PACE

One program handles everything

PACE stands for Program of All-Inclusive Care for the Elderly. Instead of juggling a health plan, a drug plan, a doctor, and separate help at home, one team takes care of all of it:

• Your doctor and your specialists.
• Hospital and nursing home care if you need it.
• Your prescriptions.
• Physical, occupational, and speech therapy.
• Help at home — bathing, dressing, meals, housekeeping.
• A day center with meals, activities, and therapy.
• Dental, vision, hearing, and foot care.
• Rides to the center and to your appointments.
• Support and a break for your family caregiver.

No separate drug plan. No separate network. Nothing to piece together.

Who can join

Four things have to be true:

1. You are 55 or older. Not 65 — 55. Most people are surprised by this one.
2. You live in a PACE program’s service area. It is set by ZIP code, and it can change one town over.
3. You need nursing-home level of care. Their team does the assessment and the State of California confirms it.
4. You can live safely at home with their help.

You do not have to be on Medicare to join.

What it costs

If you have Medicare and Medi-Cal: no monthly premium. No copays, no deductibles, no coinsurance on anything their team approves.

If you have Medicare but not Medi-Cal: there is a monthly premium, and it is not small. Ask the program for the exact number before you decide.

Not sure whether you would qualify for Medi-Cal? That is worth finding out. A lot of people who would qualify have never applied.

The trade-off — please read this part

PACE is the most complete program out there, but you give up two things.

You use their doctors. If you see a doctor outside the program without their approval, it is not covered and the bill can land on you. Emergencies are always covered.

You stay local. More than 30 days away from the service area and you would have to leave the program.

If you are attached to your current doctor, or you spend part of the year out of state, PACE is probably not the right fit. I would rather tell you that now than after you have enrolled.

When you can join

Any month of the year. PACE has no fall enrollment window like Medicare Advantage and drug plans do.

You can also leave any time. It takes effect the first day of the next month.

If you are already in PACE, read this

Do not enroll in a Medicare Advantage plan or a stand-alone drug plan. Signing up for either one automatically ends your PACE membership — including your help at home. The same is true if you elect the Medicare hospice benefit.

If someone is trying to sign you up for a plan, tell them you are in PACE first.

How it works, step by step

1. Call Frank at 559-862-5615, or fill out the form below, for a plain-English conversation about whether PACE fits your situation.
2. Confirm the basics: age 55 or older, a home ZIP code inside a service area, and the ability to live safely at home with PACE support.
3. The PACE team completes an in-home visit and health assessment.
4. The State of California confirms you meet the nursing-home level of care requirement.
5. You review the enrollment agreement, get a complete explanation, and sign.
6. Coverage begins on the 1st of the month and your coordinated care starts.

Common questions

Is PACE the same as Medicare Advantage?

No. They are separate programs with separate rules. Medicare Advantage is an insurance plan with a network. PACE is a care program that employs its own doctors, nurses, and therapists and provides the care directly.

Is PACE a nursing home?

No. It is the alternative. PACE helps people who would qualify for a nursing home keep living at home instead.

Do I have to go to the day center?

Your care plan decides. Most members go two to five days a week. Some are cared for entirely at home.

Will I keep my own doctor?

Usually not. You receive care through the PACE team. This is the single most important thing to understand before you enroll.

Does PACE cover my medications?

Yes. Part D coverage is built in. You do not need a separate drug plan, and you should not buy one.

Can my spouse join too?

Only if they meet the requirements on their own.

What if my health improves?

You can stay enrolled as long as you can be safely cared for at home. There are protections in place — you are not dropped the moment you get stronger.

Can I change my mind after enrolling?

Yes. You may leave PACE at any time, generally effective the first of the following month, and return to other Medicare and Medi-Cal options.

See if PACE fits — free, no pressure

I cannot decide whether you qualify. Only the PACE team and the State of California can do that. What I can do is look at your situation and tell you honestly whether it is worth your time. If it is not, I will tell you what does fit.

Fill this out and I will call you.

First name

Last name

ZIP code

Date of birth

Phone

Email

I agree that Anchor Point Benefit Group may contact me by phone, text, or email about my request. Consent is not a condition of enrollment. Send my request

Prefer to talk now? Call 559-862-5615.

PACE is not the same as a Medicare Advantage plan. Enrollment changes how your covered services are coordinated and delivered, so get a complete explanation before you decide. Final eligibility is determined by the PACE organization and the State of California. This page is general information and is not an offer of enrollment in any specific PACE organization.