Guide
PACE program: a nursing home alternative for living at home
Updated October 15, 2026 · Reviewed against official sources
Many Latino families want mom or dad to stay at home as long as possible. But when health problems pile up, coordinating doctors, therapies, medications, and caregivers becomes exhausting for the family caregiver. PACE was created for exactly this: a single team takes charge of all the care.
What is PACE?
PACE stands for Program of All-Inclusive Care for the Elderly. In its Spanish-language materials, Medicare calls it Programa de Cuidado Integral para Ancianos. It combines Medicare and Medicaid services in a single program, run by a local PACE organization under an agreement between CMS, the state, and that organization.
What makes it different is the interdisciplinary team: doctors, nurses, social workers, therapists, dietitians, drivers, and aides who meet to plan and follow up on each participant's care. Most services are provided at a PACE center, which works like an adult day center with a clinic and which the person attends according to their care plan.
Who qualifies
According to Medicare.gov, to join PACE a person must meet four conditions:
- Be 55 or older.
- Live in the service area of a PACE organization.
- Be certified by their state as needing a nursing home level of care.
- Be able to live safely in the community with PACE's help at the time they join.
You don't have to have Medicare or Medicaid to join: someone who has neither can pay the PACE premium on their own. Even so, most participants have one or both.
"Needing a nursing home level of care" doesn't mean the person has to move into one. It's a measure of how much help they need day to day. PACE exists precisely so they can stay at home.
To get an early idea of how much help your loved one needs, you can use our Katz and Lawton scales. They're only a guide; the official certification is done by the state.
What PACE covers
PACE covers all Medicare and Medicaid services the team considers necessary, plus other services the team approves even if they aren't normally covered. These include:
- Primary care and specialist care.
- Prescription drugs.
- Adult day care, with meals, activities, and therapies.
- Nursing, physical therapy, and occupational therapy.
- Help at home with personal care.
- Transportation to the PACE center and to medical appointments.
- Hospital care, lab tests, X-rays, and emergency care.
- Medical equipment, like walkers or wheelchairs.
- Social work and support for the family caregiver.
- Nursing home stays when medically necessary; PACE keeps coordinating and paying for that care.
How much it costs
| If the person has | What they pay |
|---|---|
| Medicaid (with or without Medicare) | No monthly premium |
| Medicare only | A monthly premium for the long-term care portion and another for Part D drugs |
| Neither Medicare nor Medicaid | They can pay the PACE premium on their own |
In all cases, there are no deductibles, copayments, or coinsurance for the drugs, services, and care that the PACE team approves.
Keep in mind: PACE uses the PACE organization's doctors and providers. If your loved one has had the same doctor for many years, ask whether that doctor works with the program before enrolling, and what happens if they use services outside the network. Also, if the person enrolls on their own in a separate Medicare drug plan, they'll be disenrolled from PACE.
Advantages and things to consider
Advantages
- One team coordinates everything: fewer calls, less paperwork, and fewer missed appointments.
- Transportation is included.
- The PACE center provides company and activities, and gives the caregiving family a break.
- If health gets worse, PACE stays in charge, even if the person needs a nursing home.
Things to consider
- It's only available in certain areas. PACE isn't offered in every state or in every county.
- You have to switch to doctors in the PACE network.
- The person attends the center according to their plan, and some people take time to get used to it.
- Some centers have staff who speak Spanish and others don't. It's worth asking.
How to find a PACE program
- Search on Medicare.gov: use the "Find a PACE plan" tool with your ZIP code.
- Call your state's Medicaid office: they'll tell you if there's PACE in your area and how the level-of-care certification is done.
- Check with the National PACE Association (npaonline.org), which publishes a directory of programs.
- Call the Eldercare Locator: 1-800-677-1116, Monday through Friday. You can ask for help in Spanish.
What the enrollment process is like
- First contact: call the PACE program in your area. They'll ask you some basic questions.
- Visit and assessment: the team visits the home and assesses health and needs.
- State certification: the state confirms that the person needs a nursing home level of care.
- Medicaid application (if it applies): the program usually helps with this paperwork.
- Signing the enrollment agreement and creating the care plan.
Helpful questions for the visit:
- How many days a week would my loved one go to the center?
- Are there staff members, doctors, or nurses who speak Spanish?
- How many hours of help at home could they get?
- How does transportation work, and how far in advance do you have to request it?
- What happens if my loved one needs to go to a hospital or a nursing home?
- What support do you give the caregiving family?
If your loved one is hesitant to accept help or go to a center, these ideas for talking with mom or dad also work for talking about PACE.
PACE compared with other options
PACE isn't the only way to get help at home. Depending on the state, Medicaid also has home care programs, such as IHSS in California, STAR+PLUS in Texas, SMMC LTC in Florida, or MLTC and CDPAP in New York. Compare options in:
- Home care for seniors
- Adult day care for seniors
- Texas Medicaid: STAR+PLUS
- Medi-Cal and IHSS in California
- Types of senior living and care options
You can also try the guided search or look for adult day centers in your area.
Frequently asked questions
Can my loved one leave PACE if they don't like it?
Yes. Under federal rules, a participant can disenroll at any time, without having to give a reason. Disenrollment takes effect on the first day of the month after the organization receives the notice. Ask the program how to go back to Original Medicare or to another plan.
Is PACE a good fit for someone with Alzheimer's?
It can be, as long as the team believes the person can live safely in the community with the program's support. If they need constant supervision, also compare it with memory care.
Do I have to leave my regular doctor?
Usually, yes, because PACE works with its own network. Ask whether your doctor works with the program.
Does PACE pay a family member to provide care?
PACE provides help at home with its own staff or providers. If what you're looking for is for a family member to be paid, ask about your state's Medicaid programs and see help for family caregivers.
PACE and Medicaid rules vary by state. This guide is for information only and is not legal or medical advice.
Sources
- Medicare.gov, PACE: https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE (accessed October 15, 2026)
- Medicare.gov, Spanish-language fact sheet on PACE (11341-S): https://es.medicare.gov/publications/11341-s-quick-facts-program-of-all-inclusive-care-for-the-elderly-pace.pdf (accessed October 15, 2026)
- CMS, PACE fact sheet: https://www.cms.gov/Medicare/Health-Plans/PACE/Downloads/externalfactsheet.pdf (accessed October 15, 2026)
- eCFR, 42 CFR Part 460 (PACE), including section 460.162 on voluntary disenrollment: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-E/part-460 (accessed October 15, 2026)
- National PACE Association: https://www.npaonline.org/ (accessed October 15, 2026)
- Eldercare Locator (ACL): https://eldercare.acl.gov/ (accessed October 15, 2026)
This is general information, not medical, legal or financial advice. Rules vary by state and by year: confirm with the official agency that applies to you.
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