PACE Resource Guide
When a California family begins planning for an aging parent's care needs, two options often come up in the same conversation: PACE and assisted living. Both can provide meaningful support for seniors with complex needs, but they are fundamentally different in structure, cost, and what they require of the participant. Understanding those differences helps families make a more informed decision.
Assisted living is a residential setting — your parent moves into a facility and receives care there. PACE is a community-based program — your parent continues living at home and receives coordinated care through a PACE organization, typically attending an adult day health center several days per week. This distinction shapes almost every other comparison between the two options.
| Factor | PACE | Assisted Living |
|---|---|---|
| Where the senior lives | At home in the community | In a residential facility |
| Cost | Often $0 for those who qualify for both Medicare and Medi-Cal | Typically $3,000–$7,000/month in California |
| Care coordination | Fully integrated — one care team manages everything | Varies by facility; often fragmented |
| Medical care | Included — primary care, specialists, behavioral health | Limited; residents typically see outside physicians |
| Prescriptions | Included, often with home delivery | Not typically included; billed separately |
| Transportation | Included to/from center and appointments | May be available for a fee |
| Eligibility | Age 55+, nursing-facility-level care, PACE service area | Generally no clinical eligibility requirement |
| Provider network | Must use PACE network for most care | Resident can typically see any provider |
PACE tends to be a strong option for seniors who want to remain at home, who qualify for both Medicare and Medi-Cal (making PACE effectively no-cost), and whose care needs are complex enough to benefit from integrated coordination. It is particularly well-suited for seniors with multiple chronic conditions, frequent medical appointments, or significant transportation challenges.
Assisted living may be more appropriate when a senior is no longer safe living alone even with in-home support, when family caregivers are unable to provide the oversight needed at home, or when the senior does not qualify for PACE due to geographic or clinical eligibility constraints. Some seniors also simply prefer the social environment and structured daily life of a residential community.
PACE requires participants to receive most of their care through the PACE network. If your parent has long-standing relationships with physicians who are not in the PACE network, or if they value the flexibility to seek care outside a defined network, this constraint is worth discussing carefully before enrolling. Final eligibility is determined by the PACE organization and the State of California, not by this website.
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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