Gray Area: Continuing-care communities let residents age in stages

Long-term contracts are at the heart of the CCRC programs, and there are many types of agreements. Type A, an extensive agreement, is "pretty prevalent" in CCRCs, says Matthiesen. There's usually an up-front entrance fee, which might be in the tens of thousands of dollars (she says they can be as high as $1 million, although that's not common), and a monthly fee that could include all of your health care, a meal plan, housekeeping and the property. It stays "relatively stable" throughout time, regardless of the level of care needed, but there are annual increases to the monthly fee, and people should be asking what those increases have run in the last few years, she advises.

You have to ask a lot of questions and not just financial ones, Matthiesen says, noting that everyone considering a CCRC needs to have a trusted financial planner look over the fine print before signing an agreement, since it's long-term and binding. Among the nonfinancial questions: Can you see an outside doctor or does your care transfer to the on-campus clinic? "Many times people look at the beautiful campus but don't focus on health services. They don't ask others about quality of the care they've received. And it's important for families to have some planning discussions."

Other questions: If you're buying your property, what happens to it when you die or have to move up to another level of service? How financially sound is the program, since you're counting on it to be there for perhaps decades. (Matthiesen says certification includes a hard look at financial issues.) Will the property hold its value? And, perhaps most important, what happens if you outlive your funds? One of the CCRCs the McGees are considering has a fund for this contingency, Roz says, so no one will be kicked out. They may not all do that, so ask.

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