Medicare Cost Plans and PACE: two lesser-known options

Besides Original Medicare and Medicare Advantage, two other kinds of Medicare coverage are available in some areas.

Medicare Cost Plans

Cost Plans are Medicare health plans offered only in certain, limited areas of the country.

• In general, you can join even if you have only Part B.
• If you have Part A and Part B and see a provider outside the plan's network, Original Medicare covers it, and you pay Original Medicare's deductibles and coinsurance.
• You can join any time the plan is taking new members, and leave any time to go back to Original Medicare.
• You can get drug coverage from the Cost Plan, if it offers it, or join a separate Medicare drug plan. You can only add or drop drug coverage at certain times.

Use Medicare.gov's Plan Finder to see whether any Cost Plans serve your area.

PACE (Program of All-inclusive Care for the Elderly)

PACE is a Medicare and Medicaid program, offered in many states, that helps people who would otherwise need nursing home care stay in their home or community as long as possible. You can join if:

• You're 55 or older,
• You live in a PACE organization's service area,
• Your state certifies that you need nursing-home-level care, and
• When you join, you can live safely in the community with PACE's help.

PACE covers all Medicare- and Medicaid-covered care, plus anything else its care team decides you need: drugs, doctor visits, transportation, home care, hospital visits and nursing home stays the team approves.

• With Medicaid: no monthly premium for PACE.
• Without Medicaid: a monthly premium that includes your drug coverage; the amount depends on whether you have Part A, Part B or both.
• Either way, there are no deductibles or copays for any drug, service or care the PACE team approves.

Find out whether PACE serves your community at Medicare.gov/pace. For long-term care more broadly, see paying for long-term care.