A continuing care retirement community, or CCRC, offers different levels of care in one place: usually independent housing, assisted living and skilled nursing on one campus (National Institute on Aging). Most charge a one-time entrance fee, which may be relatively expensive, and then a monthly fee. Before paying, read which of the four contract types you are being offered.
The four contract types
This is how the U.S. Government Accountability Office describes them (U.S. Government Accountability Office). A CCRC may offer one type or a choice.
| Type | Entrance fee | When care needs grow | Who carries the risk of higher care costs |
|---|---|---|---|
| A: Extensive or Life Care | Generally substantial | Little or no increase in monthly fees as the resident moves to assisted living or nursing care | Mostly the CCRC |
| B: Modified | Paid, with often lower monthly fees than Type A | Some care is included, such as 30, 60 or 90 days. After that, market or discounted daily rates apply | Shared; the resident after the included days |
| C: Fee-for-service | May be lower | Market rates for all health-related services as needed | The resident |
| D: Rental | Generally none | Pay as you go, based on unit size and services | The resident |
How moving between levels works
Where a resident lives depends on the level of service needed. People who can no longer live independently move to assisted living, or sometimes get home care in their independent unit. If necessary, they can enter the CCRC's nursing home (National Institute on Aging).
What to weigh before paying an entrance fee
The GAO found that entrance fees, typically a large lump-sum payment, can be a substantial portion, or even all, of a person's assets (U.S. Government Accountability Office). Its report also warned that CCRCs carry risks for residents, and that states need to stay vigilant about consumer protections. Before committing, ask:
- Is any of the entrance fee refundable? How much, on what schedule, and when is it paid: on leaving, on death, or only when the unit is resold?
- What happens to my contract and my money if the community is sold or runs into financial trouble?
- May we see recent audited financial statements and occupancy figures?
- Has the monthly fee gone up in each of the last five years, and by how much?
- Who decides when a resident must move to a higher level of care?
- Is a place in assisted living or nursing care guaranteed when it is needed?
- Which state agency oversees this community, and what protections does the state give residents?
A contract like this can tie up most of a person's savings. Have an attorney or a fee-only financial professional review it before signing.
Who pays
People pay most of these costs themselves. Medicare, Medicaid and long-term care insurance may cover some services, depending on the level of care provided (National Institute on Aging).
Who to ask
Your local Area Agency on Aging can tell you which state office oversees these communities. Use the Eldercare Locator or call 800-677-1116 (U.S. Administration for Community Living).
Common questions
Is a life plan community the same as a CCRC?
Yes. The Alzheimer's Association says life plan communities were formerly known as continuing care retirement communities.
Does Medicare pay the CCRC fees?
No. People pay most of these costs themselves. Medicare, Medicaid and long-term care insurance may cover some services, depending on the level of care.
Do you need to be healthy to move in?
Often, yes, for independent living. The GAO reported that prospective residents are generally screened for general health status and must also submit detailed financial information.
Who regulates CCRCs?
States do. The protections differ from state to state, so ask your state's insurance or aging department what applies.
Related guides
Independent living vs. assisted living
Independent living is housing with amenities. Assisted living adds daily personal care. Here is how they compare and how to choose.
What is assisted living?
What assisted living includes, who it is for, who regulates it, how fees usually work and what to ask before signing.
Assisted living vs. nursing home
How assisted living and nursing homes differ in care, oversight and who pays, with a side-by-side table and the official sources.
Sources
- Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care, National Institute on Aging (NIH). Checked November 7, 2026.
- Older Americans: Continuing Care Retirement Communities Can Provide Benefits, but Not Without Some Risk (GAO-10-611), U.S. Government Accountability Office. Checked November 8, 2026.
- Long-Term Care, Alzheimer’s Association. Checked November 8, 2026.
- Eldercare Locator, U.S. Administration for Community Living. Checked November 7, 2026.
This guide explains general rules. It is not medical, legal or financial advice for your situation. Program rules and amounts change, usually each January (Medicare and Medicaid) and each October (VA). Confirm details with the agency or a qualified professional before you decide. See our editorial policy.