Last Updated: September 29, 2026
What Is a PACE Plan in California? Medicare, Medi-Cal, Home Care & IHSS Explained (2026)
If you or an older family member needs significant help with health care and daily living, you may have heard about a program called PACE.
“What is PACE, and how is it different from regular Medicare, Medi-Cal or IHSS?”
PACE stands for Program of All-Inclusive Care for the Elderly. It is designed for certain older adults who need a nursing-home level of care but may be able to continue living safely at home or in the community with coordinated support.
PACE combines medical care, prescription drugs, long-term care, home care, rehabilitation, transportation and other services into one coordinated program.
To qualify, you generally must be 55 or older, live in a PACE service area, meet California's nursing-home level-of-care requirement, and be able to live safely in the community with help from PACE.
If you currently receive IHSS, do not assume that your existing IHSS hours and caregiver arrangement will simply continue after you enroll in PACE. PACE coordinates the home-based medical and personal care services included in your PACE plan of care.
What Does PACE Mean?
PACE stands for Program of All-Inclusive Care for the Elderly.
Instead of having separate doctors, insurance programs, transportation services, home-care providers and long-term-care services that may not communicate with each other, PACE uses an interdisciplinary team to coordinate a participant's care.
The goal is to help qualifying older adults receive the care they need while remaining in their homes and communities for as long as it is safe and appropriate.
Who Can Qualify for PACE in California?
California PACE eligibility generally requires all of the following:
- You are 55 years old or older.
- You live within the service area of a PACE organization.
- California determines that you meet the required nursing-home level of care.
- You can live safely in your home or community with assistance from PACE at the time you enroll.
Being 55 or older by itself does not qualify someone for PACE. The nursing-home level-of-care requirement and the PACE service area are also important.
What Does “Nursing-Home Level of Care” Mean?
PACE is intended for people with substantial medical or long-term-care needs.
The fact that someone is older, lives alone, or needs occasional help does not automatically mean that the person meets the nursing-home level-of-care requirement.
The PACE enrollment process includes an assessment of the person's health and care needs, and California must determine that the required level-of-care standard is met.
Example: An Older Adult Who Wants to Stay at Home
Robert is 78 and has several chronic medical conditions. He needs frequent medical care, help managing medications, physical therapy, transportation to appointments and assistance with some daily activities.
His care needs are significant enough that he may meet the nursing-home level-of-care requirement, but Robert would prefer to continue living in his own home.
If he lives in a PACE service area and meets the other requirements, PACE may be an option that allows his medical and long-term-care services to be coordinated while he continues living in the community.
What Services Does PACE Provide?
PACE can provide a broad range of medical, social and long-term-care services based on the participant's individual needs.
Services may include:
- Primary care
- Specialist care
- Hospital care
- Emergency and urgent care
- Prescription drugs
- Home health care
- Personal care and support
- Adult day health services
- Physical therapy
- Occupational therapy
- Speech therapy
- Mental and behavioral health services
- Dental care
- Vision care
- Medical equipment and supplies
- Nutritional counseling and meals when appropriate
- Transportation to PACE centers and medical appointments
- Nursing-home care when needed
- Social services
- Respite and caregiver support when included in the care plan
How Does PACE Home Care Work?
One of the most important features of PACE is that care does not take place only at a PACE center. Depending on the participant's assessed needs and plan of care, services may also be provided in the participant's home.
PACE home health and home-care services may include:
- Skilled nursing
- Physical and occupational therapy
- Personal care
- Help with certain daily activities
- Light housework
- Meal preparation
- Other home-based services determined necessary by the PACE care team
The amount and type of home care are not automatically based on a fixed number of hours. The interdisciplinary PACE team evaluates the participant and develops an individualized plan of care.
Joining PACE does not automatically mean that a caregiver will be sent to your home for a certain number of hours every day. Home-care services depend on your assessed needs and the services included in your PACE plan of care.
Can I Receive IHSS and PACE at the Same Time?
This is especially important for people who already receive In-Home Supportive Services (IHSS).
California DHCS materials explain that when a person joins PACE, PACE coordinates the participant's home-based medical and personal care services in place of the person's IHSS arrangement.
This means you should not assume that your existing IHSS authorized hours will simply continue unchanged after PACE enrollment.
For example, if you currently receive 120 IHSS hours per month, those 120 hours do not automatically become 120 hours of PACE home care.
PACE evaluates your medical, functional and long-term-care needs and develops its own individualized plan of care.
Before enrolling in PACE, ask the PACE organization exactly what home-care services would be provided, how often they would be provided, and how your current IHSS arrangement would change.
What Happens to My IHSS Hours If I Join PACE?
PACE does not simply convert existing IHSS hours into the same number of PACE home-care hours.
For example, a person who currently receives 120 IHSS hours each month should not assume that PACE will automatically provide 120 hours of in-home caregiver services.
Instead, the PACE interdisciplinary team evaluates the participant's overall needs and determines which medical, personal-care, rehabilitation, transportation, day-center and home-care services should be included in the participant's plan of care.
Because the two systems organize home-based care differently, people who depend heavily on IHSS should understand the proposed PACE care arrangement before changing programs.
Can My Family Member Continue to Be My Paid Caregiver?
This is another important question for families considering PACE.
Under IHSS, an eligible family member may serve as the recipient's paid IHSS provider. PACE uses a different system for arranging and paying for home-care services.
Some PACE organizations may have arrangements that allow an existing family caregiver to continue providing paid in-home care through an approved home-care organization or other PACE arrangement. However, this should not be assumed to apply to every PACE organization or every participant.
For example, AltaMed PACE states that it pays for in-home caregiver services when participants require help at home and that, in some cases, the paid caregiver may be a family member who was already providing care.
The specific arrangement can depend on the PACE organization, the participant's approved care plan, the home-care provider used by the organization and whether the family caregiver meets applicable requirements.
1. Can my current family caregiver continue providing my home care?
2. Can that family member be paid under your PACE home-care arrangement?
3. Does the caregiver have to become an employee of or enroll with a contracted home-care agency?
4. How many hours or visits of home care are included in my proposed care plan?
5. Who will provide care if my family caregiver is unavailable?
PACE Home Care vs. IHSS
| Feature | IHSS | PACE Home Care |
|---|---|---|
| How care is determined | County IHSS assessment and authorized services/hours | PACE interdisciplinary team and individualized care plan |
| Caregiver selection | Recipient generally hires an eligible IHSS provider | Services are arranged through the PACE organization and its care network |
| Family caregiver | Eligible family members can often be paid IHSS providers | May be possible under some PACE arrangements; confirm with the individual PACE organization |
| Existing hours | County authorizes IHSS services and hours | Existing IHSS hours do not automatically transfer as identical PACE home-care hours |
| Medical care | IHSS itself is primarily an in-home supportive services program | Medical care, long-term care and home care are coordinated together |
Who Coordinates My Care?
One of the major features of PACE is its interdisciplinary care team.
Instead of each provider managing only one part of your care, the PACE team works together to evaluate and coordinate your medical, physical, social and long-term-care needs.
The exact services you receive depend on your individual care plan and what the PACE team determines is medically necessary and appropriate.
Can I Keep My Current Doctor If I Join PACE?
This is one of the most important questions to ask before enrolling.
PACE generally requires participants to receive care through the PACE organization's providers and network.
DHCS explains that when a person enrolls in a PACE health plan, the person is assigned a primary care physician who is part of the PACE interdisciplinary team.
If keeping your current primary doctor or specialist is very important to you, ask the PACE organization whether that provider participates in PACE and how your ongoing treatment would be handled before you enroll.
What If I Have Both Medicare and Medi-Cal?
PACE can be particularly relevant for people who have both Medicare and Medi-Cal.
PACE can coordinate Medicare and Medi-Cal covered services along with long-term-care and other services authorized through the PACE program.
PACE also provides prescription drug coverage. If you have Medicare and enroll in PACE, your Medicare prescription drugs are provided through PACE rather than through a separate Medicare Part D plan.
Can I Keep My Medicare Advantage or Medicare HMO Plan and Join PACE?
Generally, no.
DHCS explains that a person cannot be enrolled in both a Medicare HMO and PACE at the same time. Enrollment in PACE results in disenrollment from the existing Medicare HMO.
This is why people who already have a Medicare Advantage plan should understand how PACE enrollment would change their Medicare coverage before enrolling.
How Much Does PACE Cost?
The cost depends on your Medicare and Medi-Cal eligibility.
According to Medicare, if you have Medicaid — called Medi-Cal in California — you generally do not pay a monthly PACE premium.
If you have Medicare but do not qualify for Medi-Cal, you may have to pay a monthly premium for the long-term-care portion of PACE and a premium for Medicare prescription drug coverage.
People who have neither Medicare nor Medi-Cal may be able to pay the PACE premium themselves if they otherwise qualify.
Medicare states that there is no deductible, copayment or coinsurance for drugs, services or care approved by the PACE care team.
PACE vs. Regular Medi-Cal Managed Care
| Feature | PACE | Regular Medi-Cal Managed Care |
|---|---|---|
| Age requirement | 55+ | No general 55+ requirement |
| Nursing-home level of care | Required | Not generally required |
| Long-term care coordination | Central part of the program | Depends on member and benefits |
| Care team | Interdisciplinary PACE team | Managed through health plan/provider network |
| Home care | Can be included as part of the PACE care plan | Depends on the benefit or separate program involved |
| Service area | Must live in a PACE service area | Plan availability depends on county/service area |
Is PACE Available Everywhere in California?
No. PACE is available only in specific service areas.
Eligibility can depend on your ZIP code, not simply whether a PACE organization operates somewhere in your county.
Always check the current California PACE service-area and ZIP-code list before assuming that PACE is available where you live.
How Do I Apply for PACE?
PACE enrollment is voluntary.
The enrollment process includes an assessment to determine your health and care needs and whether you meet the program requirements.
You can contact a PACE organization serving your ZIP code to ask about enrollment and eligibility.
Medi-Cal members can also contact Medi-Cal Health Care Options for information about PACE.
Phone: 1-800-430-4263
TTY: 1-800-430-7077 or 711
Can I Leave PACE Later?
Yes. Enrollment in PACE is voluntary, and DHCS states that participants can disenroll.
However, leaving PACE can affect how your Medicare, Medi-Cal, prescription drug and long-term-care services are arranged, so it is important to understand what coverage you will have after disenrollment before making the change.
Frequently Asked Questions
Do I have to be 65 to join PACE?
No. The minimum age for PACE is 55, provided you meet the other eligibility requirements.
Do I have to live in a nursing home to qualify?
No. PACE is specifically designed to help qualifying people who need a nursing-home level of care receive coordinated services while living safely in the community when possible.
Does PACE provide care in my home?
It can. Depending on your assessed needs and PACE care plan, home services may include skilled nursing, therapy, personal care, light housework, meal preparation and other approved services.
Can I keep my IHSS hours after joining PACE?
Do not assume that your existing IHSS hours will continue unchanged. California DHCS materials describe PACE as coordinating home-based medical and personal care in place of the participant's IHSS arrangement. Ask the PACE organization exactly how your current services would change before enrolling.
Can my daughter, son or spouse continue as my paid caregiver?
Possibly, depending on the PACE organization and its home-care arrangements. Some California PACE organizations may allow family caregivers to provide paid care through an approved home-care arrangement, but this is not something you should assume is available in every PACE program. Ask the PACE organization before enrolling.
Can I join PACE if I only have Medi-Cal?
Having Medicare is not itself one of the four basic PACE eligibility requirements. A person who meets the PACE requirements may be eligible even without Medicare.
Does PACE cover prescription drugs?
Yes. PACE provides prescription drug coverage for medications determined necessary by the PACE care team.
Does PACE provide transportation?
PACE can provide transportation to and from the PACE center and medical appointments when included in the participant's care plan.
Can I keep my current Medicare Advantage plan?
You generally cannot remain enrolled in a Medicare HMO while also enrolled in PACE. Ask the PACE organization how enrollment would affect your current Medicare coverage before making a change.
Key Takeaways
PACE coordinates medical care, prescription drugs, rehabilitation, transportation, home care and long-term-care services through one interdisciplinary team.
PACE home care is based on an individualized care plan rather than automatically matching a person's previous IHSS hours.
If you currently receive IHSS, understand exactly how your home-care services will change before enrolling in PACE.
If a family member is your paid IHSS caregiver, ask the PACE organization whether that person can continue as a paid caregiver under its home-care arrangement.
You must live in a PACE service area, and availability can depend on your ZIP code.
PACE generally uses its own provider network, so check what will happen to your current doctors before enrolling.
Official Resources
- DHCS – Program of All-Inclusive Care for the Elderly (PACE)
- DHCS – California PACE Plans and Service Areas
- DHCS – PACE Frequently Asked Questions
- Medicare.gov – PACE
- CalPACE – PACE Services
Disclaimer:
This website provides general information about California public benefit programs and is for informational purposes only. It is not affiliated with or endorsed by any government agency and does not provide legal, medical, or professional advice. Program rules, eligibility requirements, benefits, and procedures may change. For the most current information and guidance about your individual situation, please contact the appropriate government agency, county office, health plan, or program administrator.