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PACE — all-inclusive care at home
PACE is the choice families are least likely to have heard of. It is made for people whose state has already said they need nursing-home-level care. Its purpose is to give that care while they go on living at home. Where it is offered, it is worth a phone call before anything else gets decided.
What it is
Medicare's own description: PACE is "a Medicare and/or Medicaid comprehensive medical and social services program available in some states." A team of health care professionals works with the person to manage their care. The program covers all Medicare and Medicaid services, plus anything else that team decides the person needs. It is fitted to their medical, physical, social and emotional needs.[1]
Medicare lists these services as ones PACE may cover:[1]
- Primary care at an adult day center, including meals, special diets and recreation therapy
- Primary care, specialist care and preventive care
- Home care, and personal care and support services
- Hospital care, emergency services, and nursing home care when medically needed
- Prescription drugs
- Physical therapy, occupational therapy and speech therapy
- Lab tests and x-rays
- Dental care, nutrition counseling, mental health counseling and social services
- Rides
Read that list with its condition in mind. These are services PACE may cover. What one person really gets is what the care team decides is needed. It covers a lot, but not without limit. And you cannot go to any provider you like.
The four tests
All four must be true:[1]
- The person is at least 55.
- They live in an area a PACE organization serves.
- Their state certifies that they need nursing-home-level care.
- They are able to live safely in the community with help from PACE.
The second one decides most cases. PACE runs in some states and, inside those states, only in certain areas. So the question is never "does my state have PACE." It is "does a program serve this address." The National PACE Association has a program finder that answers it.
An earlier version of this page said there were 202 programs serving more than 95,000 people in 33 states and DC. We could not confirm those numbers, and counts like these go out of date fast, so they are gone. Use the finder, not a number on a website.
What it costs
With Medicaid: Medicare says you will not pay a monthly premium for PACE.[1]
With Medicare but not Medicaid: you pay a monthly premium for the long-term care part, plus a premium for Medicare Part D drug coverage.[1] What that adds up to is a question for the local program.
What only the local program can tell you
Does a program serve your address? Does your person pass the state's care-level test? Both are decided locally.
Who to ask: the National PACE Association program finder at npaonline.org; the PACE organization itself; and your state Medicaid office for the care-level test.
What to ask them:
- Does a PACE organization serve this exact address?
- What does the state's test for nursing-home-level care involve, and who does it?
- What would we pay, with Medicaid or without it?
- If my person joins, what happens to their current doctors? PACE manages care through its own team, so ask this before signing up, not after.
- What happens if their needs change and they can no longer live safely in the community?
Free local help. Your Area Agency on Aging will talk through your choices with you for free. Find yours through the federal Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov (run by the Administration for Community Living).[2] To learn about the four kinds of local helpers and what each one does, see Who helps me locally.
Quick answers
What is the PACE program for the elderly?
Medicare describes PACE, the Program of All-inclusive Care for the Elderly, as "a Medicare and/or Medicaid comprehensive medical and social services program available in some states." A team of health care professionals works with the person to manage their care. PACE covers all Medicare and Medicaid services, plus anything else the team decides the person needs. That last part is the key to how it works. What is covered is what the team decides is needed, not a fixed list. [1]
Who is eligible for PACE?
There are four conditions, and all must be met. The person is at least 55. They live in an area a PACE organization serves. Their state certifies that they need nursing-home-level care. And they are able to live safely in the community with help from PACE. The service-area test is the one that most often decides it, because PACE covers certain areas, not whole states. [1]
What does PACE cost?
If the person has Medicaid, Medicare says they will not pay a monthly premium for PACE. Someone with Medicare but not Medicaid pays a monthly premium for the long-term care part, plus a premium for Medicare Part D drug coverage. Ask the local PACE organization what that would really come to for you. [1]
Sources and what they support
Sources checked 2026-09-23 using AI-assisted editorial research. This is a source check, not benefits advice.
- Medicare, PACE. Supports the quoted description of PACE as a Medicare and/or Medicaid comprehensive medical and social services program available in some states, that a team of health professionals coordinates the care, that PACE covers all Medicare and Medicaid services plus what the team decides is needed, the full list of services it may cover, all four eligibility conditions, and both cost statements — no monthly PACE premium with Medicaid, and a long-term-care premium plus a Part D premium without it. Coverage of any individual service is decided by the interdisciplinary team, availability is by service area rather than by state, and this page publishes no count of programs or participants. The URL previously used on this page omitted the "other-medicare-health-plans" segment and no longer resolves.
- Administration for Community Living, Eldercare Locator. Supports the referral route to a local Area Agency on Aging for free options counselling. It does not determine PACE eligibility or carry out the level-of-care assessment.
Removed in this pass, for want of a source we could verify: that there are 202 PACE programs serving more than 95,000 participants in 33 states and DC. The page title also no longer says PACE "keeps people out of nursing homes" — living safely in the community is one of the program's eligibility conditions and its aim, not an outcome it can promise.