PACE Program Pennsylvania: 2026 Changes Residents Should Know

If you or someone you love takes prescription medications every month, the PACE program Pennsylvania offers could be one of the most valuable benefits you have never used. At Insurance Services of Zelienople, our licensed insurance agents work with this program regularly, and we talk about it often because we have seen firsthand what it means to a household budget. Right now, there is a proposed expansion moving through the Pennsylvania legislature that could open the door to thousands of Pennsylvanians who currently earn just a little too much to qualify. It is not law yet, but we have been tracking it closely, including calling the PACE program Pennsylvania directly for the latest updates. When something changes, you will hear it from us first.

Understanding the PACE Program in Pennsylvania

What Is the PACE Program?

PACE stands for Pharmaceutical Assistance Contract for the Elderly. It is a Pennsylvania state program that helps people age 65 and older pay less for their prescription drugs. The state lottery funds it, and the Department of Aging runs it. It has helped hundreds of thousands of older adults across Pennsylvania over the years.

How PACENET Works Alongside PACE

PACENET is the sister program to PACE. It covers people who earn a little more than PACE allows. PACE has no deductible and very low copays. PACENET has a small yearly deductible, but prescription costs are still much lower than paying full price. You can only be in one program at a time, and your income decides which one you qualify for.

Who Qualifies Right Now

Here are the current income limits for the PACE program Pennsylvania runs in 2026: PACE:

• Single person: $14,500 or less per year
• Married couple: $17,700 or less per year (combined)

PACENET:

• Single person: between $14,501 and $33,500 per year
• Married couple: between $17,701 and $41,500 per year (combined)

To qualify, you need to be 65 or older, have lived in Pennsylvania for at least 90 days in a row, and not be getting prescription help through Medicaid. Your eligibility is based on your income from the prior calendar year.

What Is Changing in 2026

What Is Already Law: COLA Protection

Here is the first piece of good news. Governor Shapiro signed House Bill 923 into law on November 24, 2025. It is now Act 49 of 2025. This law says that if your income goes up only because of a Social Security cost-of-living adjustment (COLA), Pennsylvania cannot use that increase to kick you out of PACE or PACENET. That protection runs through December 31, 2027. Why does this matter? Each year, Social Security gives retirees a small raise to keep up with inflation. Before this law, that small raise could push someone just over the income limit and cause them to lose their prescription coverage. That was never the intent of the program, and this law fixes it. Without this protection, about 10,039 PACENET enrollees would have lost coverage, and another 12,594 PACE enrollees would have been bumped down to PACENET, meaning higher costs. Both chambers of the Pennsylvania legislature passed this bill without a single no vote.

What Is Still Pending: The SB 731 Income Limit Expansion

This is the bill our team has been watching closely and calling about regularly. Senate Bill 731 would raise the income limits for PACENET. Here is what the proposed new limits would look like: Proposed PACENET limits under SB 731:

• Single person: up to $45,000 per year (currently $33,500)
• Married couple: up to $55,000 per year (currently $41,500)

That is a big jump. Thousands of Pennsylvanians who earn too much to qualify today could become eligible if this bill passes.

Where Does SB 731 Stand Right Now?

SB 731 passed the Pennsylvania Senate 50-0. The full House then passed it 203-0 in November 2025. However, the House made a change to the bill, so it went back to the Senate for a final vote to approve that change. As of today, that vote has not happened. The bill is not law yet. We want to be clear with you: SB 731 still needs that final Senate vote and the governor’s signature before anything changes. We do not know when that will happen. What we do know is that we are watching it, and you will hear from us the moment it moves forward.

What This Means for You

If You Are Already Enrolled

Act 49 of 2025 protects you. A Social Security COLA will not cause you to lose your PACE or PACENET coverage through the end of 2027. That said, it is still a good idea to confirm your enrollment status each year with the Pennsylvania Department of Aging, or our licensed insurance agents at Insurance Services of Zelienople can help.

If You Earn Too Much to Qualify Right Now

If SB 731 becomes law, single individuals earning up to $45,000 and married couples earning up to $55,000 may qualify for PACENET for the first time. The bill originally included a July 1, 2026, effective date for the income limit change. However, because that date has passed, implementation will depend on when the bill is signed and how the state applies the new limits. Stay in touch with our office; we’ll keep you informed of any updates as soon as they become official.

A Note on Medicare

PACE and PACENET work alongside Medicare Part D. They do not replace it. Keeping both active can lower what you pay at the pharmacy. Your pharmacist needs both your PACE or PACENET card and your Medicare information on file. One thing worth knowing: gaining PACE eligibility can sometimes create a Medicare Special Enrollment Period (SEP), which means you may be able to make changes to your Medicare plan outside of the normal enrollment window. A licensed insurance agent can explain how that applies to your situation.

Frequently Asked Questions

What is the PACE program in Pennsylvania?

PACE is a Pennsylvania state program that helps residents age 65 and older pay less for covered prescription drugs. It is funded by the Pennsylvania Lottery and free to apply for through the Department of Aging.

What are the current income limits to qualify?

For PACE, income must be $14,500 or less for a single person and $17,700 or less for a married couple. For PACENET, income can be up to $33,500 for a single person and up to $41,500 for a married couple.

What is the proposed change to PACENET income limits?

Senate Bill 731 would raise the PACENET income limit to $45,000 for a single person and $55,000 for a married couple. This change has not become law yet and still needs a final Senate vote and the governor’s signature.

Can I have PACE or PACENET and Medicare Part D at the same time?

Yes. PACE and PACENET work alongside Medicare Part D, not instead of it. Keeping both active may lower your total prescription costs.

How do I apply for PACE or PACENET?

Call the Pennsylvania Department of Aging at 1-800-225-7223, apply online through the state’s PACE portal, or reach out to a licensed insurance agent who can walk you through the process.

Closing Thoughts

There is real progress happening around the PACE program Pennsylvania residents depend on. One important protection is already in place. A significant expansion is in the pipeline. At Insurance Services of Zelienople, we stay on top of changes like these, so our clients do not have to. We follow the legislation, we call the program directly, and we reach out when something matters. Affordable prescriptions are essential, and you deserve a team that takes that seriously. Contact us today. We are here to help you understand your options and make the most of every benefit available.   RO5727071