How to apply for PACE — Program of All-Inclusive Care for the Elderly (North Carolina)

Who it's for

PACE provides all the medical and supportive care a frail older adult needs to keep living in the community instead of a nursing home — doctors, prescriptions, therapy, adult day care, transportation, and in-home help — coordinated by one team. To join you must be 55 or older, need a nursing-facility level of care, live in a PACE organization's service area, and be able to live safely in the community. North Carolina has 11 PACE organizations operating in 14 locations.

What you'll need

• Proof of age 55+
• Proof of residence within a PACE service area
• Medicaid/Medicare information (the PACE organization helps with the application)

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 (North Carolina). 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+, proof of residence within a PACE service area, medicaid/Medicare information (the PACE organization helps with the application) — 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. Check that you meet the basic requirements: you are 55 or older, you need a nursing-facility level of care, you can live safely in the community, and you live within a participating PACE organization's service area. Note that PACE is not available statewide — 11 organizations serve 14 locations across North Carolina.
2. Gather your required documents: proof of age (showing you are 55 or older), proof of residence within a PACE service area, and any Medicaid or Medicare information you have. The local PACE organization can help you with the Medicaid or Medicare application if needed.
3. Contact a local PACE organization to confirm it serves your area and to start the enrollment process. You can find and reach a PACE organization by calling the statewide line at 1-888-245-0179 or by applying online.
4. Complete the enrollment assessment. A PACE care team will review your health and care needs to confirm you meet the nursing-facility level of care requirement and can safely live in the community.
5. Submit your application and all required documents through the PACE organization. Staff will guide you through each step, including any Medicaid paperwork.
6. Ask the PACE organization about next steps and how long processing may take — timelines vary, so request an estimate directly from the organization.
7. Plan to renew your enrollment annually. Keep your documents and contact information up to date so the renewal process goes smoothly.

What to expect: After you submit your application, the PACE organization's care team will review your eligibility and coordinate any needed Medicaid or Medicare paperwork. Processing times vary, so ask the organization for an estimate. If approved, all your medical and supportive care — including doctors, prescriptions, therapy, adult day care, transportation, and in-home help — will be coordinated by one PACE team. Keep in mind that you must use PACE network providers for covered services. People with Medicaid generally pay nothing out of pocket; those with Medicare only, or neither Medicaid nor Medicare, may have a private-pay cost. Enrollment is renewed annually, so watch for renewal notices and respond promptly to avoid any gap in coverage.

Renewals

annual