PACE vs PACENET in Pennsylvania — Income Limits, Copays, and the Act 49 COLA Moratorium
Two Programs, One Goal: Affordable Prescriptions for Pennsylvania Seniors
PACE and PACENET are both run by the Pennsylvania Department of Aging, funded by the state lottery, and available to Pennsylvania residents 65 and older. The difference is income: PACE serves lower-income seniors, and PACENET serves those with moderately higher incomes. Neither has an asset test — asset balances are not counted, but income such as capital gains is part of the prior-year income calculation.
This matters because it separates them from the Medicare Savings Programs, which do test resources. A senior with $15,000 in countable savings is above the MSP resource limit, but savings alone do not bar them from PACE or PACENET; age, residency, and income limits still apply.
2026 Income Limits and Copays
| Program | Single Annual Income | Couple Annual Income | Copay: Generic | Copay: Brand |
|---|---|---|---|---|
| PACE | Up to $14,500 | Up to $17,700 | $6 | $9 |
| PACENET | $14,501–$33,500 | $17,701–$41,500 | $8 | $15 |
Both programs use prior-year gross income for eligibility. A change in current-year earnings does not replace the prior-calendar-year income test.
How PACE and PACENET Work with Part D and Extra Help
This is where families get confused. PACE and PACENET are prescription drug programs. Medicare Part D is also a prescription drug program. How do they fit together?
PACE Plus Medicare is the coordination layer. When a PACE or PACENET cardholder also has a Part D plan and Extra Help (Low-Income Subsidy), the programs stack:
- Part D acts as the primary payer; Extra Help reduces eligible premiums, deductibles, and copayments
- PACE or PACENET provides secondary coverage, including wraparound for covered prescriptions
The result at the pharmacy counter: the senior pays the lower PACE/PACENET copay ($6–$15) instead of the Part D cost-sharing amount.
If a PACE cardholder also qualifies for a Medicare Savings Program (QMB, SLMB, or QI), they're automatically deemed eligible for Extra Help — so all three layers stack without separate applications.
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The Act 49 COLA Moratorium — Protection Through December 2027
Governor Shapiro signed Act 49 of 2025 (House Bill 923) on December 4, 2025. The law extends the Social Security COLA moratorium for PACE and PACENET: if you are an existing enrollee and a Social Security cost-of-living increase would push you over the income limit, that COLA increase is excluded through December 31, 2027.
Over 22,000 Pennsylvania seniors are protected by this moratorium. Without it, a $75 monthly COLA increase adds $900 per year; a senior with $33,400 in annual income would exceed PACENET's $33,500 ceiling after the increase.
The moratorium applies only to existing enrollees whose eligibility would otherwise be affected by a COLA. New applicants are evaluated against the current income limits without the COLA buffer.
PACE Is NOT the Federal PACE Program
An important distinction: Pennsylvania's PACE/PACENET (Pharmaceutical Assistance Contract for the Elderly) covers only prescription drugs. The federal PACE (Program of All-Inclusive Care for the Elderly) is a comprehensive managed care model — in Pennsylvania it operates under the name LIFE (Living Independence for the Elderly), covering full medical care, adult day services, and home care for nursing-home-eligible individuals 55+.
If a family member or social worker suggests "PACE," clarify which program they mean. LIFE serves nursing-home-eligible individuals aged 55+ and is separate from prescription drug assistance. Long-term-care Medical Assistance has separate 2026 financial rules: a $2,982 monthly special income limit, with an $8,000 resource limit at or below it and a $2,400 limit above it. State PACE/PACENET has no asset test and uses the income limits shown above.
How to Apply
Apply through Pennsylvania's PACE program at the Department of Aging:
- Phone: Call the Department of Aging at 1-800-225-7223
- Online: pacecares.primetherapeutics.com
You'll need proof of age, Pennsylvania residence, and prior-year income. PACE/PACENET uses a separate application process from the MSP/CAO process, and there is no asset test.
The Pennsylvania Medicare Savings Programs, Extra Help & PACE/PACENET Guide maps out how PACE, PACENET, Extra Help, and the Medicare Savings Programs work together, including a PACE income calculator and the exact billing sequence at the pharmacy counter.
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Download the Pennsylvania — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.