Medicare beneficiaries enrolled in the Program of All-Inclusive Care for the Elderly (PACE) who are not eligible for Medicaid face Part D premium costs that are unaffordable for many who would best be served by the model of care. The PACE Part D prescription plan premium cost for these Medicare-only beneficiaries is substantially higher. In 2024, the annual cost of prescription drug coverage for a Medicare beneficiary in PACE is over $13,000 – 22 times higher than the approximately $575 average annual premium for stand-alone Part D plans. The monthly premium for a PACE Part D plan averages $1,135.09 per month, beyond the means of many Medicare beneficiaries. 

Consequently, the lack of affordable Part D plan options for Medicare-only PACE participants limits their access to the PACE program, which would, in many cases, improve their quality of care and quality of life as they seek a community-based alternative to a nursing home. More information is available in the NPA Issue Brief on this bill.

Congress has the power to improve this situation and lower the out of pocket costs for Medicare-only PACE participants by passing the PACE Part D Choice Act (S. 1703/H.R. 3549). The bill would provide Medicare-only beneficiaries enrolled in PACE the choice to obtain affordable prescription drug coverage from either the PACE organization or from a marketplace Part D plan, whichever is more affordable. 

Raise your voice for PACE and urge your Members of Congress to support this critically important bill today!