How to apply for PACE — Program of All-Inclusive Care for the Elderly

Who it's for

PACE provides all the medical and long-term care an older adult needs to keep living at home instead of moving to a nursing home — doctors, prescriptions, adult day health, in-home aides, therapy, and transportation, all coordinated by one team. To join you must be 55 or older, live in a PACE organization's service area, need a nursing-home level of care (certified by the state), and be able to live safely in the community with PACE's help. For people who have both Medicare and Medicaid, PACE is usually free; others may pay a monthly premium.

What you'll need

• Proof of age 55 or older
• Proof of address within a PACE service area
• Medicare and/or Medicaid information
• A state assessment showing a nursing-home level of care

Where to apply

What to say when you call

"Hello, I'm calling to ask about PACE — Program of All-Inclusive Care for the Elderly. I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need proof of age 55 or older, proof of address within a PACE service area, medicare and/or Medicaid information — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Confirm that a PACE organization operates in your area by calling 1-800-633-4227, since PACE is only available where a local PACE organization is active.
2. Gather proof of your age (showing you are 55 or older) and proof of your home address within the PACE organization's service area.
3. Collect your Medicare and/or Medicaid information, such as your card or member ID.
4. Obtain a state assessment that certifies you need a nursing-home level of care — your state Medicaid office or a local PACE organization can help you arrange this.
5. Make sure you and your care team agree that you can live safely at home with PACE's support, since this is a required part of eligibility.
6. Apply online or by phone at 1-800-633-4227. A PACE enrollment coordinator will walk you through the rest of the process.

What to expect: After you apply, a PACE enrollment team will review your documents and coordinate with your state to confirm your nursing-home level of care certification. Once enrolled, all your medical and long-term care — including doctors, prescriptions, adult day health, in-home aides, therapy, and transportation — is coordinated by one PACE team. For people who have both Medicare and Medicaid, PACE is usually free; if you do not have both, you may pay a monthly premium. Enrollment is ongoing, but your care plan will be reassessed periodically to make sure it still meets your needs. Processing times vary, so ask your PACE enrollment coordinator for an estimate when you apply.

Renewals

ongoing enrollment with periodic care reassessment

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