PACE (Program of All-Inclusive Care for the Elderly: all medical and social care from one team, at home instead of a nursing home): who qualifies, what you get, how to apply, and what happens next
PACE gives people 55 and older who need nursing-home level care all their medical and social care from one team, with a day center, home care and transportation, so they can stay at home. With Medi-Cal there is no premium and no copays. Apply by calling a PACE organization that serves your ZIP code.
What PACE is, in one paragraph
PACE, the Program of All-Inclusive Care for the Elderly, is a Medicare and Medicaid program for people 55 and older who need nursing-home level care but can live at home (rule:definition, rule:age_55). One PACE organization provides all of the person's care through a team: doctors, a day center, home care, hospital care, drugs and transportation (rule:covers_all, rule:team, rule:transport). In California, PACE organizations serve over 28,000 people in 28 counties (rule:ca_reach). It is only available where a PACE organization operates (rule:service_area).
$0
the monthly PACE premium for a person with Medi-Cal, and no copays for care the PACE team approves (Medicare.gov, rule:no_premium_medicaid, rule:no_copays)
Who may qualify
Test
Rule
55 or older
rule:age_55
Lives in the service area of a PACE organization
rule:service_area
Needs nursing-home level of care, as certified by the state
Find a PACE organization serving your ZIP code with the CalPACE finder or Medicare's plan search, and call it (rule:find_program). The PACE team assesses the person and the state certifies the level of care (rule:state_assessment). The PACE provider can help apply for Medicare and Medi-Cal (rule:help_apply).
Once enrolled, all care goes through the PACE team, with no deductibles or copays for what it approves (rule:no_copays). Joining a separate Medicare drug plan ends PACE enrollment (rule:drug_plan_disenroll). A Medi-Cal decision can be taken to a state hearing within 90 days (rule:hearing_90), at (800) 743-8525 (rule:hearing_phone).
The procedure, stage by stage, as data
JSONThe procedure, stage by stage, as data
[11 items
{10 keys
"id": "stage:discover",
"order": 1,
"name": "Discover",
"what_happens": "An older adult or family learns PACE exists for people 55+ who need nursing-home level care but can live at home (rule:definition)",
"who_acts": "Person / family / doctor",
"timeline": "No deadline",
"evidence": "None",
"failure_mode": "Moving to a nursing home without knowing PACE was available",
"model_role": "Ask age, county and care needs; check for a PACE organization nearby",
"automation_class": "C - availability depends on service area"
},{10 keys
"id": "stage:screen_eligibility",
"order": 2,
"name": "Screen eligibility",
"what_happens": "Four tests: 55 or older (rule:age_55), lives in a PACE service area (rule:service_area), needs nursing-home level of care (rule:nursing_home_level), can live safely at home with PACE (rule:live_safely)",
"who_acts": "Model + person",
"timeline": "Minutes",
"evidence": "Age, address, care needs",
"failure_mode": "Assuming PACE needs Medi-Cal; it does not, but Medi-Cal makes it free (rule:no_premium_medicaid)",
"model_role": "Check each test; say which only the state can decide",
"automation_class": "A"
},{10 keys
"id": "stage:gather_documents",
"order": 3,
"name": "Gather documents",
"what_happens": "Medicare and Medi-Cal cards; medical records for the assessment",
"who_acts": "Person / family",
"timeline": "Before intake",
"evidence": "Medicare card, Medi-Cal card, doctor records",
"failure_mode": "Applying without Medi-Cal when the person could qualify",
"model_role": "Note the PACE provider can help apply for Medi-Cal (rule:help_apply)",
"automation_class": "B"
},{10 keys
"id": "stage:contact_pace",
"order": 4,
"name": "Contact a PACE organization",
"what_happens": "The person calls a PACE organization serving their area (rule:find_program)",
"who_acts": "Person",
"timeline": "No deadline",
"evidence": "Address",
"failure_mode": "No PACE organization in the area",
"model_role": "Give the CalPACE finder and Medicare plan search",
"automation_class": "B"
},{10 keys
"id": "stage:interview_verification",
"order": 5,
"name": "Interview / verification",
"what_happens": "The PACE team assesses the person; the state assesses level of care (rule:state_assessment)",
"who_acts": "PACE team + state",
"timeline": "UNKNOWN: no official page read today states a time",
"what_happens": "All care through the PACE team: day center, home care, doctors, hospital, drugs, transportation (rule:covers_all, rule:day_center, rule:transport); no copays (rule:no_copays)",
"who_acts": "PACE organization",
"timeline": "From the enrollment date",
"evidence": "Enrollment card",
"failure_mode": "Seeing outside doctors without PACE approval",
"model_role": "Explain that the PACE team approves all care",
"automation_class": "C"
},{10 keys
"id": "stage:report_changes",
"order": 8,
"name": "Report changes",
"what_happens": "Moves out of the service area and Medi-Cal changes are reported",
"who_acts": "Participant",
"timeline": "UNKNOWN",
"evidence": "Address change",
"failure_mode": "Moving out of the service area",
"model_role": "Flag a planned move",
"automation_class": "B"
},{10 keys
"id": "stage:renew_recertify",
"order": 9,
"name": "Renew / recertify",
"what_happens": "Medi-Cal renewal continues for Medi-Cal participants; level of care is reviewed by the PACE team",
"who_acts": "County + PACE",
"timeline": "Medi-Cal: yearly",
"evidence": "Medi-Cal renewal",
"failure_mode": "Lost Medi-Cal brings a premium",
"model_role": "Track the Medi-Cal renewal",
"automation_class": "B"
},{10 keys
"id": "stage:appeal_fair_hearing",
"order": 10,
"name": "Appeal / fair hearing",
"what_happens": "A Medi-Cal action can go to a state hearing (rule:hearing_90, rule:hearing_phone)",
"who_acts": "Person + CDSS State Hearings Division",
"timeline": "90 days",
"evidence": "Notice",
"failure_mode": "Missing the 90-day line",
"model_role": "Give the deadline",
"automation_class": "B"
},{10 keys
"id": "stage:overpayment_exit",
"order": 11,
"name": "Overpayment / exit",
"what_happens": "Joining a separate Medicare drug plan disenrolls the person (rule:drug_plan_disenroll); moving out of the service area ends eligibility (rule:service_area)",
"who_acts": "Participant / PACE",
"timeline": "At change",
"evidence": "Disenrollment notice",
"failure_mode": "Joining a Part D plan by mistake",
"model_role": "Warn before any Medicare plan change",
"automation_class": "C"
}
]
The same facts open other programs
Age, address, care needs and Medicare or Medi-Cal status are the facts PACE asks. They also open:
"B011": "Medi-Cal (Medicaid) (level: Federal/State; administrator: CA Dept of Health Care Services + counties / Covered California; graph url: https://www.dhcs.ca.gov/services/medi-cal)",
"B016": "Multipurpose Senior Services Program (MSSP) + CBAS (level: State; administrator: DHCS / local MSSP sites; graph url: https://www.dhcs.ca.gov/services/medi-cal)",
"B014": "Medicare Part D Extra Help (Low-Income Subsidy)",
"B063": "Older Americans Act meals (Meals on Wheels / congregate)",
"B070": "Whole Person Care successor: CalAIM Enhanced Care Management + Community Supports (level: State/County; administrator: DHCS / Medi-Cal managed care plans; graph url: https://www.dhcs.ca.gov/CalAIM)",
PACE | Medicare: what PACE is — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“PACE helps eligible older adults who need nursing home-level care meet their health care needs in the community”
PACE | Medicare: care team — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“If you join PACE, a team of health care professionals will work with you to help coordinate your care.”
PACE | Medicare: what it covers — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“PACE covers all Medicare- and Medicaid-covered care and services”
PACE | Medicare: services list — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“Adult day primary care (including meals/special dietary needs and recreational therapy)”
PACE | Medicare: transportation — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“Transportation to and from the PACE center and medical appointments”
PACE | Medicare: age — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“Are at least 55”
PACE | Medicare: service area — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“Live in the service area of a PACE organization”
PACE | Medicare: level of care — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“Need a nursing home-level of care (as certified by your state)”
PACE | Medicare: living safely — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“Are able to live safely in the community with help from PACE”
PACE | Medicare: no premium with Medicaid — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“If you have Medicaid, you won't pay a monthly premium for PACE.”
PACE | Medicare: private pay — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“If you don’t have Medicare or Medicaid, you can pay the PACE premium yourself.”
PACE | Medicare: no copays — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“you won’t have a deductible, copayment, or co-insurance for any drug, service, or care your PACE team approves”
PACE | Medicare: separate drug plan — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“If you join a separate Medicare drug plan while you’re in the PACE program, you’ll be disenrolled from PACE.”
PACE | Medicare: how to apply — Medicare.gov (U.S. Centers for Medicare & Medicaid Services)“To find out if you’re eligible and if there’s a PACE program near you, search for”
CalPACE home page: California reach — California PACE Association (CalPACE)“PACE organizations serve over 28,000 participants in 28 counties across California.”
PACE Cost | CalPACE: cost in California — California PACE Association (CalPACE)“If you are enrolled in Medicare and Medi-Cal, you will pay nothing or you will pay your Medi-Cal “share of cost” to your PACE provider.”
PACE Cost | CalPACE: help applying — California PACE Association (CalPACE)“your local PACE provider can help you apply for Medicare and Medi-Cal”
Hearing Requests | CDSS: the 90 days — California Department of Social Services, State Hearings Division“you have 90 days to request a state hearing.”
Hearing Requests | CDSS: phone — California Department of Social Services, State Hearings Division“Call the State Hearings Division toll free (800) 743-8525”
the whole object this page is drawn from, as JSON
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"slug":"california-pace",
"title":"PACE (Program of All-Inclusive Care for the Elderly: all medical and social care from one team, at home instead of a nursing home): who qualifies, what you get, how to apply, and what happens next",
"kind":"procedure",
"summary":"PACE gives people 55 and older who need nursing-home level care all their medical and social care from one team, with a day center, home care and transportation, so they can stay at home. With Medi-Cal there is no premium and no copays. Apply by calling a PACE organization that serves your ZIP code.",
"tags": [
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"facts": {
"measured_at":"2026-10-09T13:55:35Z",
"article": {
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"program_id":"B073",
"jurisdiction":"US-CA",
"aliases": [
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"Program of All-Inclusive Care for the Elderly",
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"schema_version":"jarticle/1 + benefit-article/1 (these facts)"
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"procedure": {
"id":"proc:apply_pace_ca",
"type":"procedure",
"program_id":"B073",
"authority":"California Department of Health Care Services (DHCS) and the federal Centers for Medicare & Medicaid Services, through licensed PACE organizations",
"outcome":"enrollment in a PACE organization that provides all care",
"apply_at":"https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE",
"stages": [
{
"id":"stage:discover",
"order":1,
"name":"Discover",
"what_happens":"An older adult or family learns PACE exists for people 55+ who need nursing-home level care but can live at home (rule:definition)",
"who_acts":"Person / family / doctor",
"timeline":"No deadline",
"evidence":"None",
"failure_mode":"Moving to a nursing home without knowing PACE was available",
"model_role":"Ask age, county and care needs; check for a PACE organization nearby",
"automation_class":"C - availability depends on service area"
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{
"id":"stage:screen_eligibility",
"order":2,
"name":"Screen eligibility",
"what_happens":"Four tests: 55 or older (rule:age_55), lives in a PACE service area (rule:service_area), needs nursing-home level of care (rule:nursing_home_level), can live safely at home with PACE (rule:live_safely)",
"who_acts":"Model + person",
"timeline":"Minutes",
"evidence":"Age, address, care needs",
"failure_mode":"Assuming PACE needs Medi-Cal; it does not, but Medi-Cal makes it free (rule:no_premium_medicaid)",
"model_role":"Check each test; say which only the state can decide",
"automation_class":"A"
},
{
"id":"stage:gather_documents",
"order":3,
"name":"Gather documents",
"what_happens":"Medicare and Medi-Cal cards; medical records for the assessment",
"who_acts":"Person / family",
"timeline":"Before intake",
"evidence":"Medicare card, Medi-Cal card, doctor records",
"failure_mode":"Applying without Medi-Cal when the person could qualify",
"model_role":"Note the PACE provider can help apply for Medi-Cal (rule:help_apply)",
"automation_class":"B"
},
{
"id":"stage:contact_pace",
"order":4,
"name":"Contact a PACE organization",
"what_happens":"The person calls a PACE organization serving their area (rule:find_program)",
"who_acts":"Person",
"timeline":"No deadline",
"evidence":"Address",
"failure_mode":"No PACE organization in the area",
"model_role":"Give the CalPACE finder and Medicare plan search",
"automation_class":"B"
},
{
"id":"stage:interview_verification",
"order":5,
"name":"Interview / verification",
"what_happens":"The PACE team assesses the person; the state assesses level of care (rule:state_assessment)",
"who_acts":"PACE team + state",
"timeline":"UNKNOWN: no official page read today states a time",
"evidence":"Assessment",
"failure_mode":"Assessment scored below nursing-home level",
"model_role":"Prepare a list of daily-living needs",
"automation_class":"C"
},
{
"id":"stage:decision",
"order":6,
"name":"Decision",
"what_happens":"The state certifies the level of care; the person signs an enrollment agreement with the PACE organization",
"who_acts":"State + PACE organization",
"timeline":"UNKNOWN",
"evidence":"Level-of-care certification, enrollment agreement",
"failure_mode":"Not certified",
"model_role":"Explain the certification result",
"automation_class":"C"
},
{
"id":"stage:issuance_use",
"order":7,
"name":"Issuance / use",
"what_happens":"All care through the PACE team: day center, home care, doctors, hospital, drugs, transportation (rule:covers_all, rule:day_center, rule:transport); no copays (rule:no_copays)",
"who_acts":"PACE organization",
"timeline":"From the enrollment date",
"evidence":"Enrollment card",
"failure_mode":"Seeing outside doctors without PACE approval",
"model_role":"Explain that the PACE team approves all care",
"automation_class":"C"
},
{
"id":"stage:report_changes",
"order":8,
"name":"Report changes",
"what_happens":"Moves out of the service area and Medi-Cal changes are reported",
"who_acts":"Participant",
"timeline":"UNKNOWN",
"evidence":"Address change",
"failure_mode":"Moving out of the service area",
"model_role":"Flag a planned move",
"automation_class":"B"
},
{
"id":"stage:renew_recertify",
"order":9,
"name":"Renew / recertify",
"what_happens":"Medi-Cal renewal continues for Medi-Cal participants; level of care is reviewed by the PACE team",
"who_acts":"County + PACE",
"timeline":"Medi-Cal: yearly",
"evidence":"Medi-Cal renewal",
"failure_mode":"Lost Medi-Cal brings a premium",
"model_role":"Track the Medi-Cal renewal",
"automation_class":"B"
},
{
"id":"stage:appeal_fair_hearing",
"order":10,
"name":"Appeal / fair hearing",
"what_happens":"A Medi-Cal action can go to a state hearing (rule:hearing_90, rule:hearing_phone)",
"who_acts":"Person + CDSS State Hearings Division",
"timeline":"90 days",
"evidence":"Notice",
"failure_mode":"Missing the 90-day line",
"model_role":"Give the deadline",
"automation_class":"B"
},
{
"id":"stage:overpayment_exit",
"order":11,
"name":"Overpayment / exit",
"what_happens":"Joining a separate Medicare drug plan disenrolls the person (rule:drug_plan_disenroll); moving out of the service area ends eligibility (rule:service_area)",
"who_acts":"Participant / PACE",
"timeline":"At change",
"evidence":"Disenrollment notice",
"failure_mode":"Joining a Part D plan by mistake",
"model_role":"Warn before any Medicare plan change",
"automation_class":"C"
}
],
"stage_ids": [
"stage:discover",
"stage:screen_eligibility",
"stage:gather_documents",
"stage:contact_pace",
"stage:interview_verification",
"stage:decision",
"stage:issuance_use",
"stage:report_changes",
"stage:renew_recertify",
"stage:appeal_fair_hearing",
"stage:overpayment_exit"
]
},
"rules": [
{
"id":"rule:definition",
"kind":"definition",
"text":"PACE is a Medicare and Medicaid program that lets older adults who need nursing-home level care get their care in the community, coordinated by a PACE team.",
"jurisdiction":"US",
"source":"s_medicare_pace_what",
"status":"verified 2026-10-09"
},
{
"id":"rule:age_55",
"kind":"categorical",
"text":"A participant must be at least 55.",
"jurisdiction":"US",
"value_age_min":55,
"source":"s_medicare_pace_55",
"status":"verified 2026-10-09"
},
{
"id":"rule:service_area",
"kind":"categorical",
"text":"A participant must live in the service area of a PACE organization.",
"jurisdiction":"US",
"source":"s_medicare_pace_area",
"status":"verified 2026-10-09"
},
{
"id":"rule:nursing_home_level",
"kind":"categorical",
"text":"A participant must need a nursing-home level of care, as certified by the state.",
"jurisdiction":"US",
"source":"s_medicare_pace_nh",
"status":"verified 2026-10-09"
},
{
"id":"rule:live_safely",
"kind":"categorical",
"text":"A participant must be able to live safely in the community with PACE’s help.",
"jurisdiction":"US",
"source":"s_medicare_pace_safe",
"status":"verified 2026-10-09"
},
{
"id":"rule:state_assessment",
"kind":"procedure",
"text":"The state agency assesses every applicant, including those without Medi-Cal, to confirm nursing-facility level of care and PACE eligibility.",
"jurisdiction":"US-CA",
"source":"s_calpace_assess",
"status":"verified 2026-10-09"
},
{
"id":"rule:covers_all",
"kind":"benefit",
"text":"PACE covers all Medicare- and Medicaid-covered care and services, plus anything else the PACE team decides the person needs, including prescription drugs.",
"jurisdiction":"US",
"source":"s_medicare_pace_covers",
"status":"verified 2026-10-09"
},
{
"id":"rule:team",
"kind":"benefit",
"text":"A team of health care professionals coordinates the participant’s care.",
"jurisdiction":"US",
"source":"s_medicare_pace_team",
"status":"verified 2026-10-09"
},
{
"id":"rule:day_center",
"kind":"benefit",
"text":"Services include adult day primary care with meals at the PACE center.",
"jurisdiction":"US",
"source":"s_medicare_pace_center",
"status":"verified 2026-10-09"
},
{
"id":"rule:transport",
"kind":"benefit",
"text":"Transportation to and from the PACE center and medical appointments is covered.",
"jurisdiction":"US",
"source":"s_medicare_pace_transport",
"status":"verified 2026-10-09"
},
{
"id":"rule:no_premium_medicaid",
"kind":"benefit",
"text":"A person with Medicaid (Medi-Cal) pays no monthly PACE premium.",
"jurisdiction":"US",
"value_usd_monthly_premium":0,
"source":"s_medicare_pace_premium",
"status":"verified 2026-10-09"
},
{
"id":"rule:ca_cost",
"kind":"benefit",
"text":"In California a person with Medicare and Medi-Cal pays nothing, or pays their Medi-Cal share of cost to the PACE provider.",
"jurisdiction":"US-CA",
"source":"s_calpace_soc",
"status":"verified 2026-10-09"
},
{
"id":"rule:private_pay",
"kind":"benefit",
"text":"A person without Medicare or Medicaid can pay the PACE premium; the amount is set by each organization and is UNKNOWN here.",
"jurisdiction":"US",
"value_usd_monthly_premium":"UNKNOWN",
"source":"s_medicare_pace_private",
"status":"verified 2026-10-09"
},
{
"id":"rule:no_copays",
"kind":"benefit",
"text":"No deductible, copayment or co-insurance for anything the PACE team approves.",
"jurisdiction":"US",
"value_usd_copay":0,
"source":"s_medicare_pace_nocost",
"status":"verified 2026-10-09"
},
{
"id":"rule:drug_plan_disenroll",
"kind":"restriction",
"text":"Joining a separate Medicare drug plan while in PACE disenrolls the person from PACE.",
"jurisdiction":"US",
"source":"s_medicare_pace_partd",
"status":"verified 2026-10-09"
},
{
"id":"rule:find_program",
"kind":"procedure",
"text":"To apply, find a PACE organization serving the area (Medicare’s plan search or the Medicaid office) and contact it.",
"jurisdiction":"US",
"source":"s_medicare_pace_apply",
"status":"verified 2026-10-09"
},
{
"id":"rule:help_apply",
"kind":"procedure",
"text":"The local PACE provider can help the person apply for Medicare and Medi-Cal.",
"jurisdiction":"US-CA",
"source":"s_calpace_help_apply",
"status":"verified 2026-10-09"
},
{
"id":"rule:ca_reach",
"kind":"administration",
"text":"PACE organizations serve over 28,000 participants in 28 California counties.",
"jurisdiction":"US-CA",
"value_participants_min":28000,
"value_counties":28,
"source":"s_calpace_counties",
"status":"verified 2026-10-09 (CalPACE, the association of California PACE organizations; no state page could be read)"
},
{
"id":"rule:hearing_90",
"kind":"appeal",
"text":"A person who disagrees with a Medi-Cal action by the county or DHCS has 90 days to request a state hearing.",
"jurisdiction":"US-CA",
"value_days":90,
"source":"s_cdss_hearing_90",
"status":"verified 2026-10-09 (CDSS hearing page); whether a PACE organization’s own decisions go first to an internal PACE appeal could not be read on an official page today"
},
{
"id":"rule:hearing_phone",
"kind":"appeal",
"text":"State hearings can be requested by phone at (800) 743-8525.",
"jurisdiction":"US-CA",
"source":"s_cdss_hearing_phone",
"status":"verified 2026-10-09"
}
],
"fiscal_year": {
"fiscal_year":"UNKNOWN",
"effective":"UNKNOWN",
"source":null,
"area":"California PACE service areas",
"note":"PACE has no yearly eligibility dollar figures on the pages read today; the Medi-Cal income limits that decide whether a participant pays nothing are on california-medi-cal"
},
"fields": [
{
"field_id":"f:dob",
"canonical_fact":"person.identity.date_of_birth",
"label":"Date of birth",
"data_type":"date",
"required":true,
"sensitivity":"personal",
"used_by_rules": [
"rule:age_55"
]
},
{
"field_id":"f:postal_code",
"canonical_fact":"person.address.residential.postal_code",
"label":"ZIP code where you live",
"data_type":"text",
"required":true,
"sensitivity":"personal",
"used_by_rules": [
"rule:service_area"
]
},
{
"field_id":"f:county",
"canonical_fact":"person.address.residential.county",
"label":"County where you live",
"data_type":"text",
"required":true,
"sensitivity":"personal",
"used_by_rules": [
"rule:service_area",
"rule:ca_reach"
]
},
{
"field_id":"f:nh_level",
"canonical_fact":"person.health.needs_nursing_home_level_of_care",
"label":"Needs help with daily living at the level a nursing home gives",
"data_type":"boolean",
"required":true,
"sensitivity":"sensitive",
"used_by_rules": [
"rule:nursing_home_level",
"rule:state_assessment"
]
},
{
"field_id":"f:live_safely",
"canonical_fact":"person.health.can_live_safely_in_community",
"label":"Can live safely at home with help",
"data_type":"boolean",
"required":true,
"sensitivity":"sensitive",
"used_by_rules": [
"rule:live_safely"
]
},
{
"field_id":"f:coverage",
"canonical_fact":"benefits.currently_receiving[]",
"label":"Has Medicare, Medi-Cal, both or neither",
"data_type":"list",
"required":true,
"sensitivity":"personal",
"used_by_rules": [
"rule:no_premium_medicaid",
"rule:ca_cost",
"rule:private_pay",
"rule:drug_plan_disenroll"
]
}
],
"ontology": {
"program_id":"B073",
"graph":"california-benefits-graph",
"related_program_ids": [
"B011",
"B016",
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"B013":"Medicare Savings Programs (QMB / SLMB / QI / QDWI)",
"B014":"Medicare Part D Extra Help (Low-Income Subsidy)",
"B063":"Older Americans Act meals (Meals on Wheels / congregate)",
"B070":"Whole Person Care successor: CalAIM Enhanced Care Management + Community Supports (level: State/County; administrator: DHCS / Medi-Cal managed care plans; graph url: https://www.dhcs.ca.gov/CalAIM)",
"B065":"Medi-Cal Dental (Denti-Cal) + vision (level: Federal/State; administrator: DHCS; graph url: https://dental.dhcs.ca.gov)"
},
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{
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"## What PACE is, in one paragraph\n\nPACE, the Program of All-Inclusive Care for the Elderly, is a Medicare and Medicaid program for people 55 and older who need nursing-home level care but can live at home (rule:definition, rule:age_55). One PACE organization provides all of the person's care through a team: doctors, a day center, home care, hospital care, drugs and transportation (rule:covers_all, rule:team, rule:transport). In California, PACE organizations serve over 28,000 people in 28 counties (rule:ca_reach). It is only available where a PACE organization operates (rule:service_area).",
{
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"label":"the monthly PACE premium for a person with Medi-Cal, and no copays for care the PACE team approves (Medicare.gov, rule:no_premium_medicaid, rule:no_copays)"
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"## Who may qualify\n\n| Test | Rule |\n| --- | --- |\n| 55 or older | rule:age_55 |\n| Lives in the service area of a PACE organization | rule:service_area |\n| Needs nursing-home level of care, as certified by the state | rule:nursing_home_level, rule:state_assessment |\n| Can live safely in the community with PACE's help | rule:live_safely |\n\nMedi-Cal is not required to join. With Medi-Cal there is no premium; in California a person with Medicare and Medi-Cal pays nothing or their Medi-Cal share of cost (rule:no_premium_medicaid, rule:ca_cost). Without Medi-Cal the person pays a premium the organization sets (rule:private_pay). The Medi-Cal limits are on [[california-medi-cal]].",
"## What the model on this page can do for you\n\nThis article is also the context of a model you can text or chat with. The buttons under the title open Messages with a note already written, or a chat on this page. The model has read this exact page: the rules above with their source ids, the procedure below, and the other programs the same facts open. It asks age, ZIP code and care needs, checks the four tests, says which only the state can decide, and gives the exact next step. It has no tools: it cannot enroll anyone, and it says so. Every message is kept on this build's Ledger.\n\nA screening here is a screening, not a decision. The state certifies the level of care and the PACE organization enrolls.",
"## How to apply, and what happens after\n\nFind a PACE organization serving your ZIP code with the [CalPACE finder](https://calpace.org) or [Medicare's plan search](https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE), and call it (rule:find_program). The PACE team assesses the person and the state certifies the level of care (rule:state_assessment). The PACE provider can help apply for Medicare and Medi-Cal (rule:help_apply).\n\nOnce enrolled, all care goes through the PACE team, with no deductibles or copays for what it approves (rule:no_copays). Joining a separate Medicare drug plan ends PACE enrollment (rule:drug_plan_disenroll). A Medi-Cal decision can be taken to a state hearing within 90 days (rule:hearing_90), at (800) 743-8525 (rule:hearing_phone).",
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"## The same facts open other programs\n\nAge, address, care needs and Medicare or Medi-Cal status are the facts PACE asks. They also open:\n\n- [[california-medi-cal]] (B011): Medi-Cal: with it PACE has no premium.\n- [[california-mssp-cbas]] (B016): MSSP and CBAS, the other ways to get nursing-home level care at home.\n- [[california-ihss]] (B015): In-Home Supportive Services.\n- [[california-medicare-savings-programs]] (B013): Medicare Savings Programs.\n- [[california-medicare-extra-help]] (B014): Medicare Part D Extra Help.\n- [[california-older-americans-act-meals]] (B063): Older Americans Act meals.\n- [[california-calaim-ecm-community-supports]] (B070): Enhanced Care Management and Community Supports.\n- [[california-medi-cal-dental-vision]] (B065): Medi-Cal Dental and vision.",
{
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},
"## How this page works\n\nThis page is one JSON object. The page, the Markdown and the machine copy at [/a/california-pace.json](https://miscsubjects.com/a/california-pace.json) are three views of it. Its `facts` carry the article's identity, the procedure with its stages, every rule with its source id and verification status, the fields with their canonical fact names, the ontology edges into the benefits graph, the declared actions, the model's instructions, and the permissions the model has (none). The model's context is served at [/a/california-pace/context](https://miscsubjects.com/a/california-pace/context). The Department of Health Care Services PACE page shows a human check to automated readers, so the rules are quoted from Medicare.gov and from CalPACE, the association of California's PACE organizations.",
"## Official addresses\n\n- The federal program: [Medicare.gov, PACE](https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE)\n- The state program: [DHCS PACE](https://www.dhcs.ca.gov/provgovpart/Pages/PACE.aspx)\n- Find a California PACE organization: [CalPACE](https://calpace.org)\n- Get Medi-Cal: [[california-medi-cal]], [BenefitsCal](https://benefitscal.com)\n- State hearings: [CDSS hearing requests](https://www.cdss.ca.gov/hearing-requests), (800) 743-8525"
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