A defining benefit of a continuing care retirement community (CCRC), also called a life plan community, is the on-site continuum of care available if a resident’s needs change. That on-site care—whether assisted living, memory care, or skilled nursing—helps couples remain near one another and maintain community connections while one partner receives higher-level services.
We produced a short video explaining how monthly service fees are handled when one spouse or partner needs on-site care while the other remains in the independent living (IL) residence. The video highlights how different CCRC contract types affect who pays what while care is being received.
View the full 3-minute video here:
How monthly fee adjustments work
Understanding fee adjustments when one partner needs care is important when choosing a community or a contract type. These differences influence monthly costs and long-term financial planning, so it pays to review the contract language carefully before signing.
>> Related: A Primer on CCRC Residency Contracts
For CCRC Type C contracts
Type C contracts, sometimes called fee-for-service agreements, treat care costs separately from the IL monthly service fee. If one partner moves into assisted living or nursing care, the partner who remains in the IL residence typically sees their monthly charge reduced from the double-occupancy rate to the single-occupancy rate.
The partner receiving care pays the actual cost of the services they receive. That amount will vary based on the level of care—assisted living, memory care, or skilled nursing. In some cases, rehabilitation stays intended as temporary can be covered in part by Medicare, which reduces out-of-pocket cost for a short-term nursing stay.
An important nuance for Type C contracts is whether the stay in the healthcare center is classified as temporary or permanent. If the stay is temporary and the resident is expected to return to IL, many communities continue to charge the double-occupancy IL rate for the unit while billing the resident receiving care for the additional healthcare charges. If the stay is permanent, the IL rate is typically adjusted to a single residence rate and care charges apply to the resident in the healthcare center.
>> Related: What’s the Difference Between Assisted Living and Nursing Care?
For CCRC Type A contracts
A Type A lifecare contract typically bundles most healthcare services into the monthly fee. Under a true lifecare agreement, the monthly service fee remains the same whether a resident lives in IL or requires care in the community’s healthcare center. For couples, that means they generally continue paying the same double-occupancy monthly rate even if one or both partners receive care.
Keep in mind that some lifecare contracts may still include modest additional charges for services outside the base package, like extra meals or certain elective services in the healthcare center. Always check the contract for any exclusions or additional fees.
>> Related: CCRCs Keep Couples Close in Sickness and Health
For CCRC Type B contracts
Type B contracts are a hybrid: residents pay a reduced fee for healthcare services compared with fee-for-service contracts. The community may offer a specific discount on care rates or include a set number of healthcare days at no extra cost. For couples, the IL rate adjustment is often handled similarly to a Type C contract, but the healthcare charges assessed to the partner receiving care are discounted according to the contract terms.
Care close to home
One of the clearest benefits of on-site care is that couples can remain physically close even if one partner requires a higher level of care. Regular visits and proximity to familiar friends and neighbors support emotional well-being and can ease transitions to higher-care settings.
Every community handles contracts and billing a bit differently, so it’s important to review the residency agreement carefully and ask specific questions about how temporary versus permanent care stays are handled, what services are included, and whether any additional charges may apply. With the right contract and community, a CCRC can provide both financial predictability and the comfort of staying close to the people who matter most.