What is PACE?
The Program of All-Inclusive Care for the Elderly.
PACE is a special program for seniors 55 and older. It is not a nursing home. It is a way to stay out of a nursing home. With InnovAge PACE, you get a whole team. A doctor, a nurse, a driver, and a social worker all work together to provide personalized healthcare and support to help our clients age at home.
The Big Picture
Medicare Advantage is like having health insurance with a network of doctors you can visit when you need care. It basically gives you a map and says "find your way to care".
PACE is like having a full care team that comes to you and coordinates everything in your life to keep you independent at home. It isn't just insurance—it's a full support system. If your loved one needs help with daily living, PACE keeps them home instead of in a nursing home. Read below for should easy to read comparisons of both programs.
Who Decides Your Care?
| Aspect | Medicare Advantage | PACE (Program of All-inclusive Care) |
|---|---|---|
| **Doctor Choice** | You pick doctors from a specific list (network). | A **dedicated care team** gets to know you as a person. |
| **Care Coordination** | You coordinate between different doctors yourself. Each doctor works separately. | **One team coordinates everything** for you. They create one complete, unified care plan. |
| **Communication** | Doctors communicate separately. | The entire team **communicates with each other** about your specific needs. |
| **Appointments** | You schedule your own appointments. | Coordinated by the dedicated care team. |
Where Do You Get Care?
| Aspect | Medicare Advantage | PACE (Program of All-inclusive Care) |
|---|---|---|
| **Primary Location** | You drive (or find rides) to various doctor offices and different locations for different services. | **Most care comes to YOUR home.** You have a **PACE day center** you can visit for activities and care. |
| **Transportation** | You must find your own transportation. | **Transportation is provided** when you need to go somewhere. |
| **Emergency Care** | You might go to urgent care or the ER when problems come up. | The team actively **prevents problems** before they become emergencies. |
What's Included?
| Service/Benefit | Medicare Advantage | PACE (Program of All-inclusive Care) |
|---|---|---|
| Doctor Visits, Hospital Care, Prescription Drugs | ✓ (Usually) | ✓ (All included, **PLUS** everything below) |
| Dental/Vision (Extra Benefits) | ✓ (May be included) | ✓ |
| **Daily Personal Care** (Bathing, Dressing, Home Health Aide) | ✗ (Typically **NOT** included) | ✓ |
| **All Meals Provided** (Center and Delivered Home) | ✗ (Typically **NOT** included) | ✓ |
| All Transportation to Appointments | ✗ (Typically **NOT** included) | ✓ |
| Adult Day Center with Activities & Socialization | ✗ (Typically **NOT** included) | ✓ |
| Home Modifications / Medical Equipment & Supplies | ✗ (Typically **NOT** included) | ✓ |
| **24/7 Nurse Phone Line** / Care Coordination | ✗ (Typically **NOT** included) | ✓ |
What Does It Cost?
| Cost Component | Medicare Advantage | PACE (Program of All-inclusive Care) |
|---|---|---|
| **Monthly Premiums** | Varies, generally required. | $0 if you have **Medicaid**. One monthly premium covers **EVERYTHING** if you only have Medicare. |
| **Copays & Deductibles** | Copays for doctor visits, prescriptions, and deductibles are common. | **$0** (No copays at the pharmacy or doctor). |
| **Surprise Bills** | Possible, depending on the plan and care received. | **No surprise bills.** |
| **Out-of-Pocket Maximums** | You must pay up to a set maximum before the plan covers 100%. | Costs are predictable and bundled. |
The Real-Life Difference (Key Scenario Comparison)
| Life Aspect | Medicare Advantage (Mom's Scenario) | PACE (Mom's Scenario) |
|---|---|---|
| **Care Setting** | Drives self to primary doctor, diabetes specialist, and eye doctor at **different offices**. | **Nurse visits her at home** every week. Doctors are part of **one team** that talks to each other. |
| **Daily Living** | Manages medications herself. Struggles to cook healthy meals. | Home health aide helps shower and **prepare meals** 3 days a week. **Medications are delivered**. |
| **Socialization & Support** | Family worries constantly about falling or missing appointments. | Transportation to **PACE day center** twice a week for hot meal, activities, and socialization with friends. |
| **Emergency/Illness** | When she falls, she goes to **urgent care or the ER**. | Calls the **PACE nurse hotline 24/7**. The team **monitors her closely and prevents ER visits**. |
Who PACE Is Really Built For:
- Need help with daily activities (**bathing, dressing, cooking, medications**).
- Want to stay in their **own home** instead of a nursing home.
- Have **multiple health conditions** that need coordination.
- Qualify for **nursing home level of care** BUT want to avoid going there.
- Are on **Medicaid** or have limited income.