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Life plan communities: What they offer and how they work
Feb 21, 2025 5:05 AM

  

Life plan communities: What they offer and how they work1

  Housing, healthcare, and community—all in one place.© belahoche/stock.adobe.comRetirement can bring the freedom to travel, garden, cook, and enjoy life at your own pace. But if maintaining a home, preparing every meal, and handling household chores no longer appeal to you, a continuing care retirement community (CCRC) might be worth considering. A CCRC, also known as a life plan community, offers a built-in social environment and lifelong health care at a fixed rate, providing stability as you age.

  A life plan community typically offers apartments or other types of rental units along with on-site facilities for higher levels of care as needed. Many also feature amenities such as fitness centers, educational classes, social activities, and events. Depending on the type of contract, a CCRC may cover all of your medical care and daily assistance. Still, moving into a CCRC involves costs, and they can be significant. A bit of research and number crunching can help you decide whether a CCRC is the right fit.

  Levels of care in a continuing care retirement communityHousehold chores, home maintenance, cooking all your meals, and managing repairs can become tiring and more challenging as you age. Independent living at a CCRC won’t free you from every daily task, but it does provide access to higher levels of care when needed, such as help with bathing, dressing, and medication management. CCRCs offer different levels of care to meet your needs should they change with age.

  Independent living is designed for seniors who are healthy and relatively active. Residents can manage daily activities on their own with little or no assistance.Assisted living provides help with activities of daily living such as eating, bathing, dressing, taking medication, grooming, using the toilet, managing money, and doing laundry. Some assisted living facilities provide supervision and protection as needed for memory or dementia care.Skilled care provides short-term professional medical help while recovering from an illness, injury, or surgery, and doesn’t include help with daily activities. When more ongoing help is needed, many CCRCs offer long-term custodial care (nonmedical assistance) for tasks like bathing, dressing, and mobility.When spouses require different levels of careEven if you and your spouse are close in age, the way you age may differ significantly. One or both might develop dementia or face physical challenges at different times, or one of you might experience health issues the other doesn’t.

  If you live in your own home and one spouse cares for the other, the responsibility can be emotionally and physically taxing—especially for an older adult with no caregiving training.

  In a CCRC, you each receive the care you need. For example, if you are healthy but your spouse needs dementia care, they can move into the memory care assisted living section while you remain in independent living. If you need help with dressing or using the bathroom, you can move into assisted living rather than relying solely on your spouse. You and your spouse can still visit easily and spend time together, but neither is solely responsible for the other’s care.

  CCRC contract types and costsTypically, a life plan community requires an entrance fee—a one-time, up-front payment—along with ongoing monthly fees. Each contract offers different pricing structures and financial guarantees. Some contracts include a return option, which refunds a portion—or all—of the entrance fee to your beneficiary when you die or leave the community. The refund amount and conditions vary.

  Up-front costs depend on the location, floor plan, size of accommodations, and return option percentage. If a spouse or partner will be living with you, expect to pay an additional entrance fee, typically about 10% of the basic up-front cost. 

  Monthly fees typically cover residential services, meals, amenities, and some general health care such as checkups and vaccines. In the first quarter of 2023, the average monthly fee for independent living in a CCRC with entrance fees was $3,907, while rental CCRCs averaged $3,450, according to the National Investment Center for Seniors Housing & Care (NIC). Average fees can vary widely based on location, the amenities offered, and the type of contract you select.

  Extensive or all-inclusive contracts (type A) ask for an up-front entrance fee that gives unlimited access to any type of care needed during a resident’s lifetime. If you purchase a type A contract, you can often use a portion of the up-front fee as a one-time medical tax deduction in the year it was paid. Entrance fees can range from $100,000 to more than $1 million.Modified fee-for-service contracts (type B) also require an entrance fee, although it’s typically lower than a type A contract. Only a specified number of health-related services are included in the contract. Additional health-related services may be available at subsidized rates for a set period; if more care is needed, it is purchased at market rates, which you can expect to increase over time. Many CCRCs don’t offer type B contracts. Entrance fees typically range from $80,000 to over $750,000. Fee-for-service contracts (type C) have lower up-front enrollment fees, but health care isn’t included. If you need to see a doctor or have a test, you typically receive priority access, but these are paid out of pocket at the standard daily rate. Entrance fees often range from $100,000 to $500,000. Rental contracts cover only housing and residential services month to month. All health care is paid out of pocket at market rates. Some may include dining, while others may not. Availability varies; not all CCRCs offer rental contracts. Equity or co-op contracts allow the purchase, rather than the rental, of a home within the CCRC. Monthly fees cover only amenities and maintenance, while health care costs are paid out of pocket. Your heirs receive ownership of your property upon your death.Questions to ask before signing a CCRC contractThe optimal time to consider a CCRC is while you are still healthy enough to enjoy independent living. Moving also involves downsizing, which takes planning. Because some CCRCs have waiting lists, starting the process a year or two in advance can be helpful.

  Visiting several CCRCs can help you compare options, and some communities allow day visits or even overnight stays. Researching each facility’s policies and practices can give you a clearer picture of what to expect.

  Monthly and up-front costs. Contracts vary by type, cost, and coverage, and some fees may increase with time. It’s also important to understand what happens if you decide to leave or after you die.

  Daily life. Find out what type of amenities and activities are available. Learn about dining options and housekeeping, as well as any costs involved. Parking for vehicles, storage for belongings, and rules about pets may also differ, making these important factors to review.

  Financial statement. One of the biggest risks in a CCRC investment is the community’s long-term viability. Ask to see the results of its most recent audit, which may be posted on the CCRC’s website. Pay particular attention to recent income and expenses, the amount of cash on hand and in reserve, and the occupancy rate.

  Credit rating and debt outlook. If a CCRC issues bonds (i.e., borrows money) as part of its financial structure, one or more of the top ratings agencies may be tracking it. For example, Fitch Ratings reviews and issues periodic reports and credit ratings on 389 communities as of early 2025. Bond ratings run from AAA (strong financials) to D (default imminent). Any community with a rating below investment grade (lower than BBB-) may be vulnerable to a cash shortage that could hinder its ability to meet its financial commitments.

  Legally required disclosures filed with the state’s insurance regulator. Look at any construction projects that are ongoing as well as unit turnover. Find out the occupancy rate and the age of the buildings and amenities. A low occupancy rate may be a red flag.

  Check state health department or licensing agency websites for inspection reports, or ask the facility directly if it makes them available.Ask the community about security measures and how emergencies are handled.Inquire about staff longevity and turnover rates, as frequent changes could indicate deeper issues. Check online for third-party reviews, such as those posted on Google or Caring.com, or talk to current residents to get a sense of community satisfaction. The bottom lineEven if you’re in excellent health, housekeeping can become difficult as you age. And if your health declines or mobility becomes an issue, staying at home can be even more challenging. Aging at home means paying for medical care, home health aides, or assisted living services as needed—without the financial protections or price guarantees that a CCRC contract may provide.

  Selling your home could help cover the up-front costs of joining a life plan community, and reducing expenses such as utilities, maintenance, and transportation might make the monthly fee more manageable. Explore options in your community or other locations that appeal to you to make an informed decision about where to spend your retirement.

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