How Much Does PACE Cost in California?

Also see: PACE Costs · How to Qualify · How to Enroll — then request a callback with Leslie.

Not clean-energy financing

This page is about the Program of All-Inclusive Care for the Elderly (PACE) — coordinated medical and long-term care for older adults — not Property Assessed Clean Energy (PACE) home-improvement financing.

How PACE pricing works

PACE is paid primarily through Medicare and/or Medi-Cal (California’s Medicaid program). Families do not receive one statewide “PACE price list.” Your monthly responsibility depends on whether the person is:

• Eligible for both Medicare and Medi-Cal (dual-eligible)
• Eligible for Medi-Cal only (in some cases)
• Eligible for Medicare only
• Paying privately (no Medicare or Medi-Cal), or using other resources such as long-term care insurance where the carrier allows

Authoritative consumer summaries are published by CalPACE (Cost) and by CMS in Quick Facts: Program of All-inclusive Care for the Elderly (PACE) (Medicare.gov publication 11341).

What “often $0” means — with caveats

Families frequently hear that PACE can cost $0 out of pocket. That phrase is useful shorthand, but it is not a guarantee.

Per CMS Quick Facts:

• If you have Medicaid (Medi-Cal in California), you generally won’t have to pay a monthly premium for PACE.
• Regardless of financial situation, you generally won’t have a deductible, copayment, or coinsurance for drugs, services, or care your PACE team approves.
• If you have Medicare but not Medicaid, you may pay monthly premiums (long-term care portion of the PACE benefit and Medicare Part D drug coverage).
• If you have neither Medicare nor Medicaid, you can pay the PACE premium yourself.

Per CalPACE:

• If you are enrolled in Medicare and Medi-Cal, you will pay nothing or you will pay your Medi-Cal “share of cost” to your PACE provider.
• Medi-Cal beneficiaries who have a share of cost remain responsible for that share of cost.
• Participants must generally receive needed healthcare (other than emergency services) from the PACE provider or an authorized network; unauthorized out-of-network services may leave the participant personally liable for costs.

Important: This website does not guarantee $0 cost, premium amounts, or eligibility. Final cost and eligibility are determined by the PACE organization and the State of California.

Cost scenarios at a glance

The following table follows CalPACE’s consumer cost framework. It is illustrative of payment responsibility, not a quote of dollar amounts.

*CalPACE notes: Medi-Cal beneficiaries who have a share of cost remain responsible for their individual share of cost to maintain Medi-Cal benefits. If the individual lives in or moves to supportive housing (a nursing home), there may be a co-pay for that facility. (CalPACE Cost)

Dual-eligible participants (Medicare + Medi-Cal)

For many California families, the loved one qualifies for both Medicare and Medi-Cal. In that situation:

• Medicare and Medi-Cal typically cover the PACE benefit.
• The monthly premium is often $0.
• If Medi-Cal assigns a share of cost, that amount remains the participant’s responsibility and is usually paid to the PACE provider.
• Care-team-approved services generally do not carry separate deductibles or copays (CMS Quick Facts).

PACE may still be a strong option when share of cost applies — but families should confirm the dollar amount with the PACE organization during assessment, not assume $0.

Share of cost (Medi-Cal)

“Share of cost” is a Medi-Cal concept: some beneficiaries must pay a monthly amount toward medical expenses before Medi-Cal covers the rest. CalPACE states that dual-eligible (or Medi-Cal) PACE participants with share of cost remain responsible for that share and pay it to the PACE provider.

If your loved one already has a Medi-Cal share-of-cost letter, bring it to the conversation with Leslie and to the PACE intake appointment. Amounts are individual; this site cannot calculate them.

Medicare-only participants

If your loved one has Medicare but does not qualify for Medi-Cal:

• CMS Quick Facts: the amount you pay depends on Part A and/or Part B coverage and generally includes a monthly premium for the long-term care part of the PACE benefit and a monthly premium for Medicare drug coverage (Part D).
• CalPACE: the participant pays the Medi-Cal portion plus Medicare Part D.

PACE organizations can often help families explore whether Medi-Cal eligibility is possible. Enrolling in a separate stand-alone Part D plan after joining PACE can disenroll someone from PACE.

Private pay and other situations

People without Medicare or Medi-Cal may still join PACE if they meet clinical and geographic eligibility and pay the self-pay rate. CalPACE also notes that long-term care insurance may pay part of a premium if the carrier allows — that is carrier-specific and should be verified with the insurer and the PACE organization.

What you generally do not pay for (when the care team approves it)

Per CMS Quick Facts, PACE covers a broad set of medical and social services when the interdisciplinary team agrees they are needed — for example primary and specialty care, hospital care, prescriptions, transportation, adult day services, home care, therapies, dental, and more. Approved items generally come without deductibles, copays, or coinsurance.

For a California-family overview of covered services, see What Does PACE Cover?.

Network and out-of-network risk (cost implication)

Joining PACE means using the PACE organization’s network for needed care (other than emergencies). CalPACE warns that participants may be fully and personally liable for unauthorized or out-of-network services. That is a cost risk families should understand before enrollment — see also How to enroll in PACE in California.

Partner programs vs. statewide options

Leslie Kaz works as an independent licensed advisor with three PACE partners — WelbeHealth, myPlace Health (SCAN), and InnovAge. Those are the organizations this agency can help you evaluate first when your ZIP is in a partner service area.

California has additional PACE organizations beyond these three partners. For the full statewide directory of plans and service-area ZIP lists, use:

• DHCS — California PACE Plans
• CalPACE

If your ZIP is not served by a partner, Leslie will say so and can point you to official statewide resources.

How to get a real answer for your family

1. Check your loved one’s California ZIP on the homepage ZIP tool to see whether a partner program may be available.
2. Request a callback with Leslie — at no cost to your family — to talk through Medicare/Medi-Cal status, share of cost, and next steps.
3. The PACE organization confirms premium responsibility during intake and enrollment; the State of California (DHCS) and the PO determine final eligibility.

Related reading: How to Qualify for PACE in California · How to Enroll in PACE in California · PACE Program FAQ · Caregiver Guide

Frequently Asked Questions

Check your ZIP. Talk with Leslie about partner programs.

Enter your loved one’s California ZIP on the homepage to see whether WelbeHealth, myPlace Health (SCAN), or InnovAge may serve the area. Then request a callback — Leslie will review Medicare/Medi-Cal status, explain cost scenarios for your situation, and coordinate next steps with a partner organization when appropriate. Guidance is at no cost to your family.

Official statewide references (secondary): DHCS PACE Plans · CalPACE Cost · Medicare.gov PACE

Final eligibility and cost responsibility are determined by the PACE organization and the State of California. This website does not guarantee $0 cost or enrollment.

About the Author

Leslie Kaz, RHU is a licensed California insurance agent specializing in Medicare and PACE programs, operating through Syndicated Insurance Agency, LLC (CA License #0B32530). Leslie works as an independent advisor with three PACE partners — WelbeHealth, myPlace Health (SCAN), and InnovAge — and guides families through ZIP matching and enrollment coordination at no cost to the family.

Compensation. Guidance is at no cost to families. If enrollment occurs through this agency with a partner PACE organization, the agency may be compensated by that organization — not by the family.

Service area. Availability of PACE depends on ZIP code, program service area, and final eligibility as determined by the PACE organization and the State of California.