PACE Resource Guide
Families exploring PACE in California often have many of the same questions. Below are the 20 questions I hear most frequently, with clear answers for California families. If your question is not answered here, use the contact form on our homepage to request a callback from a licensed California agent.
PACE stands for Program of All-Inclusive Care for the Elderly. It is a federally and state-funded program that provides comprehensive, coordinated care for older adults with complex health needs.
Participants must be age 55 or older. There is no maximum age limit.
Participants who qualify for both Medicare and Medi-Cal often pay $0 out of pocket or their Medi-Cal share of cost. Those with Medicare but not Medi-Cal pay a monthly premium. See PACE Costs in California for duals, share of cost, and private-pay scenarios. Final cost depends on individual eligibility as determined by the PACE organization and the State of California.
No. PACE is specifically designed to help seniors remain at home. Participants typically attend an adult day health center several days per week but continue living in their own home or with family.
Medicare Advantage is a health insurance plan that replaces Original Medicare. PACE is a comprehensive care program that replaces both Medicare and Medi-Cal and provides all care through an integrated team. PACE includes services that Medicare Advantage does not, such as adult day services, transportation, and in-home support.
In most cases, no. PACE participants receive primary care and most specialist care through the PACE network. If your parent has a long-standing relationship with an out-of-network physician, this is an important factor to discuss before enrolling.
Emergency care is always available. For non-emergency hospitalizations, the PACE care team coordinates the admission and manages the discharge back to home or to a short-term rehabilitation facility.
Yes. Enrollment in PACE is voluntary, and participants may disenroll at any time. Upon disenrollment, they return to their previous Medicare and Medi-Cal coverage.
The process typically takes two to six weeks from initial inquiry to enrollment, depending on the PACE organization and the complexity of the eligibility assessment.
No. PACE is available only in specific service areas. California has multiple PACE organizations; each covers defined ZIP codes. This agency works with three partners — WelbeHealth, SCAN / myPlace Health, and InnovAge. Use the ZIP checker on our homepage or request a callback to Talk to Leslie about whether one of those partners may serve your loved one's area. If your ZIP is not in a partner service area, Leslie will say so. DHCS (https://www.dhcs.ca.gov/individuals/Pages/PACEPlans.aspx) and CalPACE (https://calpace.org/) remain optional official directories for the full statewide list.
If your parent moves outside the PACE service area, they may no longer be eligible to participate in that PACE program. The PACE organization should be notified of any address change.
No. PACE covers only the enrolled participant. Spouses and other family members must have their own Medicare or Medi-Cal coverage.
Yes. California PACE organizations provide language assistance services in multiple languages at no cost. Common languages include Spanish, Chinese, Vietnamese, Khmer, Tagalog, Hmong, Armenian, Korean, Russian, Arabic, and Farsi.
Yes. PACE covers dental care, vision care, and hearing services — areas where traditional Medicare provides very limited coverage.
Yes. All medications approved by the PACE care team are covered, with no separate Part D premium or deductible. Many PACE organizations offer home delivery.
An adult day health center is the hub of the PACE model. Participants attend the center several days per week to receive medical care, therapy, meals, social activities, and monitoring. Transportation is provided.
This is a clinical designation indicating that a person's health needs are complex enough that they would medically qualify for nursing home placement. PACE participants must meet this threshold, even though they remain at home.
Final eligibility is determined by the PACE organization and the State of California through a comprehensive assessment process. This website does not determine eligibility.
The first step is checking whether PACE is available in your loved one's ZIP code. You can use the ZIP checker on our homepage or request a callback from a licensed California agent who can guide you through the process at no cost.
No. Guidance from a licensed independent agent is provided at no cost to the family. The agent is compensated by the PACE organization upon enrollment, not by the family.
Related guides: PACE Costs · How to Enroll · How to Qualify.
Leslie Kaz, RHU is a licensed California insurance agent specializing in Medicare and PACE programs, operating through Syndicated Insurance Agency, LLC (CA License #0B32530).
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