PACE vs Medicare Advantage vs Medi-Medi Plans: How They Compare

The Program of All-Inclusive Care for the Elderly (PACE) is one choice when care needs grow. Families often weigh PACE vs Medicare Advantage, and in California a third choice: a Medi-Medi Plan. All three can cover your Medicare care, but they work in very different ways.

PACE is a care program with its own center and team. Medicare Advantage is a health plan from a private company that contracts with Medicare. A Medi-Medi Plan is a kind of Medicare Advantage plan for people who also have Medi-Cal. For PACE in depth, see our PACE in California guide.

PACE vs Medicare Advantage vs Medi-Medi Plans at a glance

The biggest difference is who each option is for. PACE is for people who already need a lot of care. Medicare Advantage is open to most people with Part A and Part B. Medi-Medi Plans are for people with both Medicare and Medi-Cal. This table sums up the rules for 2026 and 2027.

	PACE	Medicare Advantage	Medi-Medi Plan
Who it is for	Age 55 or older, nursing home level of care, able to live safely at home with help, in a PACE area	People with Part A and Part B who live in the plan's service area	People with Part A, Part B and Medi-Cal, age 21 or older, in a county with a plan
Who runs it	A local PACE organization	A private company that contracts with Medicare	A private company that contracts with Medicare; the plan also covers your Medi-Cal benefits
Doctors	Your PACE team and its network	Often the plan's network; some plans cover out-of-network care for more	Generally the plan's network
Drugs	Part D and other drugs you need, from PACE	Most plans include Part D	Part D is included
Help at home and rides	Included when your team decides you need them	Some plans add extras; they vary	The plan coordinates transportation and long-term services
What you pay	With Medi-Cal, you won't pay a monthly premium for PACE; no copays for approved care	Part B premium, maybe a plan premium, and copays up to a yearly limit	With Medi-Cal, most costs are covered
When you can join	Any month, once you meet the requirements, including the state's level-of-care decision	Set enrollment periods	Once a month with full Medi-Cal
When you can leave	Any time	Only at certain times	Once a month

What is PACE, and who is it for?

PACE is for people who need a nursing home level of care but want to stay at home. Medicare.gov lists four conditions: you are 55 or older, live in the service area of a PACE organization, are certified by your state as needing a nursing home level of care, and can live safely in the community with PACE's help.

You don't need Medicare or Medi-Cal to join, but the Centers for Medicare & Medicaid Services (CMS) says most people in PACE have both. A team of doctors, nurses, therapists and drivers plans all your care, often at a PACE center. Our post on PACE covered services lists what the program includes, and PACE eligibility requirements explains who may join.

What is Medicare Advantage, and who can join?

Medicare Advantage is another way to get your Part A and Part B coverage, through a private company that contracts with Medicare. To join, you need Part A and Part B and must live in the plan's service area. You must also meet the citizenship or lawful presence rules listed in Medicare & You 2027.

Plans cover the medically necessary services Original Medicare covers, except hospice and a few others. Most include drug coverage. Plans set their own copays, networks and prior approval rules, and those can change each year. HMOs and PPOs work differently; see Medicare Advantage HMO vs PPO.

What is a Medi-Medi Plan?

A Medi-Medi Plan is California's name for an integrated Dual Eligible Special Needs Plan (D-SNP). The California Department of Health Care Services (DHCS) says it "combines Medicare and Medi-Cal benefits into one plan," with one care team and one network. To join, you need Part A, Part B and Medi-Cal, and you must be 21 or older.

In 2026, DHCS says people with both programs can choose a Medi-Medi Plan in 41 counties. Joining is generally your choice (DHCS runs a default enrollment pilot for some plans in San Diego and San Mateo counties). Our post What is a Medi-Medi Plan? explains how it works with your Medi-Cal.

PACE vs D-SNP: the key difference

Both PACE and a D-SNP coordinate Medicare and Medi-Cal. The difference is how care is delivered. A D-SNP is a health plan with a network you choose from. In PACE, one team plans, approves and coordinates all of your care, at its center, at home and through its network. PACE is also only for people who need a nursing home level of care.

How do doctors and networks compare?

Your doctors are often what decides it. Each option has its own rules for which providers you can see.

• PACE: you get your Medicare and Medi-Cal care only through the PACE organization. Your team arranges specialists and hospitals. Emergency care is covered in or out of the PACE service area, without approval first.
• Medicare Advantage HMO: you generally use the plan's network, except for emergencies, and for urgent care and dialysis outside the plan's service area.
• Medicare Advantage PPO: you can generally see providers outside the network if they agree to treat you, usually at a higher cost.
• Medi-Medi Plan: you generally use the plan's network for both Medicare and Medi-Cal services. Ask about each doctor by name.

How does drug coverage compare?

All three can cover your prescriptions, but in different ways. Medicare.gov says PACE gives you "your Part-D covered drugs and all other necessary medication." If you join a separate Medicare drug plan while in PACE, you will be disenrolled from PACE.

Most Medicare Advantage plans include Part D, and every Special Needs Plan must. If you have full Medi-Cal, a Medicare Savings Program or SSI, you get Extra Help with drug costs automatically. See Extra Help and Medicare Savings Programs.

What does each option cost?

When you compare PACE vs Medicare Advantage, what you pay depends on your coverage as much as on the option. Here is what official sources say for 2026 and 2027.

• PACE: Medicare.gov says that if you have Medicaid (Medi-Cal in California), you won't pay a monthly premium for the PACE benefit. With Medicare only, you pay a monthly premium for the long-term care part and a premium for Part D drugs. There is no deductible or copayment for care your team approves.
• Medicare Advantage: you keep paying the Part B premium ($202.90 a month for most people in 2026, per CMS) unless Medi-Cal or a Medicare Savings Program pays it. You may also pay a plan premium and copays. Each plan has a yearly out-of-pocket limit. The highest in-network limit CMS allows is $9,250 for 2026 and $9,850 for 2027.
• Medi-Medi Plan: Medicare.gov says that if you have Medicare and Medicaid, "most of the costs will be covered for you."

For PACE costs in detail, see what PACE costs in California.

How do you join or leave each one?

Each option has different timing. Changes in all three generally start on the first day of a month.

1. PACE: you can join in any month once the state finds you need a nursing home level of care and you meet the other requirements. Coverage starts the first day of the month after the PACE organization gets your signed agreement. You can leave at any time.
2. Medicare Advantage: you join or switch in your Initial Enrollment Period, during Open Enrollment (October 15 – December 7), in the Medicare Advantage Open Enrollment Period (January 1 – March 31, for people already in a plan), or with a Special Enrollment Period (SEP).
3. Medi-Medi Plan: with full Medi-Cal you can join an integrated plan once a month. DHCS lists three ways: if you're already in a Medi-Cal plan, call that plan; call 1-800-MEDICARE, or call Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077).

Can you have PACE and Medicare Advantage at the same time?

No. In PACE, you get your Medicare benefits only through the PACE organization. When you join PACE, Medicare.gov lets you drop a Medicare Advantage plan or drug plan at any time. If you leave PACE, you get 2 full months after the month you leave to join a Medicare Advantage plan or a drug plan.

Medicare Advantage vs Medi-Medi plan: which questions help you compare?

When you weigh PACE vs Medicare Advantage or a Medi-Medi Plan, there is no single right choice. It depends on your health, your doctors and your coverage. These questions can help you and your family compare:

• Does someone need help every day, such as with bathing, meals or getting around?
• Do you have Medi-Cal as well as Medicare?
• Which doctors and specialists matter most, and are they in each network?
• Does a PACE organization or a Medi-Medi Plan serve your ZIP code?
• Would you rather choose from a plan's network or have one team manage all care?

If you leave Medicare Advantage or PACE for Original Medicare, your right to buy a Medigap policy depends on timing; see Medicare Advantage vs Medigap.

Next steps

You don't have to decide alone. Gather a few facts first, then compare the options with someone who knows the local choices.

• List your doctors, prescriptions and the help needed at home.
• Check your Medi-Cal status with your county office.
• See whether PACE serves your area in our PACE in California guide.
• For counseling at no cost to you, call HICAP (California's Health Insurance Counseling & Advocacy Program) at 1-800-434-0222.

Talk with a licensed Boomers agent

A licensed Boomers agent can go over the Medicare plans we represent in your area and check them against your doctors and prescriptions.

Find a licensed agent near you · See upcoming Medicare events

Or call 1-800-815-1943 (TTY 711), Monday – Friday, 9 AM – 5 PM Pacific.

Frequently asked questions

Is PACE a Medicare Advantage plan?

No. PACE is a separate Medicare and Medicaid program run by local PACE organizations. Medicare & You 2027 groups PACE with other Medicare health plans, but it is not a Medicare Advantage plan.

Is PACE better than a Medi-Medi plan?

Neither is right for everyone. PACE is only for people 55 or older who need a nursing home level of care, and one team manages all care. A Medi-Medi Plan is a health plan for people with Medicare and Medi-Cal, with a network you choose from.

Do I need Medi-Cal for PACE or a Medi-Medi Plan?

A Medi-Medi Plan requires Medi-Cal. PACE does not, but without Medi-Cal you pay a monthly premium for PACE. Medicare Advantage doesn't require Medi-Cal either.

Can I switch from Medicare Advantage to PACE?

Yes, if you meet PACE's rules and a PACE organization serves your area. Medicare.gov lets you drop your Medicare Advantage plan at any time when you join PACE.

Sources

• PACE (Medicare.gov)
• Compare Original Medicare and Medicare Advantage (Medicare.gov)
• Special Needs Plans (Medicare.gov)
• Special Enrollment Periods (Medicare.gov)
• Medicare & You 2027 (Medicare.gov)
• Program of All-Inclusive Care for the Elderly (CMS.gov)
• Medi-Medi Plans (California DHCS)
• Medicare Advantage Rates & Statistics: MOOP limits (CMS.gov)
• 2026 Medicare Parts A & B premiums and deductibles (CMS.gov)