H4305-001

Coordinated care

PACE coverage and eligibility

PACE coordinates medical care and social support for eligible adults who need nursing home-level care and can remain in the community with assistance.

Eligibility requires age 55 or older, residence in the organization's service area, state certification of nursing home-level care needs, and the ability to live safely in the community with PACE support.

PACE provides Medicare and Medicaid services, prescription drugs, and additional care that its care team determines is needed.

There is no deductible, copayment, or coinsurance for care, services, and drugs approved by the PACE care team.

Medicaid participants pay no monthly PACE premium. Medicare participants without Medicaid pay premiums that depend on their Part A and/or Part B coverage, including long-term care and drug coverage. People with neither Medicare nor Medicaid can pay the PACE premium themselves. Ask the organization for your amount.

PACE supplies necessary medicines. Enrolling in a separate Medicare drug plan causes disenrollment from PACE.

The annual CMS record identifies this organization and its geography. A plan-specific premium amount is unavailable in the reviewed extract; confirm eligibility, availability, and costs with the organization.

Program guidance reviewed October 11, 2026; it is general Medicare guidance, not a published 2027 price schedule.

Medicare PACE guidance ↗