PACE in California: All-in-One Care That Lets Your Loved One Stay Home

Here are the easy-to-miss angles — the early-eligibility rules and quiet ways families leave money or help on the table. Each one is explained in full below.

PACE stands for Program of All-Inclusive Care for the Elderly. It is built for people who are sick or frail enough to qualify for a nursing home but who want to keep living at home. Instead of moving into a facility, your loved one gets all their care through one program and one team.

At the center of PACE is an interdisciplinary team — doctors, nurses, therapists, social workers, dietitians, home-care aides, and drivers — who plan and coordinate everything together. Many participants come to a PACE center a few days a week for medical visits, therapy, meals, and adult day activities, and receive help at home the rest of the time.

In California, 40 PACE programs serve more than 28,000 people at 117 centers and care sites across 28 counties. The whole point is to let an older or disabled adult stay in their own home and community for as long as it is safe to do so.

There are four eligibility rules, and a person must meet all of them. Notice that PACE starts at 55 — a full decade before most people qualify for Medicare — so a younger adult with a serious condition can qualify early.

PACE bundles nearly everything into one program at no separate charge for people with Medi-Cal. There are no deductibles or copays for care the team approves, and no Part D drug 'donut hole.'

Covered services typically include:

It depends on what coverage your loved one already has. Most PACE participants — nationally, roughly eight in ten — have both Medicare and Medi-Cal (Medicaid).

If your loved one has full-scope Medi-Cal (with or without Medicare), PACE is generally free — no monthly premium, no copays, no deductibles, and no drug costs. If they have a Medi-Cal 'share of cost,' ask the PACE plan how that applies before you assume anything.

If your loved one has Medicare but not Medi-Cal, they pay a monthly premium for the long-term-care portion of PACE plus Part D drug coverage, but still no copays or deductibles for approved care. If they have neither Medicare nor Medi-Cal, they pay the full private cost — commonly reported at roughly $4,000–$5,000 a month, so confirm the current amount directly with the program.

For the state, PACE tends to cost less than a nursing home. CalPACE reports PACE costs up to 40% less than placement in a skilled nursing facility.

Yes — this is the main trade-off. Once enrolled, your loved one gets their care from the PACE network. All care must be approved by the PACE interdisciplinary team, except for emergencies, where you should always call 911 or go to the nearest ER.

That means switching away from a longtime family doctor or specialist if they are not part of PACE. For some families that is a hard change; for others, having one team that handles everything — and drives your parent to appointments — is a relief.

PACE is voluntary. Your loved one can leave (disenroll) at any time, for any reason, and go back to regular Medicare and Medi-Cal.

PACE only works if a program already serves your county and ZIP code. In California it operates in 28 counties, including the Southern California counties of Los Angeles, Orange, Riverside, San Bernardino, San Diego, Imperial, and Kern.

To find one near you, use the 'Find a PACE Program' search on the CalPACE website (calpace.org) or check the DHCS list of California PACE plans and service-area ZIP codes. You can also call a PACE organization directly and ask if your address is in their area.

If no PACE program serves your area, ask the plan whether that may change — but see the note below about California's current pause on new programs.

Enrollment is done directly through a local PACE organization, not through a county office. Here is the usual path:

This is important and easy to misread. Effective November 20, 2025, DHCS put a pause — a minimum of two years, through at least November 19, 2027 — on new PACE applications.

The pause applies to organizations, not to individual seniors. It stops new companies from becoming PACE providers and stops existing programs from expanding into new counties or ZIP codes. Applications already in the review queue, and changes of ownership, are exceptions that continue.

What this means for your family: if a PACE program already serves your area, your loved one can still apply and enroll today, as normal. But if PACE is not yet in your county, don't count on a new program opening there soon — plan around the other options in the meantime.