Continuing care retirement community cost: Can you afford it?

When you’re searching for a senior living solution for yourself or a loved one, cost is a central concern. If you love a community, but you can’t afford it, the other factors largely fall to the wayside. And navigating the costs associated with the all-in-one solution that is a continuing care retirement community (CCRC) can be a complicated feat.

Because “a CCRC offers a full continuum of care — starting with independent living and progressing through assisted living, memory care or skilled nursing care, if needed — the cost structure looks different from other senior living options,” explains Christen Bergeron, founder of Navigating Senior Living, a one-on-one support and membership community that guides families through the complexities of aging parent care. This is because “it’s not just about where you live now, it’s also about securing access to care in the future,” she adds.

With the insight of senior living experts, you will explore what those various CCRC fees and contracts are, how the costs compare to other senior living solutions and more below.

Continuing care retirement fees explained

If you’re not familiar with CCRC fees, it can feel confusing. In addition to a monthly fee (reminiscent of a rent or mortgage payment), there is also an entrance fee, which secures your place in the community. Here, experts explain both fees, as well as the (not guaranteed) entrance fee refund.

Entrance fee

The one-time entrance fee, sometimes referred to as a buy-in, according to Bergeron, is an upfront cost that “secures your spot in the community and helps offset future care.” This fee is typically substantial but may be partially refundable, depending on your contract.

Monthly fee

In addition to the entrance fee, you are responsible for a monthly, rent-like fee. This “monthly fee covers your living expenses, amenities and services — like meals, housekeeping, transportation and, eventually, higher levels of care when needed,” says Sondra “Sam” Cradduck, gerontologist, psychologist and owner of The Living Room, a non-medical senior home care agency in Phelan, California.

This cost also tends to increase with time. Because of this, Brittany Metzig, a financial advisor at Bond & Devick Wealth Partners in Saint Louis Park, Minnesota, advises “asking for historical price increases to get a feel for how they might continue to increase going forward.” Additionally, the monthly fee may or may not include “certain expenses, such as utilities,” she adds, so it’s important to ask for details.

Refund option

“Some contracts include a partial refund of the up-front fee, while others may not,” Bergeron explains. “Depending on the type of contract, you may get a fixed percentage of your up-front fee back if you move out or after you pass. Other communities may reduce the refund over time.” She adds that if a refund is paid out, it won’t be immediate, as it’s typically paid out once the unit is reoccupied.

How much do continuing care retirement communities cost?

Continuing care retirement community costs vary widely, based on many factors, including location, type of unit (apartment versus house, single occupancy versus double occupancy), amenities, contract types and more. Below experts explore these costs.

Average CCRC cost: What to expect

Most CCRCs charge an entrance fee, with the national average being $400,000, according to the 2022 Continuing Care Retirement Community (CCRC) study by the Office of the Insurance Commissioner for Washington State. 
However, entrance fees can be as high as $1 million, says Ryan McEniff, a dementia care advocate and chief executive officer of Minute Women. In addition to the entrance fee, the national average monthly fee for a CCRC is $3,353, according to the NIC Investment Guide for 2024. In addition to the national averages, below is fee data for a sampling of available states.

Entrance and monthly fees for CCRCs

	Entrance fee for CCRC	Monthly fee for CCRC
National average	$400,000	$3,353
North Carolina average*	$68,000-$370,000	$2,000-$5,000
New York average**	$115,00+	$2,100+

Factors that affect CCRC fees

Your overall cost for a CCRC can also be affected by the following factors:

• Location. “A CCRC in Southern California or a major city will cost more than one in a smaller town — just like real estate,” says Cradduck.
• Living space size and layout. Many CCRCs offer housing options with varying costs.
• Care offerings. A community may have a higher overall cost because they have built-in “24-hour nursing, onsite rehab and physician availability or a specialized memory care program,” says Bergeron.
• Amenities. “A community with a pool, spa, chef-prepared meals and multiple dining venues will likely charge more than a smaller, more modest place,” says Cradduck.

How different contracts impact CCRC fees

Most CCRCs follow standard contract structures that are designated as “Types A, B and C,” explains Bergeron. This makes it easier for families to compare what is included and how care is paid for over time, she adds. 

Type A, or extensive agreement

(Also called a Life Care contract.) These “usually comes with the highest entrance and monthly fees,” says Bergeron. “That’s because future care is built into the agreement.” You’re essentially paying more while still living independently in exchange for more predictable costs if and when care is needed later, she adds. 

These extensive agreements provide for “unlimited long-term care without substantial increases in periodic payments (except for normal operating cost and inflation adjustments),” according to the U.S. Department of Health and Human Services (HHS). This can help families avoid financial surprises down the road.

“Type B and C contracts typically have lower upfront costs, but care is billed separately and can get expensive quickly as needs increase. That lower buy-in might feel like the right choice now… but it’s important to think long-term.”

— Christen Bergeron, senior care expert and advisor

Type B, or modified agreement

These mid-range contracts have a lower entrance fee than Type A, but they provide “health care services either at a discounted rate or for a limited number of days (unlike Type A that has one set rate even when care levels change),” says Bergeron. These contracts provide assisted living or skilled nursing “at a discounted rate for a set period, typically 30-60 days, and after that the individual would pay the current market rate for that care.”

Type C, or fee-for-services agreement

With these agreements, “residents only pay for health care services used,” according to the HHS. The up-front fees for these contracts are typically lower; “however, the resident also accepts the risk of paying for care which may eventually become too expensive for him or her to pay for.”

According to Bergeron, “type B and C contracts typically have lower upfront costs, but care is billed separately and can get expensive quickly as needs increase,” she warns. “That lower buy-in might feel like the right choice now when your parent is independent, but it’s important to think long-term.”

CCRC cost vs. other senior living options

With its hefty up-front entrance fee, a continuing care retirement community can feel daunting. However, it’s important to remember that (depending on the contract) this fee may cover all future potential care and be partially refundable. The entrance fee aside, here are the national average monthly costs of different senior care options.

National median monthly costs of senior care*

CCRC	$3,353/month
Assisted Living	$5,900/month
Nursing Home	$9,277-$10,646/month (semi-private vs. private)
Home Health Aide	$6,483/month

Is a CCRC more expensive than aging in place?

Aging in place can be cheaper than a CCRC, according to the experts we spoke to — and it comes without the sticker shock of an entrance fee. In addition to the obvious benefit of staying in your own home, Metzig adds that staying at home can also allow you to have more control over financially weighty decisions, such as hours of care needed and level of care.

“[A CCRC] protects you from some of the rising care costs later. And for many people, it’s worth it not to have to move again as their needs change.”

— Sondra “Sam” Cradduck, gerontologist and psychologist

McEniff says that unless 24/7 care is required, aging in place is usually more affordable. In fact, he adds, “it could take years of such care to match the upfront cost of a CCRC, and that doesn’t include ongoing monthly charges.”

However, Cradduck says that the answer really comes down to “what you need and want.” She adds that it “might seem more expensive up front, but [a CCRC] protects you from some of the rising care costs later. And for many people, it’s worth it not to have to move again as their needs change.”

It’s important to note that not all CCRCs allow direct admission into assisted living or nursing care without first requiring a stay in independent living. It will depend on the specific CCRC’s policies and contract types, and in some cases admittance may be dependent on space availability. Existing independent living residents usually have priority for beds in assisted living or nursing care units. This is a vital consideration as you make long-term plans.

Is the cost of a CCRC worth it? 

In the end, the main benefit of a CCRC is security. So, if it’s something you and/or your family can afford, and the reassurance of guaranteed care as you age is a priority for you, a continuing care retirement community may be the right fit. 

As Bergeron acknowledges, “CCRCs come with a higher upfront cost, and they’re not within reach for every family. But for someone who’s planning ahead and can afford it, they offer something most other options don’t, in that you gain a long-term plan that’s already in place.”