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PACE: North Carolina's Program for Dual-Eligibles, Explained

PACE (Program of All-Inclusive Care for the Elderly) is North Carolina's Medicaid program for adults 55+ who need nursing-home-level care but want to stay in the community.

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Short answer

Program of All-Inclusive Care for the Elderly (PACE) — an NC Medicaid program (not a 1915(c) waiver) for adults 55+ needing nursing-home-level care who want to stay in the community. Accepts individuals with Medicare, Medicaid, both (dual-eligible), private pay, or 'PACE Medicaid' for those over standard NC Medicaid income limits but meeting long-term-care financial criteria.

Coverage area

As of the source page (last modified Nov 14, 2025), there are 11 PACE organizations operating in 14 locations statewide; the page does not confirm Wake/Durham/Triangle coverage in the fetched excerpt — Senior CommUnity Care of North Carolina (a PACE provider) is based in Durham/Triangle area per third-party listings, but confirm current service area directly via NC Medicaid's PACE contact list before publishing specific site claims.

No program status change or transition noted on the NC Medicaid PACE page as of the research date (Aug 2026).

Source: NC Medicaid PACE program

Questions families ask

What are the income and asset limits for nursing home Medicaid in North Carolina in 2026?

For 2026, North Carolina's aged/blind/disabled Medicaid resource limit is $2,000 for an individual and $3,000 for a couple. The nursing facility Medicaid income cap is generally derived as 300% of the SSI federal benefit rate, and nursing facility residents must apply nearly all monthly income toward their cost of care, retaining only a $70/month personal needs allowance.

What is the NC Medicaid Estate Recovery Program and will it take my parent's house after they pass away?

North Carolina's Medicaid Estate Recovery Program (MERP) allows the state to seek reimbursement from a deceased Medicaid recipient's probate estate for nursing facility, home- and community-based waiver, and related hospital/prescription costs paid on their behalf, generally for recipients who were 55 or older when they received those services. Recovery only begins after death, is generally deferred while a surviving spouse is alive, and includes protections for a minor or disabled child and for cases of undue hardship.

Do assisted living costs vary between different parts of the Triangle, like Cary versus more rural Harnett County?

Almost certainly yes in practice, but there is no published metro-specific cost breakdown to confirm exact differences -- CareScout's Cost of Care Survey reports only a single North Carolina statewide median ($6,496/month for assisted living in 2025), not figures broken out by city or county. Wake County communities in higher-cost areas like Cary or North Raleigh may charge more than communities in more rural counties such as Harnett or Franklin, but families need to request direct quotes to compare.

What does long-term care insurance typically cover, and should I buy it now to help pay for future care in Raleigh?

Long-term care insurance is a private insurance product that can help pay for services like assisted living, nursing home care, memory care, and in-home care once a policyholder meets the policy's benefit trigger (typically needing help with a set number of activities of daily living or having cognitive impairment). Whether to buy a policy is a personal financial decision that depends on health, age, and budget, and should be made with a licensed insurance agent or financial advisor -- this is general information, not personalized financial advice.

If my family can't afford private-pay assisted living in Wake County, what are our realistic options?

Options generally include North Carolina's State/County Special Assistance program (a state/county cash supplement for low-income adult care home residents, paired with automatic Medicaid eligibility), CAP/DA Medicaid waiver services if the person can remain safely at home, and eventually nursing facility Medicaid if a nursing-facility level of care is needed and financial limits are met. VA Aid & Attendance can also help qualifying wartime veterans and surviving spouses. Contact the Wake County Department of Human Services or an elder law attorney to determine which programs apply.

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