Pennsylvania – PACE Application Worksheet

Article: 50446

Overview 

If you are a Pennsylvania taxpayer who is eligible for pharmaceutical benefits under Medicaid, you must disclose this status when completing the PACE Application Worksheet. This helps determine your eligibility for PACE or PACENET, Pennsylvania’s prescription assistance programs for older residents. 

What is PACE? 

PACE (Pharmaceutical Assistance Contract for the Elderly) and PACENET are Pennsylvania programs that provide low-cost prescription medications to qualified older residents. 

These programs are income-based, and eligibility may be impacted if you are already covered under another pharmaceutical benefit such as Medicaid. 

What is PACE? 

Use this worksheet if: 

  • You are completing Schedule SP (Special Tax Forgiveness) or 
  • You are applying for PACE/PACENET via the income process. 
  • You want to opt in or disclose coverage from other programs (like Medicaid). 

How to Report 

  1. Navigate to the State Taxes section on the left-hand side of the screen. 
  1. Click the link: “I’d like to see the forms I’ve filled out or search for a form.” 
  1. In the dropdown menu, select Pennsylvania
  1. Click on the Other tab. 
  1. Click on “PACE Application Worksheet” to open the form. 
  1. Enter all applicable information.  
  1. Click ‘Save‘ once complete. 

Additional Resources 

For full details, refer to the official Pennsylvania Personal Income Tax Return Instructions: 

https://www.revenue.pa.gov/FormsandPublications/FormsforIndividuals/PIT/Documents/2024/2024_pa-40_instr.pdf