PACE is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home. PACE stands for Programs of All-Inclusive Care for the Elderly.
With PACE, the focus is on you — you have a team of health care professionals working with you and your family to make sure you get the coordinated care you need. Your team is experienced in caring for older adults. Usually they care for a small number of people, so they really get to know you.
How does PACE work?
PACE organizations provide care and services in the home, the community (which includes assisted living, memory care and adult care homes), and the PACE center. They have contracts with many specialists and other providers in the community. Most PACE participants get most of their care from staff employed by the PACE organization in the PACE center, which meet state and federal safety requirements.
Who can get PACE?
You can have either Medicare or Medicaid, or both, to join PACE. To qualify for PACE, you must be 55 or older; live in the service area of a PACE organization; need a nursing home-level of care (as certified by your state); be able to live safely in the community with help from PACE.
What does PACE cover?
PACE provides all the care and services covered by Medicare and Medicaid, and if authorized by your health care team, may cover services that Medicare and Medicaid doesn’t cover. Services covered include primary and specialty medical care; dentistry, vision and audiology; emergency services and hospital care; care at home; nursing home care; physical, occupational and speech therapy; medications and medical equipment; social services; care management; and transportation to the PACE center for activities or medical appointments, if medically necessary.
How to apply for PACE
In Oregon, to find out if you’re eligible call Providence ElderPlace, or call your Medicaid office.
What you pay for PACE depends on your financial situation
If you have Medicaid, you won’t pay a monthly premium for the long-term care portion of the PACE benefit. If you don’t qualify for Medicaid but you have Medicare, you’ll be charged a monthly premium to cover the long-term care portion of the PACE benefit and a premium for Medicare Part D drugs
There’s no deductible or copayment for any drug, service, or care approved by your health care team.
If you don’t have Medicare or Medicaid, you can pay for PACE privately.