The Programs of All-Inclusive Care for the Elderly (PACE) is designed to provide comprehensive medical and social services to support frail, older adults who are still living in their communities. Many PACE participants are eligible for both Medicare and Medicaid, often referred to as “dually eligible.” PACE utilizes an interdisciplinary team of healthcare professionals to deliver coordinated care to each participant. This comprehensive approach aims to enable seniors to continue living at home and in their communities, avoiding the need for nursing home care for as long as possible.
A key feature of PACE is its capped financing structure. This unique funding model allows PACE providers the flexibility to deliver all necessary services to participants, rather than being restricted to only those services reimbursed under traditional Medicare and Medicaid fee-for-service plans. PACE operates under Medicare, and states have the option to include PACE services as a benefit for Medicaid recipients. For individuals enrolled in PACE, the program becomes their single source for both Medicare and Medicaid benefits. This integrated approach ensures seamless and comprehensive care coordination.
PACE Eligibility Requirements
To be eligible for PACE, individuals must meet specific criteria:
- Age 55 or older: PACE is specifically designed for older adults.
- Reside in a PACE Organization’s Service Area: Applicants must live within the geographical area served by a PACE program.
- Require Nursing Home Level Care: Participants must be assessed as needing the level of care typically provided in a nursing home, as certified by the state.
- Ability to Live Safely in the Community: It must be determined that the individual can live safely at home with the support of PACE services at the time of enrollment.
Once enrolled in PACE, the program manages all Medicare and Medicaid benefits for eligible individuals. Participants retain the right to disenroll from PACE at any time should their needs or preferences change.
Discover More About PACE
The PACE program offers a valuable option for older adults who require significant health and social support but wish to remain living in their own homes and communities. It provides a holistic and integrated approach to care, focusing on maintaining the well-being and independence of its participants.
