The cost of moving into a continuing care retirement community (CCRC) usually includes a substantial entrance fee, as well as monthly fees. The type of contract determines the amount of the entry fee and the monthly fees. Each CCRC sets its own rates; there are no regulations governing the amount of the entry fee and the monthly fee.
In order to meet the cost of the entrance fee and the monthly fees in a CCRC, applicants must have access to fairly substantial funds. Individuals must be financially pre-screened before an application is accepted.
Individuals with insufficient funds to sustain them for their expected lifetime may not be accepted as residents.
Entrance fees range from $60,000 to over $400,000. The new Life Care at Home model entry fee starts at about $20,000. The amount of the entrance fee is based on the size of the apartment/cottage chosen.
The entrance fee may be refundable or non-refundable. A refundable fee may be fully or only partially refundable; the amount of the refund is stipulated in the contract. The refund, when applicable, is made if the resident chooses to leave the facility or dies.
The monthly fees currently range from $1,000 to $4,000. This fee is based on the type of contract signed, the size of the accommodation and the section in which the individual resides (independent living, assisted living, or nursing care) because the services offered and care provided vary greatly among the different sections.
Medical services and some personal care assistance may be covered by health insurance or long-term care insurance. The monthly fee in the CCRC does not cover these services.
Medicare or other health insurance will pay for covered medical services received at the CCRC. These may include, but are not limited to, physician services, skilled services (nursing care, physical therapy, occupational therapy, speech therapy, wound care), some home health care and durable medical equipment (for example, wheelchairs and walkers). Some retirement communities require that residents be enrolled in Medicare Part A and B, as well as maintaining a supplemental health insurance (Medigap) policy. Long-term care insurance may also be required at some CCRCs.
Long-Term Care Insurance
Individuals who have long-term care insurance policies should know that such policies cover some services provide at a CCRC. The amount of coverage and the eligibility requirements may differ. It is important to carefully read the policy to understand its limits. In addition, make sure the CCRC you are considering will accept your policy.
Individuals who do not have long-term care insurance before making application to a CCRC may be required to obtain it before admission. If so, the following should be considered:
- Must the long-term care insurance policy be purchased from a company recommended by the CCRC?
- Will the CCRC accept an individual if the application for long-term care insurance has been denied?
- Is the cost of the long-term care insurance included in the monthly fees (if purchased through the CCRC)?
Life Care at Home
Programs that provide life care in your own home, rather than in a CCRC, have become available in Maryland. The monthly fee for Life Care at Home can range from $150 to $450. There will be costs above and beyond this when specific services are brought into the home. Long-term care insurance may also be required to participate in some Life Care at Home programs.