Program of All-Inclusive Care for the Elderly (PACE): Helping Seniors Remain Living at Home

The Program of All-Inclusive Care for the Elderly (PACE) coordinates healthcare and long-term care coverage for people over age 55 who require a high-level of care but would prefer not to live in a nursing home. Being in enrolled in Medicaid or Medicare is not a requirement for PACE, but the majority of program participants are dual-eligible, meaning they’re enrolled in both Medicaid and Medicare. In some states, PACE is known as Living Independence for the Elderly, or LIFE.


What are PACE / LIFE Programs?

PACE is a federally-funded program run by individual states. The state-level PACE programs coordinate healthcare, long-term care and social service benefits and coverage for program participants. An interdisciplinary team of PACE healthcare professionals will create a streamlined approach for all PACE beneficiaries so they can receive all their care through one plan. This includes Medicaid and Medicare benefits for seniors who are dual-eligible, meaning they are enrolled in both Medicaid, which is for low-income individuals, and Medicare, which is for anyone over age 65.

Every PACE program also has adult day health center where program participants can go on a daily basis. These PACE centers aren’t identical, but most of them provide medical oversight, nursing services, therapies, social activities, exercise programs, meals, snacks and access to audiologists, optometrists, dentists and podiatrists. PACE will also provide transportation to and from the center, as well.

The program’s primary purpose is to help individuals who require a Nursing Facility Level of Care remain living at home (or somewhere else in the community) instead of moving into a nursing home. Most people would prefer to reside in their own home or the home of a loved one rather than an institution, and providing some in-home care and support is less expensive for the government than paying for a full-time bed in a nursing home. So, providing long-term care at home is usually beneficial to all parties, and the National PACE Association says that, “95 percent of PACE participants are able to continue to live in their community.”

 Toolbox: Medicaid eligibility can be complicated and depends on a number of factors including marriage status and state of residence. To learn about the specific eligibility criteria for your situation, use our Medicaid Eligibility Requirements Finder.


What are the Eligibility Requirements for PACE/LIFE Programs?

Individuals need to meet four basic requirements in order to be eligible for PACE:

  • Age: Must be 55-years-old or older
  • Physical/functional need: Must require a Nursing Facility Level of Care
  • Demonstrable benefit: The benefits provided through PACE must make it safe for the individual to live in the home or assisted living community
  • Geographic region: A PACE program must be available in the area where the individual lives

There are no financial requirements for PACE. However, the program is fully covered for Medicaid beneficiaries. In most states in 2024, the individual asset limit for Medicaid for individuals is $2,000 and the individual income limit is $2,829/month. However, these limits can change depending on the program, the state and the applicant’s marital status and financial situation. To find the specific financial eligibility criteria for your situation, use our Medicaid Eligibility Requirements Finder.

People who are not Medicaid beneficiaries can pay a monthly premium to join PACE. Once enrolled, PACE program participants never have to pay a deductible or co-pay for any care, medication or service provided by the PACE interdisciplinary team.


What is a Nursing Facility Level of Care?

While PACE is intended to prevent nursing home placement, one of its requirements for applicants is to be certified by their state as needing a Nursing Facility Level of Care (NFLOC). In general, this means the kind of care and supervision that is normally associated with a nursing home. However, states can differ on how they define and measure NFLOC.

For example, one state may define a NFLOC  as needing help with two of the five Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Another state may define a NFLOC as needing help with three of the five. Many states also have their own evaluation procedures and tools. In Florida, for example, Medicaid uses the Comprehensive Assessment and Review for Long-Term Care Services Program to determine if a NFLOC is met for Medicaid requirements. In New York, the Uniform Assessment System tool is used by a registered nurse from the New York Medicaid Choice’s Conflict-Free Eligibility & Enrollment Center to determine what level of care Medicaid applicants might need.


PACE for People with Dementia

A diagnosis of Alzheimer’s disease or dementia does not necessarily equate to needing a NFLOC, which is a requirement for the PACE program, as we just discussed. However, the National PACE Association estimates that nearly half of its program members have been diagnosed dementia, and the program can be especially helpful for these people. Dementia makes it difficult to live independently, but PACE’s coordinated and comprehensive approach provides a safety net. PACE will manage all aspects of its members care, including things like scheduling appointments, setting reminders, providing transportation and medication management that can be crucial for people with cognitive impairments.

What’s more, PACE will provide benefits to program members who reside in memory care units for people with Alzheimer’s and other dementias. These can be standalone facilities or part of a larger assisted living residence or medical facility.


Which States Have PACE / LIFE Programs?

Medicare benefits and eligibility requirements are the same for recipients across the country, but Medicaid benefits and eligibility requirements all vary significantly by state. Since PACE is funded by both Medicare and Medicaid, it is up to each state and its legislators to decide if they want to create and run a PACE program. As of January 2024, 32 states and the District of Columbia have PACE/LIFE programs.

The states without PACE/LIFE programs (or plans to have them) are Alaska, Arizona, Connecticut, Georgia, Hawaii, Idaho, Maine, Minnesota, Mississippi, Montana, Nevada, New Hampshire, South Dakota, Utah, Vermont, West Virginia and Wyoming.

The table below lists the states that currently have PACE/LIFE programs, the number of programs in the state, the location of those programs and their names.

 Moving for Benefits: PACE programs have no length of residency requirements. Therefore, aging seniors can move from one state where there are no PACE programs, such as Arizona, to another state, such as California, where they are multiple programs. This is mostly relevant when aging parents are wanting to move to be closer to their adult children.
States with Medicare & Medicaid PACE / LIFE Programs (Updated Jan. 2024)
State Number of Programs Locations & Program Names
Alabama 1 Daphne, Mercy LIFE of Alabama (Trinity)
Arkansas 3 Jonesboro, Total Life Healthcare
North Little Rock, Baptist Health PACE
Springdale, PACE of the Ozarks
California 25 Commerce, AltaMed PACE
Eureka, Redwood Coast PACE
Fresno, WelbeHealth Fresno
Garden Grove, CalOptima Health PACE
Long Beach, WelbeHealth Long Beach
Los Angeles, InnovAge Crenshaw
Merced, Central Valley PACE
Napa, Providence PACE
Newport Beach, Innovative Integrated Health
Oakland, Center for Elders’ Independence
Pasadena, WelbeHealth Pasadena
Reseda, Brandman Centers for Senior Care
Riverside, Neighborhood Healthcare PACE
Rohnert Park, AgeWell PACE
Sacramento (2), Sutter SeniorCare PACE and InnovAge California PACE – Sacramento
San Bernardino, InnovAge California PACE – San Bernardino
San Diego (2), St. Paul’s PACE and Family Health Centers of San Diego PACE
San Francisco (2), NEMS PACE and On Lok PACE)
San Marcos, Gary and Mary West West PACE)
San Ysidro, San Diego PACE
Stockton, WelbeHealth Stockton
Colorado 5 Colorado Springs, Rocky Mountain PACE
Denver, InnovAge Colorado PACE
Grand Junction, HopeWest PACE
Lafayette, TRU PACE
Montrose, Senior CommUnity Care of CO
Delaware 2 Milford, PACE Your LIFE
Wilmington, Saint Francis LIFE (Trinity)
District of Columbia 1 Edenbridge PACE at Skyland
Florida 7 Fort Myers, Hope PACE
Hialeah, Mount Sinai Eldercare
Jacksonville, The PACE Place
Miami, Florida PACE Centers, Inc.
Pinellas Park, Suncoast PACE, Inc.
Tampa, Empath LIFE
West Palm Beach, Palm Beach PACE
Indiana 5 Fort Wayne, PACE of Northeast Indiana
Indianapolis (2), Ascension Living St. Vincent PACE and Franciscan Senior Health & Wellness
Mishawaka, Saint Joseph PACE (Trinity)
Richmond, Reid Health PACE Center
Iowa 2 Council Bluffs, PACE Iowa
Sioux City, Siouxland PACE
Kansas 3 McPherson, Bluestem PACE
Topeka, Midland Care PACE
Wichita, Ascension Living HOPE
Kentucky 1 Lexington, Bluegrass PACE
Louisville, Senior CommUnity Care of Kentucky
Richmond, Horizon PACE
Louisiana 2 Baton Rouge, PACE Baton Rouge
New Orleans, PACE Greater New Orleans
Maryland 1 Baltimore, Hopkins ElderPlus
Massachusetts 8 Cambridge, CHA PACE
Dorchester, Upham’s PACE
Lynn, Element Care
Mattapan, Harbor Health Elder Service Plan
Revere, Neighborhood PACE
Springfield, Serenity Care PACE
West Springfield, Mercy LIFE MA
Worcester, Summit ElderCare
Michigan 14 Battle Creek, Senior Care Partners PACE
Flint, Ascension Living PACE Michigan
Fort Gratiot, Sunrise PACE
Grand Rapids, Care Resources
Jackson, Thome PACE
Lansing, Senior CommUnity Care of Michigan
Mount Pleasant, PACE Central Michigan
Newaygo, Community PACE at Home, Inc.
Norton Shores, LifeCircles PACE
Saginaw, Great Lakes PACE
Saint Joseph, PACE of Southwest Michigan
Southfield, PACE Southeast Michigan
Traverse City, PACE North
Ypsilanti, Huron Valley PACE
Missouri 1 St. Louis, New Horizons PACE
Nebraska 1 Omaha, PACE Nebraska
New Jersey 6 Atlantic City, AtlantiCare LIFE Connection
Bordentown, Capital Health LIFE
Jersey City, Lutheran Senior Life at Jersey City
Oceanport, Beacon of LIFE
Pennsauken, Trinity Health LIFE New Jersey
Vineland, Inspira Health Network LIFE
New Mexico 1 Albuquerque, InnovAge New Mexico PACE
New York 9 Buffalo (2), Catholic Health LIFE and Fallon Health Weinberg-PACE
New York City (2), ArchCare Senior Life and CenterLight Healthcare
Niagara Falls, Complete SeniorCare
Olean, Total Senior Care, Inc.
Rochester, ElderONE)
Schenectady, Eddy SeniorCare
Syracuse (PACE CNY)
North Carolina 11 Asheboro, Randolph Health StayWell Senior Care

Asheboro, Randolph Health StayWell Senior Care
Asheville, CarePartners PACE
Chapel Hill, Piedmont Health SeniorCare
Charlotte, PACE of the Southern Piedmont
Durham, Senior CommUnity Care of North Carolina
Fayetteville, LIFE St. Joseph
Gastonia, Senior TLC
Greensboro, PACE of the Triad
Lexington, Carolina SeniorCare
Newton, PACE@Home
Wilmington, Elderhaus PACE

North Dakota 1 Bismarck, Northland PACE
Ohio 1 Cleveland Heights, McGregor PACE
Oklahoma 3 Oklahoma City, Valir PACE
Tahlequah, Cherokee Elder Care
Oregon 2 Grants Pass, AllCare PACE
Portland, Providence ElderPlace PACE Oregon
Pennsylvania 18 Aliquippa, LIFE Beaver County
Alleghany, InnovAge Pennsylvania LIFE
Bethlehem, Senior LIFE Lehigh Valley
Butler, LIFE Butler County
Conshohocken, Mercy LIFE PA
Danville, LIFE Geisinger
Edensburg, Senior LIFE Edensburg
Feastville Trevose, LIFE St. Mary
Greensburg, Senior LIFE Greensburg
Johnstown, Senior LIFE Johnstown
Kittanning, LIFE Armstrong County
Lewisburg, Albright LIFE
Philadelphia, Mercy LIFE – West Philadelphia
Pittsburgh (2), Community LIFE and LIFE Pittsburgh
Washington, Senior LIFE Washington
York, Senior LIFE York
Rhode Island 1 Providence, PACE Organization of Rhode Island
South Carolina 3 Columbia, Prisma Health SeniorCare PACE – Midlands
Greenville, Prisma Health SeniorCare PACE – Upstate
Orangeburg, Orangeburg Senior Helping Center
Tennessee 1 Chattanooga, Ascension Living Alexian PACE
Texas 3 Amarillo, The Basics at Jan Werner
El Paso, Bienvivir Senior Health Services
Lubbock, Silver Star PACE
Virginia 8 Alexandria, Cherry Blossom PACE
Big Stone Gap, Mountain Empire PACE
Cedar Bluff, AllCARE for Seniors
Charlottesville, InnovAge Virginia PACE – Blue Ridge
Lynchburg, Centra PACE
Newport News, InnovAge Virginia PACE – Richmond and Peninsula
Salem, InnovAge Virginia PACE – Roanoke Valley
Norfolk, Sentara PACE
Washington 3 Seattle (2), International Community Health Services and Providence ElderPlace Seattle
Tacoma, Pacific Northwest PACE Partners
Wisconsin 1 Milwaukee, Community Care

What Benefits Do PACE/LIFE Programs Provide?

PACE programs administer all healthcare and long-term care services and supports that are deemed medically necessary to maintain or improve the health of its members. This includes all of the benefits available under both Medicaid and Medicare. And PACE will cover these benefits in the beneficiary’s home, the home of a loved one and assisted living facilities, including memory care units for people with Alzheimer’s disease and other dementias. However, PACE will not cover room and board expenses in these settings.

Every PACE plan includes routine care visits to a primary care provider with an office that is on-call 24 hours a day, seven days a week. PACE covers all prescription medication and over the counter supplements that are considered medically necessary. PACE also handles hearing, vision, eye and foot care, if needed, as well as other special needs like cardiology, rheumatology and women’s services. Outpatient and inpatient services are covered as well, such as lab work, x-rays, radiology, hospitalizations, inpatient specialists and skilled rehab, as are psychiatric assessments and care for grief, loss and other issues.

PACE’s in-home benefits can include:

  • Meal delivery
  • Homemaker services
  • Chore services
  • Physical therapy
  • Occupational therapy
  • Skilled nursing
  • Transportation
  • Personal care assistance with the Activities of Daily Living
  • Wheelchairs
  • Walkers
  • Oxygen
  • Hospital beds
  • Diabetic testing supplies
  • Respite care for family caregivers

PACE adult day health centers can very depending on the location. However, many of them will offer the following benefits:

  • Medical oversight
  • Nursing services
  • Physical therapy
  • Social activities
  • Exercise programs
  • Lunch/snacks
  • Social services
  • Vision, hearing, dental and foot care
  • Transportation

Individuals residing in nursing homes can be enrolled in PACE benefits, but only about 5 percent of program participants live in institutions, according to the National PACE Association. In most cases, the nursing home or skilled medical facility will coordinate all of the healthcare and long-term services their residents need.

While PACE offers many benefits, it does not necessarily offer all of them to every program participant. Instead, an in-home assessment will be conducted for each PACE applicant by the local PACE interdisciplinary team.  This assessment will be done early in the application process, and after the applicant has been accepted into the program, the assessment will be used to help create an individualized care plan.


How to Apply for PACE / LIFE Programs

People already enrolled in Medicaid and/or Medicare, or people who are willing to pay out-of-pocket, can contact their local PACE office to find out how to apply and receive benefits.

Americans over the age of 65 can sign up for Medicare online here.

Applying for Medicaid is more complicated, and the rules can vary by state. For help finding one’s specific eligibility criteria, try our Medicaid Eligibility Requirements Finder tool. For more information on alternative pathways to eligibility, click here.