Co-Living vs Co-Housing: What’s the difference?

Co-living and co-housing are two types of housing arrangements that may be confused. Both are types of “intentional communities” — that is, communities in which the residents share some or all of the space. There are important distinctions in how that space is shared, though, outlined in July/August 2020 edition of NAR’s SRES newsletter.

In a co-living arrangement, all residents share a single dwelling, and the residents are not relatives. Each resident will normally have a private bedroom and possibly a private bathroom. The rest of the rooms are communal, including the kitchen, dining room, living room, and laundry area. This will be familiar to college students living in dorms, but it’s also a potentially beneficial housing arrangement of seniors who may not be able to afford their own housing space or may need assistance.

Co-housing communities, on the other hand, are more private, and likely more expensive. Each party in a co-housing situation may or may not be a single individual; they could be couples or families as well. In any case, the living unit is not shared with other parties, and no room inside the dwelling is communal. Instead, the communal space all exists outside the dwelling, in the form of activity rooms, pools, meeting rooms, or similar such areas.

Photo by Nastuh Abootalebi on Unsplash

55+ Options in South Bay

This is not intended to be an exhaustive list of 55+ housing choices, but a reference point for the more commonly known, age-restricted accommodations available in the Los Angeles South Bay. We welcome your input, but cannot guarantee inclusion.

Condominiums

  • Breakwater Village, 2750 Artesia Blvd, Redondo Beach, CA 90278
  • Courtyard Villas Estates, 3970 Sepulveda Blvd, Torrance, CA 90505
  • Gables, 3550 Torrance Blvd, Torrance, CA 90503
  • Meridian, 2742 Cabrillo Ave, Torrance, CA 90501
  • Montecito, 2001 Artesia Blvd, Redondo Beach, CA 90278
  • New Horizons, 22603-23047 Maple Ave and 22601-23071 Nadine Circle, Torrance, CA 90505
  • Pacific Village, 3120 Pacific Blvd, Torrance, CA 90505
  • Parkview Court, 2367 Jefferson St, Torrance, CA 90501
  • Rolling Hills Villas, 901 Deep Valley Dr, Rolling Hills Estates, CA 90274
  • Sol y Mar, 5601 Crestridge Road, Rancho Palos Verdes, CA 90275
  • Sunset Gardens, 24410 Crenshaw Blvd, Torrance, CA 90505
  • Tradewinds, 2605 Sepulveda Blvd, Torrance, CA 90505
  • Village Court, 21345 Hawthorne Blvd, Torrance, CA 90503

Independent/Assisted Living/Memory Care Facilities

  • Belmont Village, 5701 Crestridge Road, Rancho Palos Verdes, CA 90275; 310-377-9977
  • Brookdale Senior Living, 5481 W Torrance Blvd, Torrance, CA 90503; 310-543-1174
  • Canterbury, 5801 West Crestridge Road, Rancho Palos Verdes, CA 90275; (877) 727-3213
  • Clearwater at South Bay, 3210 Sepulveda Blvd,Torrance, CA 90505; 424-250-8492; (previously Wellbrook)
  • Kensington, 320 Knob Hill Ave, Redondo Beach, 90277; (424) 210-8041
  • Manhattan Village Senior Villas, 1300 Parkview Ave, Manhattan Beach, CA 90266; (310) 546-4062
  • Silverado Senior Living, 514 N. Prospect Avenue, Redondo Beach, CA 90277; (310) 896-3100
  • Sunrise of Hermosa Beach, 1837 Pacific Coast Hwy Hermosa Beach CA 90254; 310-937-0959
  • Sunrise of Palos Verdes, 25535 Hawthorne Blvd, Torrance, CA 90505; 408-215-9608

Independent Living Only

  • Casa De Los Amigos, 123 S Catalina Ave, Redondo Beach, CA 90277; 310 376 3457
  • Heritage Pointe Senior Apartments, 1801 Aviation Way, Redondo Beach, CA 90278; (844) 220-4169
  • Seasons at Redondo Beach, 109 S Francisca Ave, Redondo Beach, CA 90277; (310) 374-6664

Mobile Home Parks

  • Skyline, 2550 Pacific Coast Hwy, Torrance
  • South Bay Estates, 18801 Hawthorne Blvd, Torrance
  • South Shores, 2275 25th St, San Pedro

Tips for seniors to find a housemate

More and more seniors are looking for a financially viable way to retain their independence as long as possible. Co-living is a promising solution, which means finding the right housemate for you. Here are a few tips to help, taken from an article in the July/August 2020 edition of NAR’s senior newsletter.

Don’t limit yourself to only looking for other seniors to be your housemate. College students are often looking for co-living situations as well, so such an arrangement could be mutually beneficial. You may look for other types of individuals that are not usually home, such as business professionals or frequent travellers. It’s okay if you and your housemate have differences. Learn to appreciate those differences and enjoy your time together.

Make sure they aren’t too different, though. Take the usual precautions to determine whether you and your housemate are compatible, such as shared interests, lifestyle, and privacy expectations. You and your housemate should complement each other’s strengths and weaknesses. Your safety is also important — meet first in a public place, have friends with you, get references and maybe even a background check or credit check.

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Upgrade Your Home for Senior Living Convenience

As if there has ever been a doubt, surveys clearly demonstrate that those of us in the Baby Boomer generation want to maintain our independence and remain in our family homes as long as possible. The older we get, the more adamantly we pursue that goal. Along with us getting older, our homes are also aging. Things we loved about the house when we were younger are not so lovable now that we’re less agile and adaptable than we were those many years ago.

That upstairs kitchen, with the tremendous views–getting up those stairs becomes a dreaded task when joints become creaky and complaining. Likewise, getting down on hands and knees to reach into the back of a corner cabinet can make one curse the arthritis creeping in on us.

Photo by AndriyKo Podilnyk on Unsplash

In some cases the solution is medical. Doctors can literally rebuild a body today, replacing old, failing parts with new technological wonders. On a more practical level, rebuilding our homes to meet our changing needs can be easier and less expensive. Depending on the structure and your needs, you may be able to adapt the family home to your new lifestyle demands more readily than you can change residences.

Elevator
Photo by Martin Péchy on Unsplash

In our experience, inability to climb stairs is the most expensive and challenging difficulty to remedy. In multi-story homes, options include installing an elevator or adding a chair lift, while in single story homes, it may be as simple as adding a ramp at the exterior entrances.

Elevators may add up to tens of thousands of dollars, but don’t let that deter you from investigating. Sometimes the architect has designed in a space that’s just waiting to be used. Besides, it’s probably less expensive than moving the kitchen downstairs. Though not as aesthetically appealing, a chair lift can be a relatively inexpensive solution, costing only a few thousand dollars.

In terms of cost and difficulty, bathrooms and kitchens come right behind stairs. The key problems are usually related to getting in and out of bathtubs, and manipulating faucet knobs. Whether the result of declining strength, arthritis, or another aspect of aging, these are literally pains we can avoid.

Walk-in bathtubs are available, but very expensive, and most of us haven’t been in a tub since we were children. The most common solution is a “curbless” shower which eliminates the pain and the trip hazard. Adding a seat to your shower is a minor effort for the contractor and a major plus for you. Any update of your faucets will probably solve the knob issue, since nearly all manufacturers have shifted from knobs to levers to meet the needs of the disabled.

Many of the complaints we have as aging boomers have been addressed by manufacturers of “add-on” or “after market” products. Roll out drawers, pull out shelves, lazy susan corner units and similar tools can be wonderful. For the most part these fixes are inexpensive and easy to install. None of them will make us any younger, but with them we can all feel better about growing older.

Main Photo by Jason Pofahl on Unsplash

Growing Old at Home

You knew someone would conduct a survey asking senior citizens where they would prefer to live as they grow older. I’m sure you also knew the answer before the survey was done. There’s no place like home!

A study by the American Association of Retired Persons (AARP) shows an overwhelming 76% of seniors aged 50+ want to stay in their current home and 77% want to remain in their community as long as possible. Sadly, only 46% expect they’ll be able to stay in their home. Another 13% believe they’ll be able to move to a different residence in the same community.

How strongly do those surveyed feel about staying in their home? Over half wanted it to the extent they were willing to share their home (32%), build an accessory dwelling unit (31%) or join a “village” that provides services to enable aging in place (56%). (We plan to explore “senior villages” in a future article.

“half of the survey respondents indicated they would be
willing to share their home simply for companionship”

In an interesting sidelight, half of the survey respondents indicated they would be willing to share their home simply for companionship. The strength of this psychological need is supported by anecdotal tales we’ve all heard about retirees who move in together for companionship, but remain single for financial reasons. Even more telling is the response of 30% who reported lacking companionship, feeling left out or feeling isolated.

About one third of those surveyed expect their existing home to require major modifications. Most of that group, roughly 25% of the respondents, are not willing or able to make those changes. As a result, they plan on relocating completely to a new area. Moving to a new area can offer a tremendous incentive in that the average price of housing varies dramatically from state to state across the nation.

“less than 25% of seniors are attracted to senior developments”

Some active adult communities, designed for the 55+ cohort, offer pools, gyms, coffee bars, workshops, golf courses and cooking classes. Despite all the amenities, less than 25% of seniors are attracted to senior developments.

In many cases, the problem lies with the lack of social interaction. The AARP concluded “creating a social environment that appeals to everyone is a key part of forming strong, livable communities.” The group cited results showing over 80% of seniors felt it important to socialize with friends and neighbors; engage with both young and old residents; volunteer in the community; and continue formal education.

While we’re looking at the things seniors desire, it’s equally interesting to see what it is they don’t want. On the list of “least important community features” we find that over 75% of the respondents don’t want “Activities specifically geared towards adults with dementia.” Nor are they interested in “Local schools that involve older adults in events and activities,” or “Activities geared specifically towards older adults.” This further reinforces the idea that seniors want to interact with both young and old people.

There are those who say “Children will keep you young.” This survey would suggest a whole lot of us believe that maxim.

Photo by Vidar Nordli-Mathisen on Unsplash

What is the California Department of Aging?

The California Department of Aging (CDA) is practically unheard of. I recently discovered it and knew immediately we would have to publish the information for our Beach Cities seniors. The Department administers programs that serve older adults, adults with disabilities, family caregivers, and residents in long-term care facilities throughout the State. These programs are funded through the federal Older Americans Act, the Older Californians Act, and through the Medi-Cal program.

To get things done, the CDA contracts with the network of Area Agencies on Aging (AAA), which are organized roughly along county lines. The local AAA directly manages services that provide meals; support for family members, and to generally promote healthy aging and community involvement. In this article we’ll focus on meals and family help, both of which are elements of “Aging At Home.”

“Meals On Wheels”

Here in Los Angeles County, seniors are eligible for home delivered meal service if they meet the following basic requirements. (For detail, see http://wdacs.lacounty.gov/ or call them at (213-738-4004.)

  • Persons 60 years of age or older who are homebound because of illness, incapacity, disability, or are otherwise isolated regardless of income level
  • Spouses and caregivers of eligible participants if it is beneficial to the participant
  • Persons with a disability who live at home with a participant

The Home-Delivered Meals Program also provides nutrition education, nutrition risk screening and nutrition counseling.

Being a senior citizen can be very challenging in our society. Even with family care givers, there can be a lot of questions, and a good deal of confusion. High on the priority list is finding ways so family members can help as much as possible.

Many times close relatives would be happy to stay home and help, but a formal job leaves no time to do so. The In-Home Supportive Services (IHSS) program is designed to provide training and income for a person who provides services to family members under the program.

Getting paid to take care of a family member

Are you caring for a senior member of the family? Or, are you a senior caring for a grandchild? Either way, you are performing a valuable service, and one you can be paid for! The California Department of Social Services (CDSS) can help you with qualifying for a paycheck in 90 days or less. The best part–it can be tax free income! The requirements:

  • Adult family members or other informal caregivers age 18 or older providing care to individuals age 60 or older
  • Adult family members or other informal caregivers age 18 or older providing care to individuals of any age with Alzheimer’s disease or related disorder with neurologic and organic brain dysfunction
  • Relatives, not parents, age 55 or older providing care to children under the age of 18
  • Relatives, including parents, age 55 or older providing care to individuals of any age with a disability

CDA also contracts with agencies that certify approximately 242 Adult Day Health Care Centers participating in the Medi-Cal Community Based Adult Services (CBAS) Program.

So every Californian has the opportunity to enjoy wellness, longevity and quality of life in strong healthy communities, CDA actively works to ensure:
– transportation,
– housing and accessibility
– wellness and nutrition,
– falls and injury prevention,
– dementia care.
For additional information, contact the CDA at https://www.aging.ca.gov/Programs_and_Services/ or you can locate the AAA in your area by selecting your county on the Find Services in My County page of this website.

Photo by CDC on Unsplash

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Planning to Grow Old in the Family Home?

In the course of a week I talk to a lot of people who are over 55 years of age. Most of them live in the home where they raised their family many years ago. And as any real estate agent or broker can tell you, most plan to live out their life right there.

And why not? They’re intimately familiar with the house, and probably with most of the neighbors. In many cases, the house is already paid for, so a mortgage won’t drag down their retirement income. The house may be a little bigger than needed, but that just means it holds more memories–right?

Senior Housing Challenges

Maybe, and maybe not. As we grow older, aging adds new challenges for our bodies. We’re not able to move around as easily, can’t climb stairs like we used to, and we don’t keep up with chores like we used to.

Typically, one of the first things I notice when visiting a 55+ client is the condition of the paint under the eaves of the house. As seniors we’re constantly being admonished to “stay off ladders” or “don’t risk falling and breaking bones.” Needless to say, very few of us get those eaves painted. Often those same physical limitations extend to the gardening tasks we used to love, and to cleaning the gutters of fall leaves.

Aging in place, rather than moving to a less challenging home, will work out well for some seniors, and prove impossible for others. Some people may be able to modify their homes to allow themselves to remain. (See Remodels for Aging in Place in the summer 2019 issue and at https://www.beachchatter.com/2019/09/11/remodels-for-aging-in-place/.)

These changes could include adding: ramps, railings or grab bars; stair lifts; plus additional safety and security features. Making our homes safer as we age is important. It isn’t the whole story, though. We still have to find someone to do the painting, clean the gutters, and make the little fixes we used to do ourselves.

Depending on the need, modifications can be cost prohibitive, and even when they are made, some seniors may still need the assistance of a caregiver. In the end, dollars and cents will weigh heavily on the decision. It may make more sense to downsize, move closer to family members who can help — perhaps into a family member’s casita — or relocate to an active adult community.

Designed for Active Adults

Recent years have seen considerable growth in residences designed and built exclusively for residents who are 55+ years old. Some seniors are still physically capable, but have decided retirement should free them from the mundane chores of adult life. The “active adult” lifestyle afforded by 55+ communities often is the perfect solution.

Imagine suddenly deciding on a romantic weekend out of town and being able to leave immediately. You’re in a secure environment–no need to make special arrangements. Maintenance tasks are all handled for you. You and the neighbors watch out for each other all the time, so just pack and go! That’s the real appeal to 55+ homes–they give you freedom.

In addition to the freedom, planned communities offer opportunities to spend time golfing, woodworking, sculpting etc., with peers who love the same things you do. It could be time in the gym, or lying by the pool. Whatever your favorite things are, there’s a 55+ complex out there to help you enjoy them.

There are trade-offs. Typically a down-sizing senior goes from three or more bedrooms, in 2500+ square feet, to a two bedroom unit with less than 1200 square feet. That means a lot of furnishings, knick-knacks and memorabilia get sorted and distributed. It’s work, but handled appropriately can be a valuable experience in turning the familial reins over to the upcoming generation. Writing these words, I have a mental picture of the happiness when my wife gifts her grandmother’s jewelry to our granddaughter. It certainly outshines putting family heirlooms in a will to be routinely read out with no hugs and tears of joy.

Senior Renters Face a Shortage

Seniors who own their homes have the option of modifying their homes or selling and downsizing. But senior renters, living on a fixed income, are much more vulnerable to the rent increases that are occurring more frequently across California.

In a growing trend across the nation, investors have been buying up rentals in bulk and raising the rent and/or sending eviction notices to senior tenants. (See article in the Los Angeles Times.) Tenants who try to fight the increases face lengthy and costly legal battles that don’t always turn out in their favor. The result?

In Los Angeles, 26% of no-fault evictions happen to residents who are 62 years or older. In contrast, roughly 13% of the city’s units are occupied by seniors. Thus, the eviction rate for seniors in Los Angeles is almost twice as large as it is for other age groups.

No-fault evictions usually occur when a renter is living with a month-to-month lease. Some seniors are unaware they have this type of lease, as when their annual lease ends the landlord may choose to continue the lease on a month-to-month basis. Then, when the landlord decides to re-list the unit at a higher rate, they may simply evict the long-term tenant with very little notice.

The number of homeless seniors is rising at an alarming rate. In Los Angeles, the number of homeless seniors rose 22% in 2018, leaving 4,800 seniors on the streets. Experts predict the number could rise to 30,000 by 2030.

Decisions, Decisions, Decisions

In summary, the three overarching choices for seniors considering a change in housing are: remain in the family home, sell and move to an active adult community, or try to secure stable rental housing. There are lots of variations on each theme. For example, one could rent out the family home to provide an income to cover the cost of a senior rental property.

Regardless of the route you take, the California Department of Aging offers a good deal of assistance for seniors facing housing changes. That department provides more detail about the types of senior housing and assistance here.

For those of you who are considering making a change in where you live, we would be happy to sit with you and find answers for any questions you may have.

Remodels for Aging in Place

Every year the National Association of Home Builders (NAHB) conducts a broad survey of professionals involved in the housing industry. The results of that survey are published as the Remodelling Market Index (RMI). Among other data collected are details about the improvements made by seniors who plan to live in their current home as long as possible.

The ‘Aging-In-Place’ data includes how many professional remodelers do it, how many of their customers are receptive to it and what kinds of projects are completed. Using data from NAHB’s RMI survey for the 4th quarter of 2018, we look now at some of the specific types of Aging-in-Place projects undertaken last year.

It probably comes as little surprise to most readers that bathroom projects dominated the top spots. Over 80 percent of remodelers who answered the question reported installing grab bars, higher toilets and curb-less showers. The next-most-common project on the list, widening doorways, followed at a considerable distance (59 percent).

Much like the relationship between bathtubs and showers in general, walk-in bathtubs are not nearly as desired as curb-less showers. Only 12 percent of remodelers reported installing walk-in tubs in 2018, and only two of the 14 projects on the Aging-in-Place list were less desirable: lowering kitchen cabinets and lowering countertops.

When NAHB began asking Aging-in-Place remodeling questions in 2004, curb-less showers were about as common as wider doorways. But over the years the share of NAHB remodelers installing curb-less showers has grown, from 54 to 82 percent. Requests for curb-less showers are now nearly as common as higher toilets—even though installing higher toilets also reached an all-time high of 85 percent in 2018, up from 68 percent in 2004.

When the RMI questionnaire expanded in 2006, it started asking remodelers about reasons their customers undertake Aging-in-Place projects. Since that time “planning ahead for future needs” has consistently ranked as the most common motivation, cited by 75 percent of remodelers in 2006, and up to a record 86 percent in 2018.

“Acute age related disabilities” and “non-age disabilities” were also higher than ever in 2018, at 51 and 27 percent, respectively. This is only a 1 to 2 percentage point gain over their previous peaks, however.

Meanwhile, the share of remodelers citing “living with older parents” as a motivation has tended to drift downward over time, from over 50 percent in 2006 and 2007, to under 45 percent in 2016 and 2018.

For further results and more detail on the Aging-in-Place questions in NAHB’s RMI survey, the complete report may be found at http://eyeonhousing.org/wp-content/uploads/2019/05/RMI-2018-Q4.pdf.

New Horizons

For this issue we visit a couple who live in one of the original 55+ communities in the South Bay. The 600 homes in New Horizons were built in the early sixties. Most units have seen some remodelling, while a few have been extensively redone.

The basic units come in three configurations. The two story structures comprising the two most common, with single level ‘A’ units on the ground floor, and single level ‘B’ units upstairs. There are 237 each of the ‘A’ and ‘B’ units in that configuration.

Here an owner has installed a lift chair on the external stair of a two story building.

The two story buildings have downstairs units with essentially no stairs, and a nice patio, frequently enclosed in a wooden fence. The upstairs units have a large balcony off the living room.

New Horizon’s single story, ground level bungalows are highly sought after.

The third style is the highly sought-after bungalow with a total of 126 units. Each ground level building has three units, most in a staggered pattern to minimize shared walls.

Approximately 400 of the 600 units are identified as occupied by the owners. In many cases the official ownership record reflects the names of future heirs. Some units are occupied by seniors, but owned by investors, and we’ve found that often neighboring seniors will purchase available units for their own investment portfolio.

For this visit to New Horizons we’re talking to DeeDee and Arlo (names have been changed) who live in an upper story unit in one of the two story buildings.

  • Q1: How long have you lived here?
  • DD:We bought here seven years ago. It was just what we were looking for. The owner had done a lot of upgrades, so we have dual pane windows & patio doors, and tile floors. A lot of things other units don’t have.
Dining area with custom tile adjacent to kitchen.
  • Q2: Is it your first time living in a condominium?
  • DD:We’ve both lived in an apartment before. This isn’t much different, except for involvement in the association. I was on a committee for a while, but it was too much. After I retire, I’ll get more involved … maybe.
Wide and deep balconies offer immediately accessible outdoor space in addition to large units.
  • Q3: Have you made new friends here?
  • DD:Lots of them! We’re friends with just about everyone in our building and the one facing us.
    AR:It’s like a little Mayberry here. Everyone knows everyone and everything that’s going on. It’s really nice because the neighbors are very watchful. We know when there’s a stranger around, or a wild animal comes visiting.
  • Q4: Have friends from your old neighborhood come to visit? What did they have to say about your new home?
  • DD:We’ve had old friends come by regularly. There’ve been many family birthdays, and even super bowl parties! Everyone likes it. It’s much bigger than most condos.”
The New Horizons golf course has a gorgeous water trap!
  • Q5: Obviously there are things you like and some you don’t care for. What is your favorite part of living here?
  • DD:I play Bunko every second Tuesday. It’s fun and I’ve met a lot of new people–mostly ladies–that way.
    AR:I love the green. Everywhere you look there’s grass, trees, planters, and things growing. The golf course is especially nice with the lake and fountains.
    DD:We’re not at the beach, but being upstairs we get a nice cross-breeze. We wanted to be upstairs because of the extra light coming in and the upstairs units all have attic storage.
Custom built barbeque for al fresco dining on the grounds.
  • Q6: 55+ communities vary considerably in the amenities provided. What does the association provide that you like most?
  • AR:We haven’t even tried everything. There’s a gym with showers, a wood shop with all kinds of tools, and a pottery shop with a kiln. There’s a pool and hot tub here, bocce ball, and a bigger pool over by the recreation center. The rec center has ping pong, pool tables, card rooms, a meeting room with a stage and audio/visual equipment. There’s even a library.
    DD:The association cares for the owners. One of our neighbors needed a lift chair to get upstairs to the second level. The HOA was totally cooperative.”
The grounds are among the most opulent in the South Bay.
  • Q7: How about the things you like least. What would those be?
  • AR:There are all the usual things about living with other people–the gossip, pettiness, and perpetual complainers.”
    DD:The garages are shared, and you can’t really store anything in them.”
    AR:Guests and delivery people have a hard time finding addresses. I usually have to go out to guide them in because there’s a combination of block numbers, building numbers, street addresses and unit numbers.
  • Q8: What are your plans for the future?
  • AR:For right now, we’re staying right here. We’ve talked about moving to Temecula, but haven’t looked into it.”
    DD:We could swap to an inexpensive house there, but we really like being close to the beach and near family and friends.

When Is Assisted Living “In-Home Health Care?”

Last year the Centers for Medicare & Medicaid Services (CMS) expanded how it defines many of the “primarily health-related” benefits that insurers are allowed to include in their Medicare Advantage (MA) policies. Air conditioners for people with asthma, healthy groceries, rides to medical appointments and home-delivered meals are among the new benefits now being considered for coverage by insurers. More importantly, insurers are now allowed to cover non-skilled in-home care starting this year.

Assisted living providers often provide this type of care, such as helping residents with bathing and dressing. Thus, the CMS change opened up the possibility that insurance dollars could start flowing to senior housing and care companies. Analysts already envision major MA insurers buying into senior housing companies to maximize profits.

Technically, the Assisted Living facility is your home,
so “home health care” benefits should apply.

Only a handful of insurance companies are offering any new benefits in 2019. Among them, Long Beach, California-based SCAN, announced its “Returning to Home” and “Home Advantage” offerings in mid-November. SCAN was able to quickly add new supplemental home care benefits because it has covered similar services in the past

To provide these benefits, SCAN already has contracts in place with home care agencies. According to SCAN executives, it’s possible SCAN would contract directly with an independent living or assisted living company if it has caregivers on staff, and residents signed up for these new plan offerings.

It’s possible a retiree will have health care
provided by a medical organization
owned by the insurer. Would that be
considered a conflict of interest?

Both SCAN and Anthem, another major player in the MA arena, have indicated they are open to contracting with senior living providers or otherwise forging partnerships with them. We can expect a variety of differing relationships between insurers and providers as best practices are devised.

As insurance companies create their benefits packages and consider potential senior living moves, some senior living providers are looking at ways to add MA policies to the 55+ living packages they offer.

Sunrise Senior Living has a newly established plan called Sunrise Advantage which is currently offered in four states (California is not included). The Sunrise plan replaces the insurance company that normally comes in between the health provider and Medicare. Physician referrals to Sunrise are up 300% since Sunrise Advantage launched, per Sunrise executives.

Should we allow the health industry,
providers or insurers, to engage in monopoly?

Senior living providers like Sunrise, who create their own plans can tap into the new supplemental benefits as well as more well-established options. The changes promise to add bottom-line value for the senior living business, while enhancing residents’ outcomes and reducing some of their expenses.

Many Medicare Advantage plans already offer some health benefits not covered by traditional Medicare, such as eyeglasses, hearing aids, dental care and gym memberships. The new rules, developed with industry input, expands that significantly to items and services not directly considered medical treatment.

CMS said the insurers will be permitted to provide care and devices that prevent or treat illness or injuries, compensate for physical impairments, address the psychological effects of illness or injuries, or reduce emergency medical care.

The changes were adopted late in 2018, so many insurers are still designing their modifications, and many changes will come in 2020. Some health insurance experts said additional benefits could include modifications in beneficiaries’ homes, such as installing grab bars in the bathroom, or aides to help with daily activities, including dressing, eating and other personal care needs.

Even though a physician’s order or prescription is not necessary, the new benefits must be “medically appropriate” and recommended by a licensed health care provider, according to the new rules.