September 1,2026: When discussing Medicare coverage options with clients, Medicare Advantage and Medicare Supplement plans typically dominate the conversation. However, for certain beneficiaries with complex healthcare needs, the Program of All-Inclusive Care for the Elderly (PACE) may be worth exploring.
PACE is a Medicare and/or Medicaid program designed to help eligible older adults who require a nursing home level of care to continue to live safely in their homes and communities. The program provides coordinated medical and social services through a dedicated interdisciplinary care team.1
Who Qualifies for PACE?
To enroll in PACE, individuals generally must:
- Be age 55 or older
- Live within a PACE service area
- Be certified by the state as requiring a nursing home level of care
- Be able to live safely in the community with support from PACE services2
What Does PACE Cover?
PACE takes an all-in-one approach to healthcare and support services. Depending on the participant’s needs, services may include:
- Primary and specialty care
- Hospital services
- Prescription drugs
- Home health care
- Adult day services
- Physical, occupational, and speech therapy
- Transportation to medical appointments
- Dental services
- Nursing home care when necessary2
How Is PACE Different?
Unlike traditional Medicare Advantage or Original Medicare arrangements, PACE participants receive their Medicare and Medicaid services through the PACE organization and care team. The goal is to coordinate care across medical, social, and long-term care needs through a single program.3
Why Agents Should Know About PACE
PACE may be a strong fit for:
- Dual-eligible beneficiaries
- Clients with multiple chronic conditions
- Individuals at risk of nursing home placement
- Families seeking a highly coordinated care solution
While PACE is not available everywhere and not everyone qualifies, understanding the program can help agents identify clients who may benefit from an alternative to traditional Medicare coverage options.
In markets where PACE is available, agents typically contract directly with the PACE organization, similar to how they contract with traditional Medicare carriers, creating another opportunity to serve eligible beneficiaries.
Bottom Line
PACE is one of Medicare’s most comprehensive care models, designed to help qualifying seniors remain independent while receiving coordinated healthcare and support services. For agents, knowing when to recognize a potential PACE candidate can strengthen client relationships and reinforce your role as a trusted advisor.
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1 – Centers for Medicare & Medicare Services – https://www.cms.gov/medicare/medicaid-coordination/about/pace
2 – Medicare.gov – https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE
3 – Code of Federal Regulations – https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-E/part-460/subpart-F