California PACE Program: Eligibility, Locations, and What It Covers

PACE — the Program of All-Inclusive Care for the Elderly — is a Medicare and Medi-Cal program that bundles medical care, personal care, adult day services, prescription drugs, and transportation into a single coordinated plan, all managed by an interdisciplinary team. If your aging parent qualifies, PACE can reduce the need to coordinate separate doctors, home care agencies, pharmacy plans, and ride arrangements. In California, availability depends on the specific plan's service area and ZIP codes.

Where PACE Operates in California

California has PACE plans serving multiple counties, with service areas listed by plan and ZIP code. Examples from the California Department of Health Care Services (DHCS) July 2026 directory include:

• AgeWell PACE — Marin and Sonoma counties
• AltaMed Senior Buena Care — Los Angeles, Orange, Riverside, and San Bernardino counties
• Brandman Centers for Senior Care PACE — Los Angeles County
• CalOptima PACE — Orange County
• Center for Elders' Independence PACE — Alameda and Contra Costa counties
• On Lok PACE — Alameda, San Francisco, and Santa Clara counties
• San Diego PACE and St. Paul's PACE — San Diego County
• Sutter SeniorCare PACE — Sacramento County

This is not an exhaustive list. DHCS is currently pausing applications for new PACE organizations and service-area expansions from November 20, 2025, through at least November 19, 2027. Each organization serves a defined geographic area — your parent must live within that boundary to enroll. Even in a county with a PACE provider, coverage may not extend to every ZIP code. Confirm directly with the provider whether your parent's specific address is in-area before building a plan around PACE.

Who Qualifies for PACE in California

Four conditions must all be met:

1. Age 55 or older. Despite the name referencing "the Elderly," PACE serves adults starting at 55, not 65.
2. Certified as needing a nursing-facility level of care. The PACE organization assesses whether your parent needs the level of care provided in a nursing facility, and DHCS certifies the determination. A diagnosis by itself does not decide eligibility.
3. Live within the PACE organization's service area.
4. Able to live safely in the community at the time of enrollment, with the support PACE provides.

A dementia diagnosis does not automatically meet or disqualify someone from the nursing-facility level of care standard. The assessment considers the person's functional needs and whether they can live safely in the community.

How PACE Enrollment and Cost Works

Many PACE participants are eligible for both Medicare and Medi-Cal, but a person with only Medicare or only Medi-Cal may also qualify if they meet the program criteria. For someone eligible for both programs, Medicare and Medi-Cal pay their respective portions of the PACE capitation, and covered PACE services do not have Medicare or Medicaid deductibles, copayments, coinsurance, or other cost sharing. Ask the plan how any separate Medicare premiums are handled.

If your parent has Medicare but does not qualify for Medi-Cal, they can still enroll in PACE by privately paying the portion of the monthly premium that Medicaid would otherwise pay, along with a Medicare Part D premium. Contact the PACE organization directly for current figures, as they vary by plan. For families in this situation, it may be useful to compare the PACE premium with the cost of arranging equivalent services separately.

If your parent has Medi-Cal but not Medicare, PACE enrollment may still be possible — the state pays the full cost to the PACE organization for eligible participants.

What PACE Covers

PACE uses a capitated model: the PACE organization receives a fixed monthly payment per participant from Medicare, Medi-Cal, or private premiums, and in return provides or arranges all medically necessary services. The interdisciplinary team — physician, nurse, social worker, therapists, dietitian, home care coordinator, and center staff — builds and adjusts a care plan based on your parent's needs. Services typically include:

• Primary and specialty medical care — physician visits, lab work, imaging, and referrals managed by the PACE team
• Prescription drugs — managed through the PACE pharmacy
• Adult day health services — structured programming at the PACE center, with frequency based on the individual care plan
• In-home personal care — help with bathing, dressing, meals, and other daily tasks
• Physical, occupational, and speech therapy
• Social work and mental health services
• Meals — as authorized by the care plan
• Transportation — to and from the PACE center and covered appointments, arranged by the plan
• Hospital and skilled nursing facility care when medically necessary
• Dental care and other services authorized by the interdisciplinary team

The specific intensity and frequency of each service is determined by the care plan, not a fixed schedule. If your parent's needs increase — a fall, a hospitalization, worsening dementia — the interdisciplinary team can reassess and adjust the care plan.

The Tradeoff: Your Parent's Existing Doctors

The most important thing to understand about PACE is that participants agree to receive covered care through the PACE organization's interdisciplinary team and contracted providers, except in emergencies or other authorized situations. This is what makes the tight coordination possible — the same team that sees your parent at the day center also manages their prescriptions, orders their lab work, and communicates with home-care providers. It may mean leaving a primary care physician your parent has seen for years.

For some families, this is a dealbreaker. For others — especially those already struggling to coordinate between multiple specialists who don't talk to each other — it is exactly the point.

PACE vs. Medi-Cal Home and Community-Based Alternatives

California offers several alternatives for keeping an aging parent at home through Medi-Cal. Here is how PACE compares to the most common ones:

IHSS is a statewide, county-administered program for authorized in-home tasks such as personal care, meal preparation, and protective supervision. It requires an application and functional assessment; it does not by itself coordinate medical care or cover prescriptions, and transportation is handled separately. PACE provides a broader integrated benefit, but requires your parent to receive covered care within the PACE system.

For families where the parent's needs are primarily hands-on help at home and they have a stable medical team, IHSS or MSSP may be sufficient. For families managing complex medical needs, multiple chronic conditions, or dementia alongside the need for daily personal care, PACE's integrated model may reduce the coordination burden that often falls on an adult child.

One important enrollment tradeoff is that DHCS says PACE participants cannot be served simultaneously by MSSP, another fee-for-service Medi-Cal program, or Medi-Cal managed-care community supports. If your parent already receives one of these services, ask the PACE organization what would change before enrolling.

How to Start the PACE Enrollment Process

1. Confirm a PACE organization serves your parent's address. Call the provider or check the California Department of Health Care Services PACE page. Do not assume county-level coverage means every address is included.
2. Request an eligibility assessment. The PACE organization will arrange a medical and social assessment, often starting with a home visit, to determine whether your parent meets the nursing-facility level of care standard.
3. Apply for Medi-Cal in parallel if your parent is not already enrolled. Ask the PACE organization or county office which current application pathway applies to your parent.
4. Meet the interdisciplinary team to build the initial care plan once enrollment is approved.

Enrollment timing varies between plans. If your parent is coming out of a hospital stay or their care needs are escalating quickly, tell the PACE organization when you contact it and ask what assessment timeline is realistic.

Getting the Financial Side Right

PACE eligibility and Medi-Cal financial eligibility are related but not identical. If your parent needs Medi-Cal, ask the current PACE plan and county office about the income and asset rules that apply. California's phased 30-month transfer look-back concerns institutional nursing-facility coverage; do not assume it applies to PACE enrollment itself. A transfer or joint-account decision can affect other Medi-Cal pathways, so do not act on this article alone.

Our California Medi-Cal Long-Term Care & Asset Protection Guide is the related process-navigation guide for organizing eligibility questions, documenting assets and transfers, and preparing for county review. Confirm current rules with the relevant agency before making a financial or care decision.

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