary certifications stating that you need a nursing home-level of care.
— Contact your local PACE provider to schedule an assessment.
PACE offers enrollment opportunities on a monthly basis. This sign-up structure may increase accessibility for some patients, especially if they’ve struggled to meet annual enrollment deadlines with other health plans. Despite this, PACE enrollment isn’t always quick or easy.
Because patients must be certified as nursing home-eligible before they can join the program, Casillas says prospective enrollees typically undergo a few weeks of waiting before starting PACE. This waiting period can consist of clinical assessments from state workers and visits from PACE team members. In some places, PACE programs may also have a waitlist, which may delay enrollment.
Understanding Enrollment Barriers and State Restrictions
Certain barriers may prevent your loved one from joining PACE, even if you feel they are eligible for the program. A big one is location.
PACE is not currently available in every state or in every ZIP code within the states it serves. Due to restrictions such as time limits for how long patients can be in transportation vehicles, PACE service areas can be tightly limited to neighborhoods around the center. However, the PACE program has been expanding, and more than 15 new locations opened between March 2025 and February 2026. There are now 200 PACE organizations across the country.
Whether or not this growth will continue is unclear. Progress is stalling in some states, like California, which in November 2025 initiated a two-year pause in accepting new PACE applications.
The pause does not impact existing PACE programs, which are able to continue enrolling patients in their areas, Casillas says.
Is PACE Right for You or Your Loved One?
If your loved one is unsure whether or not to enroll in PACE, consider the following steps:
— Have an open conversation about their health needs: “Ask if they are overwhelmed having to coordinate all of their many appointments and if they are more interested in receiving all of their services through one site,” suggests Monica Macias-Garcia, director of PACE at CalOptima Health in Orange, California. “Someone who prefers to manage their own care and who doesn’t have a lot of chronic illnesses may not benefit as much from PACE.”
— Visit a center near you: “It’s good to be aware and to be exposed to that environment (to see) whether they feel like it’s something they fit into,” Casillas says. Encourage them to ask detailed questions about the value-added aspects — from a rehab and long-term care perspective — that may be beneficial for them.
— Discuss post-visit observations: Some visitors may leave a visit feeling like it’s a place where they can fit into, Casillas says, whereas others may feel that they do not need such a high level of support. If your loved one feels that they do not need so much support, that could be a sign that PACE isn’t right for them at this point in time.
— Plan for the future: Talk about what kind of support they may need down the line and whether joining PACE now could help them prepare to tackle future health issues. “The family and patients should acknowledge some of the realistic, expected declines in the coming years,” Casillas says. “Anticipate those functional supports with caregivers or therapy that they may need.”
— Think about your budget: Consider how much future needs will cost. For instance, if your loved one is becoming increasingly reliant on rehab, they may be shelling out a lot of money on treatment copays with another health plan. If they join PACE, they will not have a copay for rehab.
— Consider how you can tailor the PACE experience: It can help to remember that while some patients visit the PACE center multiple times a week, others come in more sparingly, Casillas says. With the guidance of their doctors, your loved one would be able to personalize their plan to fit their needs.
Frequently Asked Questions
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PACE and Medicare: Eligibility, Coverage and Cost originally appeared on usnews.com
Update 08/21/26: This story was published at an earlier date and has been updated with new information.
