PACE Program: Help for Aging Parents Who Want to Stay at Home

PACE stands for Program of All-Inclusive Care for the Elderly. It is not a regular Medicare Advantage plan. It is a comprehensive care program for some older adults who need a nursing-home level of care but may still be able to live safely at home or in the community with the right support.

Michelle’s Take: PACE is one of those programs families often find out about too late. If Mom or Dad is declining, needing more help, or burning through savings to stay safe, PACE should at least be on the list of questions to ask.

What Is PACE?

PACE is a Medicare and Medicaid program that provides coordinated medical and social services for certain older adults who are frail enough to qualify for nursing-home-level care but want to remain in the community.

Instead of the family trying to coordinate doctors, transportation, therapies, medications, home support, and care planning alone, PACE uses a team-based model to manage the person’s care.

Who May Qualify for PACE?

Age Requirement

The person must generally be age 55 or older.

Service Area

The person must live in a ZIP code or service area served by a local PACE organization.

Care Need

The person must be certified as needing a nursing-home level of care.

Community Safety

The person must be able to live safely in the community with the support PACE provides.

What Services Can PACE Include?

Services vary by the person’s care plan, but PACE may coordinate or provide:

  • Primary medical care
  • Specialist care
  • Prescription drugs
  • Adult day health services
  • Transportation to medical appointments
  • Physical, occupational, or speech therapy
  • Meals and nutrition support
  • Home care and personal care assistance
  • Medical equipment
  • Hospital care when needed
  • Nursing home care if it becomes necessary

Is PACE Available Everywhere?

No. This is the part families need to understand. PACE is not available in every state, and even in states that have PACE, it is usually limited to certain counties, cities, or ZIP codes.

Before a family counts on PACE, they should verify whether a local PACE organization serves the exact ZIP code where the older adult lives.

How Much Does PACE Cost?

Cost depends on whether the person has Medicare, Medicaid, both, or neither. Many PACE participants are eligible for both Medicare and Medicaid. If someone has Medicaid, they may pay little or nothing for the long-term care portion. If they do not qualify for Medicaid, they may have to pay a monthly premium.

This is one reason families should not guess. If money is running out, it may be time to talk with the local PACE organization, the state Medicaid office, and possibly an elder law attorney.

Is PACE Something You Enroll In at 65?

Usually, no. PACE is not a normal “turning 65” Medicare choice.

PACE usually becomes relevant later, when someone’s health has declined, caregiving needs are increasing, or the family is trying to avoid or delay nursing home placement.

Questions Families Should Ask

  • Does a PACE organization serve my parent’s ZIP code?
  • Does my parent need help bathing, dressing, walking, eating, or managing medications?
  • Has a doctor said nursing home care may be needed?
  • Is the family paying privately for assisted living or extra care?
  • How long will the current savings last?
  • Does my parent have Medi-Cal or Medicaid?
  • Would PACE allow my parent to remain where they are safely?
  • Would my parent have to change doctors?

PACE and Assisted Living or Senior Communities

Living in a senior community does not automatically rule PACE out. What matters is whether the person lives in a PACE service area, meets the care-level requirements, and can safely remain in the community with PACE support.

But families also need to ask whether the current community accepts Medi-Cal or Medicaid, whether PACE can coordinate care there, and what happens when private funds run out.

When PACE May Be Worth Exploring

  • A parent has Parkinson’s, dementia, frailty, falls, or worsening mobility.
  • One spouse is becoming the full-time caregiver for the other.
  • The family wants to avoid moving directly to a nursing home.
  • The parent is running out of money for private-pay care.
  • The family needs transportation, medication support, therapy, and care coordination.
  • The parent may qualify for Medicaid or Medi-Cal.

Need Help Thinking Through the Medicare Side?

PACE is not the right fit for everyone. But if your family is trying to understand Medicare, care options, and what happens when aging parents need more help, it is worth asking the right questions early.

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Sources: Medicare.gov PACE | CMS PACE | National PACE Association