PACE Pros and Cons: An Honest Look for California Families

What families tend to like about PACE

• One team for everything. A PACE interdisciplinary team (doctor, nurse, social worker, therapists, drivers, and others) plans and coordinates care, so families aren't juggling separate offices. (Source: CMS)
• Broad coverage. PACE covers all Medicare- and Medicaid-covered care and services, plus other services the care team decides are needed, including prescription drugs. (Source: Medicare.gov)
• Help at home and a day center. Depending on the care plan, PACE can include in-home support, transportation, and time at a PACE center for meals, activities, and therapy.
• No copays for approved care. For care the PACE team approves, there are generally no deductibles or copays. What a family pays each month depends on Medicare and Medi-Cal status. (Sources: CMS Quick Facts; see our PACE costs guide.)
• You can leave. A participant can leave PACE at any time; disenrollment takes effect on the first day of the following month. (Source: 42 CFR 460.162)

The trade-offs to think about

• Changing doctors. In PACE, care comes from the PACE organization's doctors and providers. In most cases your parent can't keep their current primary care doctor. Some PACE organizations may work with a current specialist, so ask during intake. (Sources: CANHR; Mass.gov PACE FAQ)
• Care must be arranged by PACE. Other than emergencies, care outside the PACE network that the team hasn't approved can leave the participant personally responsible for the cost. (Source: CalPACE)
• No separate drug plan. PACE provides prescription drugs. Joining a separate Medicare drug plan while in PACE ends PACE enrollment. (Source: Medicare.gov)
• Service areas are limited. PACE is only available in certain ZIP codes. (Source: DHCS)
• Not the same as IHSS. In California you can't receive IHSS (In-Home Supportive Services) and PACE at the same time, although PACE provides its own in-home care. (Source: Disability Rights California)

Who PACE tends to fit best

PACE is designed for people 55 and older who need a nursing-home level of care, as certified by the State, but can live safely at home with support. It often fits families who want coordinated care, help with transportation and daily needs, and a single team to call. (Source: CalPACE)

Questions to ask before you decide

1. Which PACE center would my parent attend, and how does transportation work?
2. Can any of my parent's current specialists stay involved?
3. How much in-home help is typical for someone with my parent's needs?
4. What will we pay each month based on Medicare and Medi-Cal status?
5. How do we leave PACE later if it isn't the right fit?

Frequently asked questions

Not sure if PACE fits? Check your loved one's ZIP, then request a callback. Leslie will walk through the pros and cons for your family's situation at no cost to you.

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