For families facing a difficult crossroads — a parent or spouse who needs the level of care a nursing home provides but wants, above all, to keep living at home — Medicare's rules can feel like a series of "no" answers. The Program of All-Inclusive Care for the Elderly, better known as PACE, is one place where the answer may be "yes." PACE combines Medicare and Medicaid funding into a single coordinated program built around helping people who qualify for nursing-home-level care stay safely in their communities instead. Here is how PACE works, who qualifies, what it covers, and what it costs in 2026.
The Short Answer
PACE is a joint Medicare and Medicaid program that provides comprehensive medical care and long-term care support to people age 55 and older who need a nursing-home level of care but can live safely at home with help. An interdisciplinary team — doctors, nurses, therapists, social workers, dietitians, drivers, and aides — plans and delivers all of a participant's care, generally centered around a local PACE center.
As of mid-2026, there are 202 PACE programs operating in 33 states plus the District of Columbia, serving more than 95,500 participants, according to the National PACE Association. In Pennsylvania, the health program goes by a different name: LIFE (Living Independence for the Elderly). PACE is not available everywhere — you must live in a PACE organization's service area — but where it exists, it may cover more than Medicare and Medicaid do separately, often with no deductibles, copays, or coinsurance for care the PACE team approves.
Who Is Eligible for PACE
To join PACE, you generally must meet all four requirements:
- Be age 55 or older
- Live in a PACE organization's service area
- Be certified by your state as needing a nursing-home level of care
- Be able to live safely in the community with PACE's support at the time you enroll
You do not need to be enrolled in Medicare or Medicaid to join PACE — private-pay enrollment is possible. In practice, though, about 90% of participants are dually eligible for both Medicare and Medicaid, and the average participant is 76 years old with multiple complex health conditions. For a refresher on how the two programs differ, see our guide to how Medicare and Medicaid compare.
One important rule: you generally cannot be enrolled in PACE at the same time as a Medicare Advantage plan, a standalone Part D drug plan, or hospice. Joining PACE means the PACE organization becomes the source of all your covered care, including prescription drugs.
What PACE Covers
PACE covers everything Medicare and Medicaid cover — plus any additional care and services the interdisciplinary team determines are necessary to keep you healthy and living in the community. That generally includes:
- Primary care and specialty care, delivered or arranged by the PACE medical team
- Hospital care and nursing home care when the team determines you need them
- Prescription drugs — PACE includes Part D drug coverage, so enrollees get medications through the program rather than a separate drug plan
- Adult day care at the PACE center, including social activities and supervision
- Transportation to the PACE center and medical appointments
- Meals, both at the center and, when needed, at home
- Physical and occupational therapy
- Dental, vision, and hearing care
- Home care, such as personal care and homemaker services
- Caregiver support and respite care for family members
This breadth is what sets PACE apart. Original Medicare generally does not pay for ongoing custodial long-term care — our guide to what Medicare does and doesn't cover for long-term care explains that gap. PACE fills much of it for those who qualify, wrapping medical care, home health-style services, and daily-living support into one program. For families providing hands-on care, the built-in respite can matter as much as the medical coverage — see our guide for caregivers helping a loved one on Medicare.
What PACE Costs in 2026
What you pay for PACE depends on your coverage situation:
- If you have Medicaid (whether dually eligible or Medicaid-only), you generally pay no monthly premium for the long-term-care portion of PACE.
- If you have Medicare but not Medicaid, you pay a monthly premium for the long-term-care portion, plus a premium for Part D drug coverage.
- If you have neither, you may enroll privately and pay the full premium — as a rough market figure, typically several thousand dollars per month.
For care approved by your PACE team, there are no deductibles, no copays, and no coinsurance — a predictability that contrasts with Original Medicare's cost-sharing, such as the $283 Part B deductible (2026) and 20% coinsurance.
The Trade-Off to Understand
PACE's coordination comes with a real trade-off: your care generally comes from PACE's contracted doctors and providers, not the physicians you see today. For some families that loss of continuity is significant; for others, gaining a single accountable team outweighs it.
Enrollment is voluntary, and there is no lock-in. You may disenroll in any month and return to Original Medicare or join a Medicare Advantage plan if PACE is not the right fit.
How to Find a PACE Program
Because PACE operates through local organizations with defined service areas, availability is the first question. You can check three places: the PACE page and plan finder on Medicare.gov, the National PACE Association directory at npaonline.org, or your state Medicaid office, which certifies PACE eligibility.
How to Get Help and Learn More
If PACE sounds like it may fit your situation, these official resources can help:
- Medicare.gov — Search "PACE" at medicare.gov to find the official program page under other Medicare health plans.
- 1-800-MEDICARE (1-800-633-4227) — Medicare's official helpline can answer questions about PACE and your current coverage. TTY users can call 1-877-486-2048.
- State Health Insurance Assistance Program (SHIP) — SHIP offers free, unbiased counseling and can help you compare PACE against your other options. Find your local program at shiphelp.org or by calling 1-800-MEDICARE.
Summary and Next Steps
PACE serves people caught between needing nursing-home-level care and wanting to remain at home. Key points:
- PACE combines Medicare and Medicaid into one coordinated program — 202 programs in 33 states plus DC, serving more than 95,500 people as of mid-2026
- Eligibility requires being 55 or older, living in a PACE service area, being state-certified as needing nursing-home-level care, and being able to live safely in the community with PACE support
- Coverage includes everything Medicare and Medicaid cover plus more, with no cost-sharing for team-approved care
- With Medicaid, there is generally no premium for the long-term-care portion; Medicare-only enrollees pay monthly premiums; private pay typically runs several thousand dollars per month
- The main trade-off: care comes from PACE's team, not your current doctors — and you may disenroll any month with no lock-in
If a loved one may qualify, start by checking whether a PACE organization serves your area, then contact it directly. For an independent read on how PACE compares with your other options, your local SHIP counselor can walk through it with you for free.
