Social Security counts as income for PACE, and it affects both whether you can join and how much you pay

Yes, Social Security income counts toward your total income when PACE (Programs of All-Inclusive Care for the Elderly) determines whether you meet their financial limits. PACE programs use income to decide if you are may be able to access and, if you are, what you will pay each month for services. The amount of Social Security you receive is added to any other income you have — pensions, earnings, rental income, or support from family — to reach your total household income.

PACE is a Medicare and Medicaid program that serves people age 55 and older who need nursing home-level care but want to stay at home. Because PACE is a public program, it has income limits that vary by state and by the specific PACE organization running the program in your area. If your Social Security plus other income exceeds that limit, you will not be able to join. If you are already enrolled and your income changes, you may need to report it.

Key Takeaways

  • PACE programs add your Social Security to all other income sources to determine if you meet the financial limit for your state and organization.
  • Income limits for PACE vary by state and by individual PACE organization, so you must check with the specific program serving your area.
  • If you are already enrolled in PACE and your Social Security amount changes, report it to your PACE organization because it may affect your monthly cost.
  • PACE counts gross Social Security income before taxes, not the amount you receive after Medicare premiums are deducted.
  • Some PACE programs may count only the income of the person joining, while others count household income; ask your local PACE organization which rule they use.

How PACE calculates your income

PACE programs count gross Social Security income — the full amount before Medicare Part B and Part D premiums are taken out. If you receive $1,800 per month in Social Security but pay $175 for Medicare Part B, PACE counts the full $1,800, not $1,625. This is the standard way federal programs measure income.

Your PACE organization will ask you to provide proof of your Social Security income, usually a recent Social Security statement or a letter from the Social Security Administration showing your monthly benefit amount. You will also report any other income: a pension, part-time work, interest from savings, rental income, or money from a spouse or adult child living in your home. The total of all these sources is what PACE uses to check against the income limit.

If you are married and only one spouse is joining PACE, some PACE organizations count only that person's income, while others count the household income of both spouses. This rule differs by program and by state, so you must ask your local PACE organization which approach they use before you assume you meet the limit.

Income limits vary by location

PACE does not have a single national income limit. Instead, each state sets limits, and sometimes individual PACE organizations within a state set their own limits as long as they do not exceed the state maximum. In some states, the limit is around 200% to 300% of the federal poverty level, but this varies significantly. A few states have higher limits; others are lower.

To find out the income limit for the PACE program you are interested in, contact that specific organization directly. You can search for PACE programs in your state through the National PACE Association website or by calling your local Area Agency on Aging. When you call, ask for the current income limit and whether they count individual or household income. Do not assume a limit based on another state or another PACE program — each one sets its own rules within state guidelines.

What happens if your income changes after you join

If you are already enrolled in PACE and your Social Security amount increases — for example, because you reach a new age milestone or because of a cost-of-living adjustment — you should report this change to your PACE organization. PACE programs are required to review your income periodically, usually once a year, but you do not have to wait for that review if your situation changes.

An increase in Social Security income may raise the monthly cost you pay to PACE, because some PACE programs charge a sliding scale based on income. It will not cause you to lose coverage unless your new income exceeds the program's limit by a large margin, but you could be asked to pay more. Conversely, if your Social Security decreases, your PACE cost may decrease as well.

Report income changes by contacting your PACE organization's enrollment or billing department. They will tell you what documents they need and when the change takes effect in your billing.

Other income sources that count alongside Social Security

PACE counts Social Security together with any other income you receive. This includes a pension from a former employer, ongoing earnings from part-time work, interest or dividends from savings or investments, rental income from property you own, and regular financial support from family members. If you receive Supplemental Security Income (SSI) in addition to Social Security, both amounts count.

Some types of income do not count. For example, Supplemental Nutrition information Program (SNAP) benefits, housing information, and certain one-time payments usually do not count as income for PACE purposes. However, the rules can differ slightly by state, so ask your PACE organization which sources they count and which they do not.

If you are unsure whether a particular income source counts, bring documentation of it when you contact PACE. It is better to report something you are uncertain about than to leave it out and have PACE discover it later during a review.

How to prepare your income information for PACE

Before you contact a PACE organization, gather documents showing all your income. For Social Security, you will need a recent statement from your Social Security account (available at ssa.gov) or a letter from the Social Security Administration. For a pension, bring the most recent statement or letter from your pension administrator. For earnings, bring recent pay stubs. For interest or rental income, bring bank statements or tax documents.

Write down the monthly amount for each source. Add them together to get your total monthly income. Then contact your local PACE organization and ask them for their current income limit. This will tell you when ready whether you are likely to meet their requirement. If you are close to the limit, ask whether they count individual or household income, because that can make a difference.

Keep copies of all income documents in one folder. You will need to provide them again during PACE's annual review, and having them organized will make the process faster.

Frequently Asked Questions

Does PACE count the money my child gives me each month?

Yes, regular financial support from a family member counts as income for PACE. If your adult child gives you $500 every month, PACE counts that $500 as part of your total income. One-time gifts do not count, but ongoing support does. Tell your PACE organization about it and bring documentation, such as bank deposits or a written statement from your child.

If I have a spouse, does PACE count their Social Security even if only I am joining?

It depends on the PACE organization. Some count only your income; others count your household income, which includes your spouse's Social Security and other income. This rule varies by program and state. Ask your local PACE organization which method they use before you assume you meet the limit. If they count household income and your combined income is too high, your spouse's income may prevent you from joining.

What if my Social Security is about to increase because I am turning 70?

Report the expected increase to your PACE organization before it happens, if you can. Bring documentation showing the new amount, such as a letter from Social Security. PACE will update your income record and adjust your monthly cost if needed. Do not wait until after the increase takes effect; reporting it in advance prevents billing confusion.

Can I hide income to meet the PACE limit?

No. PACE programs verify income through Social Security records, tax returns, and bank statements. If you do not report income and PACE discovers it during a review, you could be disenrolled from the program and asked to repay costs. It is always better to report what you have and let PACE tell you whether you meet the limit.

Does PACE count my spouse's pension if we are both enrolled?

If both you and your spouse are enrolled in the same PACE program, each of you is evaluated separately for income purposes. Your spouse's pension counts toward their income limit, and your Social Security counts toward yours. If you are in different PACE programs, ask each organization how they handle married couples, because the rule may differ.