A nursing home move isn't the only option when daily health needs start to outpace what family can manage alone. A federal program called PACE, the Program of All-Inclusive Care for the Elderly, pays for medical care, therapy, meals, and transportation, the kind of support people usually associate with a facility, while you keep living at home.
PACE reaches most states now, but not every county inside them, and the rules for who qualifies are specific. Here's what the program actually covers and how to find out if it reaches you.
Decision
Who are you looking into this for?
PACE asks the same eligibility questions either way, but your situation shapes what to check first.
What PACE Actually Covers
PACE builds one care team around you instead of billing separately for each piece of care. Doctors, nurses, therapists, and social workers coordinate out of a PACE center you visit part of most weeks, then follow up with services at home and rides to outside appointments when needed.
The coverage list is long on purpose. If your care team decides you need something to stay healthy and independent, PACE is responsible for arranging and paying for it, not just the items on a standard Medicare or Medicaid list.
Who Qualifies, and How to Apply
PACE has four requirements, and all four have to be true at once. You need to be 55 or older, certified by your state as needing a nursing-home level of care, living inside a PACE organization's service area, and able to live safely in the community as long as PACE's support is in place.
The service-area requirement is the real bottleneck. PACE has grown steadily, but it still isn't available in every state, or in every county inside a state that has it. The first practical step is finding out whether one actually reaches your address, not whether you qualify on paper.
If you're calling on someone else's behalf, one more step comes first.
Before you make that call, it helps to see whether a PACE week actually fits real life, since center days, ride pickups, and home visits all need to line up on the calendar.
Make sure rides, meals, and follow-up help are covered.
Build my scheduleClose tool
Organize rides, meals, pickups, and check-ins with dates, helpers, and follow-up timing.
Checklist
See what's actually included
This is the short version of a long list.
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Checklist
Check these before you call
A few minutes of searching tells you whether this is worth pursuing.
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Timeline
Work through it in order
Check off each step as you finish it.
Look up Medicare's PACE organization finder for your ZIP code.
Ask how their intake process works and how long it typically takes.
Contact your state Medicaid office about a home and community-based services waiver, or ask a nearby PACE organization if they keep a waitlist for your county.
Checklist
Ask these before your first day
A few questions upfront prevent surprises later.
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Save what you found out and what's next before you make the first call.
Finding a PACE Program Near You
Not every state has adopted PACE, and coverage inside a state can stop at a county line. If nothing shows up for your ZIP code today, that isn't necessarily permanent. New PACE organizations open most years, and some maintain waitlists you can join in advance.
If PACE isn't available where you live yet, the four eligibility rules above still matter, because related state programs, like a Medicaid home and community-based services waiver, often use similar criteria to decide who can get care at home instead of in a facility.
If a facility move is still on the table while you wait, How to Check a Nursing Home's Inspection Record Before You Sign covers what to look for before you sign anything.
What Changes Once You Enroll
Joining PACE means leaving other Medicare Advantage or Part D drug plans behind, since PACE takes over that coverage instead. Most participants visit the PACE center on a regular schedule for meals, therapy, and social time, with home visits and transportation filling in the rest of the week.
The care team meets regularly to adjust the plan as needs change, including adding home health aides or, if it's ever necessary, nursing home care, without switching programs to get it.
Common questions
What does the PACE program actually pay for?
PACE covers primary and specialist medical care, hospital care and nursing home care if it's ever needed, prescription drugs, physical and occupational therapy, nutritional counseling, meals, transportation to the center and to outside appointments, and social activities. If your care team decides you need something to stay healthy and independent, PACE is responsible for arranging and paying for it, not just the items on a standard Medicare or Medicaid list.
Who qualifies for PACE?
You need to meet four requirements at the same time: be 55 or older, be certified by your state as needing a nursing-home level of care, live inside a PACE organization's service area, and be able to live safely in the community as long as PACE's support is in place. The service-area requirement is usually the deciding factor, since PACE still isn't available in every state or county.
How do I find a PACE program near me?
Search Medicare's PACE organization finder using your ZIP code, then call the nearest program directly. Enrollment isn't tied to Medicare's annual sign-up windows, so you can apply whenever a program is available to you. If nothing serves your area yet, ask your state Medicaid office about a home and community-based services waiver, which often uses similar eligibility rules.
What happens to my Medicare Advantage plan if I join PACE?
PACE takes over that coverage. You leave your existing Medicare Advantage or Part D drug plan behind once you enroll, since PACE becomes responsible for your medical care and prescription drugs instead. Ask the PACE organization to walk you through that transition before your first visit.
