PACE Program Wisconsin: All-Inclusive Care for Seniors Explained

PACE — the Program of All-Inclusive Care for the Elderly — is Wisconsin's most comprehensive option for keeping a nursing-home-eligible parent living at home. It wraps medical care, personal care, prescriptions, therapy, transportation, adult day services, and even dental and vision into a single coordinated program. No deductibles, no co-pays, no separate billing.

The catch: it's only available in certain Wisconsin counties, and your parent must be willing to receive primary medical care from the PACE team rather than their current doctor.

How PACE Works

PACE operates as a combined health plan and care provider. Unlike Family Care (which contracts with outside agencies) or IRIS (which lets you self-direct), PACE delivers most services directly through its own centers and staff.

Each participant gets an interdisciplinary team — physician, nurse, social worker, physical therapist, occupational therapist, dietitian, recreation therapist, and personal care aides — all working from the same PACE center. Your parent's entire care plan is managed by this team.

Services included:

• Primary medical care (PACE physician)
• Prescription drugs (no Part D needed)
• Adult day health services at the PACE center
• In-home personal care and nursing
• Physical, occupational, and speech therapy
• Transportation to the PACE center and medical appointments
• Hospital and nursing home care when needed
• Dental, vision, and hearing services
• Medical equipment and supplies
• Meals at the center and nutritional counseling
• Respite care and caregiver support

The model is built around the adult day center — most participants attend the PACE center several days per week, where they receive therapy, meals, socialization, and health monitoring. On non-center days, personal care aides come to the home.

Eligibility

Your parent qualifies for PACE if they:

• Are age 55 or older
• Live in a PACE service area
• Meet the nursing home level of care (determined by the Long-Term Care Functional Screen administered by your county ADRC)
• Can safely live in the community at the time of enrollment (PACE is for people who could go to a nursing home but don't need to yet)

Financial eligibility follows Wisconsin Medicaid rules: $2,000 countable asset limit for a single applicant, income up to $2,982/month (300% of SSI). If your parent qualifies for both Medicare and Medicaid (dual-eligible), there's no monthly premium — PACE is fully covered.

If your parent has Medicare but doesn't qualify for Medicaid, they can still enroll by paying a monthly premium that covers the Medicaid portion. This premium varies but typically runs $4,000 to $6,000 per month — expensive, but still less than private-pay nursing home care.

Where PACE Is Available in Wisconsin

PACE has limited geographic availability compared to Family Care (which is statewide). As of 2026, Wisconsin PACE programs operate in:

• Community Care, Inc. — serving Milwaukee County and surrounding areas
• My Choice Wisconsin (Molina Healthcare) — serving southeastern Wisconsin counties

Your county ADRC can confirm whether PACE is available in your specific area and which organizations operate there. If your parent lives outside a PACE service area, Family Care or IRIS are the alternative Medicaid long-term care programs.

PACE vs. Family Care vs. IRIS

PACE is strongest for parents who need intensive medical coordination, benefit from the structure and socialization of an adult day center, and whose families want zero administrative burden. It's essentially one-stop care management.

PACE is weakest for parents who want to keep their existing doctor, live in rural Wisconsin, or whose families want control over who provides care and how the budget is spent. Those families are better served by IRIS or Family Care.

The Enrollment Process

1. Contact your county ADRC — they administer the Long-Term Care Functional Screen to determine if your parent meets nursing home level of care
2. Options counseling — the ADRC explains all three programs (PACE, Family Care, IRIS) and helps you compare
3. Financial eligibility — the regional Income Maintenance consortium verifies assets and income against Medicaid thresholds
4. Choose PACE — if eligible and in the service area, enrollment can begin immediately
5. Initial assessment — the PACE team conducts a comprehensive evaluation and develops the individualized care plan

Enrollment in PACE means your parent's Medicare coverage shifts to the PACE organization — PACE replaces Medicare Parts A, B, and D. If your parent disenrolls from PACE later, their Medicare coverage returns to standard fee-for-service.

Getting More Information

If your parent might qualify for PACE or you're weighing it against Family Care and IRIS, the Wisconsin Home Care Navigation Guide compares all three programs side by side with the specific financial thresholds, service differences, and decision criteria that matter for your family's situation.

PACE isn't right for everyone — but for the right parent, it's the most comprehensive aging-in-place program Wisconsin offers.

See more Wisconsin guides →