All-Inclusive vs. A la Carte: Which Pricing Structure is Best for Assisted Living

Both models have their advantages, but the all-inclusive model offers families the biggest benefits.
Posted by The Arbors on Aug 2, 2019 10:00:00 AM

Elderly couple sitting together looking at a computer with smiles on their faces

Understanding the pricing structure of an assisted living community can be a bit confusing in the beginning. Some communities charge rent and also for each individual service — known as the à la cart model. Other assisted living communities charge an all-inclusive rate that includes most of the everyday services.

Both the all-inclusive and à la carte models have their advantages, but the all-inclusive model offers families the biggest benefits. Here’s a closer look at the two most common assisted living pricing structures and why the all-inclusive model might be best for your family.


Assisted Living Services

Before you can navigate the pricing structure of an assisted living community, it helps to understand what most assisted living communities typically provide.

Residents usually live in their own private apartment, and communities offer meals, housekeeping, laundry, transportation to errands and appointments, social and recreational activities, and exercise and wellness programs.

They also provide help when needed for instrumental activities of daily living (e.g., shopping, housekeeping, managing medications, etc.), activities of daily living (e.g. bathing, dressing, eating, etc.) and some medical assistance for those who do not need around-the-clock skilled nursing care.

But assisted living services, costs, and pricing structures vary wildly. À la carte communities offer an apartment at a base rate and then charge extra fees for services — also known as the fee-for-service model. All-inclusive communities offer much more for one monthly fee.

Confused? Here’s a closer look at each pricing structure.


The À la Carte Model

In the à la carte model, assisted living communities charge a flat monthly fee for rent or for rent and meals. Then each service provided comes with an additional cost. For example, an assisted living community might charge a flat monthly fee or an hourly fee to manage a resident’s medication or help them get dressed every morning.

The advantage of this fee for services pricing model is that you only pay for the specific services you need. If your loved one can cook and care for themselves or if they can provide for their own transportation, the costs will be lower.

However, if your loved one needs more services, this can quickly become expensive. One month the fees might be low, but the next month you might need to pay for care after a fall or a trip to the emergency room.

This arrangement can be challenging because it can be unpredictable and change often. Before you opt for this pricing model, make sure you ask the community about the services that are most likely to be needed and take their fees into account.


The All-Inclusive Model

The most predictable assisted living pricing structure is the all-inclusive model in which the community simply charges a flat fee each month. You receive one monthly bill for rent, some utilities, meals, and services that can include housekeeping, laundry, personal care, recreational activities, transportation, and more.

The advantage of this pricing model is that the price doesn’t increase as your loved one’s needs change. For example, if your loved one suffers a health crisis that requires more services, their monthly rate won’t increase. This arrangement is much simpler because of the predictability of cost month to month.

However, the definition of “all-inclusive” varies among assisted living communities. For example, a service such as medication management or scheduled transportation that’s covered in one community’s package may not be included in the rate charged by a different all-inclusive community. Some communities also have a cap on the number of services per resident or will still charge extra for certain services that are considered above and beyond, such as medication management.


3 Benefits of the All-inclusive Pricing Structure

One of the biggest concerns families have when considering assisted living is the cost. It can be hard to determine and budget for your loved one’s living and care costs.

That’s why the all-inclusive pricing structure is so beneficial: The à la carte model can mean an unexpected — and sometimes drastic — changes to your monthly bill. With all-inclusive pricing, costs are much more predictable for families. Here’s a closer look at three benefits to an all-inclusive pricing structure that may be worth considering.


1. The price doesn’t increase as care needs change.

Is your loved one fairly healthy now but prefers to be prepared for future costs associated with care? With all-inclusive pricing, you can count on one price for assisted living lodging and care.

On the other hand, many assisted living communities that use the à la carte model offer a low, introductory monthly rate to make the pricing structure seem more appealing. But as soon as your loved one needs additional health services, the price increases — and, depending on the community, it can increase even if your loved one only needs 15 additional minutes of help getting dressed in the morning.

When comparing communities, make sure you get a clear description of what is and is not included in an all-inclusive agreement. Alternatively, for an à la carte agreement, make sure you get a breakdown of fees for each service. Keep in mind that many communities also charge a move-in fee. Always make sure you have a breakdown of fees, including flat month-to-month fees, taxes, and any other specific service fees.


2. It’s easier to manage your budget.

How important to you is predictability when planning for assisted living costs? Many families want an idea of the total monthly cost for assisted living. The all-inclusive model can be helpful when it comes to budgeting because you know exactly how much money you will need each month to pay the bill.

If budgeting isn’t as critical — and your loved one doesn’t need high levels of care — then the à la carte model can be advantageous.


3. Your loved one gets care when they need it.

Does your loved one have an illness or disease that is expected to progress, requiring additional personal care services over time? With the all-inclusive model, when the caregivers see that your loved one needs additional care, let alone might benefit from it, they get it.

On the other hand, with à la carte pricing, there may be a lapse in time before the new level of care is provided. Because the new care service will increase the monthly bill, the staff needs to obtain permission from the family and from who is paying the monthly bill if it’s a different person.


Which Pricing Structure Is Best?

If your loved one doesn’t need many services and you don’t expect their needs to change in the future, the all-inclusive model may not be the most economical approach to paying for assisted living care.

But if your loved one needs, or will eventually need, a high level of service, you may find that the all-inclusive model is actually cheaper than the fee-for-service pricing structure. Generally, all-inclusive pricing will create cost savings over the duration of a resident’s stay with the community.

To learn more about financial resources for assisted living and how to find the right community for your loved one, download our guide to Assisted Living Frequently Asked Questions and Answers.

do you have questions about assisted living? get the answers with this free guide

Topics: Assisted Living