The Program of All-Inclusive Care for the Elderly (PACE) is an important option for older adults who need a high level of care but wish to remain living safely at home rather than in a nursing facility. PACE brings together medical care, long-term services, and social supports under one coordinated program.
While PACE continues to be a valuable resource, MassHealth has announced several upcoming changes that may affect eligibility and planning for individuals and married couples considering PACE now or in the future.
PACE Is Expanding to New Areas
PACE services have recently expanded into additional parts of Southeastern Massachusetts, including Plymouth and portions of Barnstable County. This expansion means that more families—particularly on the South Shore and Cape Cod—may now have access to PACE services where they previously did not.
New Rules for Married Applicants Starting January 15
As of January 15, new rules apply to new PACE applications submitted to MassHealth.
Under these changes,when one spouse applies for PACE, the assets of both spouses may be considered when determining eligibility. In the past, PACE did not always count a non-applicant spouse’s assets in this way.
It is important to note that:
- These rules apply only to new PACE applications submitted after January 15.
- Individuals who are already enrolled in PACE will not be subject to these new spousal asset rules during routine eligibility reviews.
- Even if coverage is temporarily interrupted during a review, MassHealth has indicated there will generally be a 90-day window to resolve the issue without immediately applying the new spousal asset limits.
Possible Changes to Transfer Rules
Currently, MassHealth does not impose penalties for certain asset transfers when someone applies for PACE. However, MassHealth has indicated that it expects to begin implementing transfer penalty rules for PACE in the near future.
If implemented, these rules could affect individuals who transferred assets to someone other than a spouse within a certain period of time before applying. Additional guidance from MassHealth is expected, and we will continue monitoring these developments closely.
Questions Still Being Worked Out
One area that has not yet been fully clarified involves individuals who are enrolled in PACE and later require admission to a skilled nursing facility. It remains unclear how the new spousal asset rules may apply in those situations, and further guidance is anticipated.
What This Means for You
PACE remains a strong and comprehensive care option for many older adults. However, these changes highlight the importance of planning ahead, especially for married couples or families who may need long-term care in the future.
Rules that once allowed more flexibility may no longer apply in the same way, and timing is becoming increasingly important. Understanding your options early can help avoid surprises and preserve choices down the road.
If you have questions about how these changes may affect you or a loved one, we encourage you to reach out below to discuss your individual situation.
