Age 55 or Older
Participants must be at least 55 years old.
✦
PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY
PACE: Coordinated Care. Designed Around the Person.
PACE brings medical care, prescriptions, therapies and supportive services together through one coordinated care program.
For eligible older adults who need a higher level of support, PACE may help make it possible to continue living safely in the community while receiving comprehensive care.
✓ Coordinated Care
✓ Community Support
✓ One Care Team
Care That Works Together
Medical, social and supportive services coordinated through
one interdisciplinary team.
✦
UNDERSTANDING PACE
What Exactly Is PACE?
PACE stands for Program of All-Inclusive Care for the Elderly. It is designed to coordinate healthcare and supportive services for eligible older adults who need a nursing-home level of care but can continue living safely in the community with PACE support.
One Program. One Team. One Care Plan.
Instead of coordinating multiple providers, prescriptions, therapies and support services independently, PACE brings care together through an interdisciplinary healthcare team.
That team evaluates the participant's needs, develops a care plan and coordinates approved medical and supportive services.
1
Healthcare Coordination
Primary care, specialists, medications and therapies can be
coordinated through the PACE program.
2
Support Beyond the Doctor's Office
Depending on need, PACE may include transportation,
home support, nutrition and other services.
3
Helping People Remain in the Community
PACE is built around helping eligible participants remain
safely in their home and community whenever possible.
✦
WHO MAY QUALIFY
PACE Has Specific Eligibility Requirements.
PACE is not available to everyone. A participant generally must meet all four of the following requirements.
Live in a PACE Service Area
You must reside in the approved service area of a PACE organization.
Need Nursing-Home Level Care
Your state must certify that you meet its required nursing-facility level-of-care standard.
Live Safely in the Community
At enrollment, you must be able to live safely in the community with the support of the PACE program.
Eligibility is determined by the PACE program and applicable
state requirements.
A quick online questionnaire can help identify whether PACE
may be worth exploring, but it cannot determine actual eligibility.
✦
MORE THAN A HEALTH PLAN
PACE Can Coordinate A Wide Range of Services.
The exact services depend on the participant's individual care plan, but PACE can include medical, prescription, rehabilitation and supportive services approved by the care team.
Primary & Specialty Care
Physician, nursing, preventive and specialty medical care.
Prescription Drugs
Medically necessary medications coordinated through PACE.
Transportation
Transportation to the PACE center and certain medical appointments.
Therapy & Rehabilitation
Physical, occupational and speech therapy when included in care.
Home Support
Home care and personal-support services when medically appropriate.
Nutrition
Nutritional counseling and other dietary support services.
Social Services
Social support and assistance coordinated with the care team.
Hospital & Facility Care
Hospital and nursing-facility care when medically necessary.
✦
CARE THAT LOOKS AT THE WHOLE PERSON
Sometimes the Challenge Isn't One Doctor. It's Coordinating Everything.
Multiple providers, medications, therapies, appointments and family responsibilities can become difficult to manage independently.
PACE is designed around coordinated care. Instead of treating each service like a separate piece, the care team works from a more complete picture of the participant's needs.
✓ Medical Care
✓ Medications
✓ Transportation
✓ Therapies
✓ Home Support
✓ Family Coordination
✦
HOW COORDINATED CARE WORKS
One Team Helps Connect The Pieces of Care.
PACE uses an interdisciplinary team approach. The participant's needs are assessed and a coordinated care plan is developed around medical, social, rehabilitation and supportive needs.
This structure can be especially valuable when several different services need to work together.
1
Assess the Participant's Needs
The PACE team evaluates health, functional and supportive-care needs.
2
Build a Coordinated Care Plan
The team determines which medical and supportive services are needed.
3
Coordinate Approved Services
Providers, prescriptions, therapy, transportation and support can be organized through the PACE program.
✦
PACE FIT CHECK
Could PACE Be Worth Exploring?
Answer five simple questions. This does not determine eligibility, but it can help you decide whether a conversation about PACE may be worthwhile.
PACE FIT CHECK
QUESTION 1 OF 5
Do you or your loved one need help coordinating medical care?
This might include multiple doctors, appointments, prescriptions or therapies.
Is remaining safely at home and in the community important?
PACE is designed around helping eligible participants remain in the community whenever safely possible.
Are there several health conditions, medications or providers to manage?
Complex healthcare needs can make coordinated care especially valuable.
Would reliable transportation to care be helpful?
Transportation is one of the services PACE can provide for approved care.
Would having one coordinated care team reduce stress for the family?
PACE can help bring medical and supportive services into one coordinated care structure.
PACE May Be Worth Exploring
This questionnaire is educational only. Actual PACE eligibility
depends on age, residence within a PACE service area, state
level-of-care requirements and the ability to live safely in the
community with PACE support.
✦
DIFFERENT WAYS TO RECEIVE MEDICARE CARE
PACE Is Different From Traditional Medicare Choices.
PACE, Medicare Advantage and Original Medicare can structure healthcare very differently. The right fit depends on your health, eligibility, providers and support needs.
PACE
Highly Coordinated Care
✓ Interdisciplinary care team
✓ Medical and supportive services coordinated together
✓ Prescription coverage through PACE
✓ May include transportation and home support
✓ Requires PACE eligibility
MEDICARE ADVANTAGE
Private Medicare Plan
✓ Medicare benefits through a private plan
✓ Often includes prescription coverage
✓ Provider networks may apply
✓ Copays and coinsurance vary by plan
✓ Does not require nursing-home level-of-care eligibility
ORIGINAL MEDICARE
Traditional Medicare
✓ Medicare Parts A and B
✓ Broad nationwide provider access
✓ Part D generally selected separately
✓ Medigap may be added if eligible
✓ Care coordination is generally less centralized
✦
BEFORE CHOOSING PACE
Important Things To Understand.
PACE can be a strong fit for some people, but it works differently from traditional Medicare coverage.
PACE Must Be Available Where You Live
PACE is service-area based and is not available everywhere.
Your Care Is Coordinated Through PACE
Once enrolled, Medicare and Medicaid-covered services are generally received through the PACE program and its care arrangements.
Drug Coverage Is Included Through PACE
Participants receive their medically necessary prescription drugs through PACE rather than enrolling in a separate Part D plan.
PACE Eligibility Is More Than Having Medicare
Nursing-home level-of-care requirements and community-safety requirements are part of the eligibility process.
✦
COMPLIMENTARY 2027 MEDICARE GUIDE
Want the Big Picture?
PACE is only one way Medicare beneficiaries may receive care. Understanding how the major Medicare options differ can make the entire decision much easier.
Our complimentary Understanding Medicare — 2027 Edition guide explains Medicare in straightforward, easy-to-follow language.
✓
Coverage Options Explained
Understand the major ways Medicare coverage can be structured.
✓
Costs & Enrollment
Learn how premiums, deductibles and enrollment periods work.
✓
Planning Information
Build a clearer picture before making Medicare decisions.
✦
EXPLORE YOUR OPTIONS
Could PACE Be Right for You or a Loved One?
PACE can be an excellent option for some older adults who need significant care coordination and support while remaining in the community.
We'll help you understand how PACE works and how it compares with other Medicare coverage options.
No cost. No obligation. Just clear Medicare guidance.
WE'LL HELP YOU UNDERSTAND
55+
PACE Eligibility Requirements
+
How Coordinated Care Works
⌂
Community & Home Support
✓
How PACE Compares With Other Options
We may not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.