Long-Term Care & PACE
Medicare generally does not pay for long-term custodial care. Learn what may help — Medicaid or long-term care insurance — and how PACE can help some people get care at home instead of a nursing home.
Long-term care means help with everyday activities — such as bathing, dressing, eating, or using the bathroom — when a person needs that help over a long period.
What Medicare generally does NOT cover:
- Medicare usually does not pay for long-term custodial care when that is the only care a person needs.
- It does not pay for an indefinite nursing-home stay that is only for personal or custodial help.
What may help with long-term care:
- Medicaid: may help pay for long-term care for people who meet income, resource, and level-of-care rules. Rules vary by state.
- Long-term care insurance: a separate private policy that some people buy before they need care.
- Family support and community programs.
PACE — Programs of All-Inclusive Care for the Elderly:
- PACE combines medical and long-term-care services to help certain people get care in their home and community instead of a nursing home.
- It is generally for people who are 55 or older, need a nursing-home level of care, can live safely in the community with help, and live in a PACE service area.
- Availability depends on the state and the service area.
Note: This is general educational information. Eligibility and benefits for Medicaid, long-term care insurance, and PACE depend on individual circumstances and state rules. Verify with Medicare, Medicaid, your state agency, or a licensed advisor before making decisions.
This guide is for general education only. Plan availability, benefits, costs, networks, medications, and eligibility may vary by county, plan, and individual situation. For a specific review, a licensed advisor must verify your information.