Program for the All-Inclusive Care for the Elderly (PACE)

Eligibility for Enrollment into a Program of All-Inclusive Care for the Elderly plan

The PACE program is for people 55 years of age or older who have Medicare and Medicaid or Medicaid only. With a PACE plan, health care and long term care services are provided by a PACE team of doctors, nurses, social workers, and other professionals who help coordinate all of the member’s Medicare, Medicaid, long term care, and drug benefits under one plan.

You are eligible to join the PACE Program, if you meet all of the following requirements:

1. Are age 55 years or older,
2. Reside in the Plan's service area,
3. Have Medicaid,
4. If Medicare eligible, you have evidence of Medicare Part A & B coverage and enroll in the PACE plan’s aligned Medicare Health Plan
5. Are capable at the time of enrollment of returning to or remaining in your home and community without jeopardy to your health and safety,
6. Need nursing home level of care, and
7. Need at least one CBLTSS for more than 120 days.

Service Authorization, Appeals, and Notices

• Partial, MAP, and PACE

PACE Model Contract

• Programs for All-inclusive Care for the Elderly (PACE) (PDF)

NYS Contracted Health Plan Ownership and Control Interest Information

• Partial, MAP, and PACE (XLSX)

NYS Contracted Health Plan Network Adequacy Standards

• Network Adequacy Standards
• To see if a specific provider participates with a specific managed care organization, please visit here.