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Published: Jun 05, 2023 27 min read
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  • Nation’s leader in Long-Term Care insurance since 1976
  • As an independent brokerage, they provide unbiased information based on your needs
  • GoldenCare has access to the Top LTC companies & discounts available
  • They also offer Hybrid Long-Term Care insurance, Short-Term Care & Home Health Care plans
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  • A+ score, BBB-accredited
  • Brokers with decades of experience
  • Many long term care provider partners
  • Comprehensive, affordable plans
  • Protects your assets with tax-free benefits
  • Eligibility: ages 45-79, $100k+ net worth, in good health

Securing the best long-term care insurance is a fundamental part of future healthcare planning. According to government statistics, the majority of people over the age of 65 will require some form of ongoing care and support later in life, and the cost of such services can add up fast.

A long-term care policy can help cover expenses associated with your care as you get older. This includes assistance with everyday activities or specialized care related to Alzheimer’s disease, Parkinson’s and dementia. The best long-term insurance will include multiple types of coverage, a variety of features and discounts.

If you’re considering this type of insurance policy, our picks for the best long-term care insurance can help you get started. Read more below.

Our Top Picks for the Best Long-Term Care Insurance Companies

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Best Long-Term Care Insurance Reviews

  • Offers universal and variable universal life insurance policies with LTC rider
  • Inflation protection available on their CareMatters policies
  • Informal caregivers permitted
  • No online chat available at this time
  • No stand-alone long-term care policies
  • LTC rider isn't available in Montana or U.S. territories

Why we chose it: Nationwide ranks among the best insurers for customer satisfaction for its low NAIC complaint index and high rank in customer satisfaction surveys. As a well-known national insurer, Nationwide’s reputation adds an extra layer of assurance for customers looking to invest in financially secure products.

Nationwide is one of the largest insurers in the United States, and was ranked among the best for customer satisfaction in J.D. Power’s 2022 U.S. Life Insurance Study. Additionally, the National Association of Insurance Commissioners (NAIC), a regulatory organization, reports a low complaint index from Nationwide compared to other insurance companies in the market.

Nationwide sells universal life insurance policies with two long-term care options:

  • LTC as an add-on (or rider) to another policy
  • Care Matters, a hybrid policy that includes both life insurance and LTC benefits

Nationwide policies have some pretty convenient perks. For one, under its CareMatters program, you’re not required to submit receipts and bills monthly in order to receive your benefits. After the elimination period, CareMatters also pays the first three months' LTC benefit retroactively along with the first benefit payment. Lastly, policyholders can use their benefits to pay for care from informal caretakers, such as family members.

A+ (Superior)
J.D. Power Rating
Pool of Money/Benefit Period
LTC rider: 25, 33.3, or 50 months. CareMatters: 2-7 years
Maximum Daily/Monthly Benefit
Elimination Period
90 calendar days
  • Three types of discounts for policyholders
  • 15% couples discount
  • 15% discount for individuals in good health
  • Policy includes a care coordinator
  • Choose your preferred benefit payment method from month to month (cash or reimbursement)
  • Couples discount is only available if married or if living together for 3 years
  • Only one LTC plan available

Why we chose it: Mutual of Omaha made it to our top picks for its discount program. The company awards 15% off to partners who purchase the same policy, 15% for being in good health and 5% for married customers (and whose partners aren’t under the same policy).

Mutual of Omaha offers stackable discounts, with premium discounts applied to the total premium amount and additional discounts applied to the remainder.

The company sells long-term care insurance coverage exclusively as a stand-alone product. Available policy options include the MutualCare® Custom Solution and the MutualCare® Secure Solution, which include:

  • Monthly benefits from $1,500 to $10,000
  • Elimination periods between 0 and 365 calendar days
  • Policy limit of $50,000 to $500,000
  • Waiver of premium benefit
  • Optional inflation protection benefit

Mutual of Omaha also earns a shout-out for customer satisfaction. The company ranked third place in J.D. Power’s 2022 U.S. Life Insurance Study and has a solid financial strength rating of A+ from AM Best.

AM Best Rating
A+ (Superior)
J.D. Power Rating
Pool of Money/Benefit Period
2–5 years. Pool of Money: $50,000–$500,000
Maximum Daily/Monthly Benefit
$1,500–10,000 per month
Elimination Period
0, 30, 60, 90, 180 or 365 calendar days
  • Shop and compare multiple long-term care providers
  • Specializes in critical care, life and long-term care hybrid policies, life insurance and annuities
  • Partners with multiple LTC providers
  • No online quotes or matching tool
  • The company is an insurance broker, not a provider

Why we chose it: GoldenCare partners with insurance providers to help match customers with insurers within its network. You can get multiple quotes in one place, and a Golden Care agent is available to guide you through the process.

As an online insurance broker, GoldenCare partners with some of the most prominent companies in the market to help customers find the best options for their long-term care needs.

GoldenCare currently partners with 18 insurance providers (some of which are part of our top picks), including Mutual of Omaha, Transamerica, Aetna, Thrivent, Securian Financial, OneAmerica and National Guardian Life Insurance Company.

The company matches clients with a long-term care specialist who will work on their care plan and recommend the insurer that best aligns with their situation. GoldenCare also includes various insurance products for Medicare clients.

GoldenCare offers critical illness insurance policies as an alternative for people who don’t qualify for long-term care insurance because of a pre-existing condition. A critical illness insurance policy may cover loss of income, co-pays, rehabilitation, travel, lodging, home modifications and medical equipment such as wheelchairs and portable oxygen.

For more information, please refer to our detailed review.

AM Best Rating
J.D. Power Score
Pool of Money/Benefit Period
Varies by company
Maximum Daily/Monthly Benefit
Varies by company
Elimination Period
Varies by company
  • Policies can cover 100% of care costs
  • Premiums are guaranteed not to increase on hybrid (life/long-term care) policies
  • Offers a money-back guarantee for hybrid policies if the insured doesn't use the policy
  • Benefit period options and covered benefits may vary by state
  • No online quotes available at this time

Why we chose it: Policyholders enrolled with New York Life don’t have to worry about the company’s ability to pay. New York Life has strong financial ratings not just from AM Best, which rates it A++, but from other financial ratings companies like Fitch (AAA), Moody’s (Aaaa) and Standard & Poor’s (AA+).

New York Life is our pick for the best long-term care insurer for financial stability. It has superior financial ratings — the third-highest of any insurance company on our list, regardless of type — and is one of the nation’s oldest mutual insurance providers. The company also ranks above industry average in J.D Power’s 2022 U.S. Individual Life Insurance Study.

New York Life offers two types of long-term care insurance options: traditional stand-alone policies and a combination long-term care and life insurance policies. Maximum daily benefits range from $50 to $400 per day and waiting periods between 0 and 365 days. You can choose a benefit period of two, three, five, seven, or 10 years.

AM Best Rating
A+ (Superior)
J.D. Power Score
Pool of Money/Benefit Period
2, 3, 5, 7, or 10 years
Maximum Daily/Monthly Benefit
$1,500-$7,000 per month
Elimination Period
0, 90, 180 and 365 days
  • Premium Payment option waives premium once you meet the need for care, even if you're not yet receiving benefits
  • Long-term care policies are "participating" policies, eligible for dividends
  • Up to 20% of the maximum monthly limit can be used for caregiver education and training
  • No online quotes available at this time
  • Only two benefit periods: three or six years of protection
  • Only covers care services from providers approved by the plan

Why we chose it: Three out of four rating agencies award Northwestern Mutual top marks for financial stability while the fourth one rates it just a step below its highest grade. Such stability signals to policyholders that their money is safe and that Northwestern Mutual will be able to make future payouts.

Northwestern Mutual makes our list thanks to its superior financial strength and above-average customer service rankings. The insurer also has a remarkably low complaint index for long-term care policies, according to the NAIC’s National Complaint Index Report and ranks fourth in J.D Power’s 2022 U.S. Individual Life Insurance Study.

Northwestern's QuietCare traditional long-term care policy lets you select a maximum monthly benefit from $1,500 to $12,000 in $100 increments. It also lets you choose four elimination period alternatives: six, 12, 25 or 52 weeks. (An elimination period is the length of time between when you first need care and when the policy will start paying benefits.)

One major drawback of this policy is that it will only cover services offered by providers approved by the plan, and not all approved care providers are certified in every state.

AM Best Rating
A++ (Superior)
J.D. Power Score
Pool of Money/Benefit Period
3 or 6 years
Maximum Daily/Monthly Benefit
$1,500 – $12,000 per month in $100 increments
Elimination Period
6, 12, 25 or 52 weeks
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Other long-term care insurance companies we considered

The following companies didn’t make our list of top insurers, but they offer LTC coverage and features, like guaranteed lifetime benefits, some consumers might find attractive.

Brighthouse Financial

  • Guaranteed death benefit and terminal illness benefit
  • Ability to link the policy to an index and grow LTC benefits
  • Cash indemnity plan pays out base benefit regardless of the actual expense amount
  • No stand-alone LTC policies are available

Brighthouse Financial is an insurance company that specializes in annuities and life insurance policies. Unfortunately, its below-average customer satisfaction score, relatively low AM Best rating and high NAIC complaint ratio disqualified it from our main list.

OneAmerica (State Life Insurance Company)

  • Sells hybrid life insurance and annuity plans with LTC benefits
  • Policies underwritten by State Life Insurance Company
  • Get LTC benefits for a limited period or opt for guaranteed lifetime benefits
  • No stand-alone LTC policies are available

OneAmerica is a financial services and mutual insurance company that specializes in life insurance and annuity products. It offers hybrid life insurance policies and annuity plans, both of which include LTC benefits. Its relatively high NAIC complaint ratio and low financial strength rating kept it out of our main list.

Lincoln Financial Long-Term Insurance

  • Income tax-free reimbursements are available for approved long-term care costs
  • Benefits are available internationally
  • Two inflation protection options: simple (3%) or compound (3% or 5%)
  • Product features and benefits may vary by state

Although Lincoln Financial has attractive product offerings and a great financial stability rating, the customer satisfaction rating of 764/1000 is ten points lower than the industry’s.


  • Offers a rider to switch from daily benefits to monthly benefits
  • Policies are highly customizable and eligible for discounts
  • Pool of money varies by state

Transamerica allows policyholders to customize their long-term care insurance coverage based on the price range they can afford. However, its low J.D. Power score and high NAIC complaint ratio kept it out of our main list.

California Long Term Care Insurance Services (CLTC)

  • Works with different carriers
  • Offers critical illness insurance, annuities and life insurance with LTC riders
  • Plan information on the site is lacking

California Long Term Care Insurance Services, also known as CLTC Insurance Services, is an independent insurance brokerage that specializes in selling long-term care insurance and related products in the state of California. Since CLTC’s services are limited to one state, it did not make our main list.

Long-Term Care Insurance Guide

According to the Administration of Community Living (ACL), a branch of the U.S. Department of Health and Human Services, most people over 65 will require long-term care sometime in their lives, with women needing care longer than men and having to pay more as a consequence.

Despite this, long-term care insurance isn’t as widely known as other types of insurance. Keep reading to understand how long-term care insurance works, how much it costs and what services are eligible for coverage.

What is long-term care insurance?

Long-term care insurance provides coverage for home health care or facility care if you have a chronic health condition, cognitive impairment and can no longer perform at least two of the six basic activities of daily living: personal hygiene, dressing, grooming, using the bathroom, walking or eating.

Many people erroneously believe that Medicare will cover these expenses when the time comes. However, Medicare will not cover most costs associated with long-term care, and many patients end up paying for these costs out of pocket.

How does long-term care insurance work?

Long-term care coverage pays for costs that regular health insurance doesn’t, such as:

  • personalized care in your home by a family member or a healthcare professional
  • a nursing facility
  • an assisted living facility
  • an adult day care center

It works much like other types of insurance policies — you’ll pay a monthly premium and the policy will pay for your expenses once you file a claim.

The policy will only go into effect after the elimination period (the time between when you first need care and the point when the policy starts paying benefits). This elimination period is also known as the deductible or waiting period and it can be between 30 and 90 days, depending on your policy.

The benefit period — the number of years the insurance company will payout — starts once the elimination period ends and ranges from five to seven years, depending on the provider. In the past, the benefit period could also be unlimited (lifetime long-term care coverage) but insurers rarely offer it now.

There are specific events that can activate your benefits. These typically include having a cognitive impairment or not being able to perform two to six activities of daily living.

How do long-term care insurance state partnership plans work?

Most states’ Medicaid programs have partnership programs with long-term care insurance providers. These programs aim to promote the purchase of these types of policies.

As a needs-based program, Medicaid has strict financial guidelines — in other words, in order to qualify, the income and assets of potential recipients must not exceed a certain amount.

Participants in these state partnership programs, however, can keep assets beyond those limits set by Medicaid. These partnerships may also protect participants’ assets from Medicaid’s estate recovery program.

State partnerships use the “dollar for dollar” model — for every dollar that the participant’s policy pays out, one more dollar in personal assets is exempt when calculating eligibility. So, if you or your loved one’s policy pays $100,000 for long-term care expenses, Medicaid would disregard an additional $100,000 in personal assets when calculating eligibility.

What does long-term insurance cover?

Long-term care benefits cover the following services:

  • Custodial care - Refers to assistance with daily living activities such as bathing, dressing and eating. The caregiver doesn’t need to be licensed
  • Skilled nursing - Defined as care that’s provided by a licensed medical professional

Such medical and non-medical services may be provided in a variety of settings such as:

  • Assisted living facilities
  • Nursing homes
  • The beneficiary’s home

Finally, the policy may also cover the following more specialized services:

  • Hospice care
  • Respite care
  • Alzheimer's and dementia care
  • Family member training, equipment and home modifications

Types of long-term care insurance

There are two main kinds of LTC insurance policies: stand-alone and hybrid. Understanding which type of LTC policy is right for you and your loved ones can help you make the right decisions and provide you with peace of mind.

Stand-alone long-term care insurance policies

A traditional long-term care insurance policy can reimburse you for some of the costs of the care you receive at home, at a nursing home or in a residential care facility.

This type of policy usually offers some flexibility when it comes to the kind of care you receive, when and where you receive it and for how long.

Stand-alone long-term care insurance policies provide a monthly benefit amount that is paid out during a benefit period. Benefit periods typically range from two to five years, and benefits are disbursed after an elimination period, which customarily ranges between 30 days to 90 days.

You may add riders to your LTC policy that increase or modify coverage, such as one that adds inflation protection to prevent your benefit from losing value as the cost of living increases.

Hybrid long-term care insurance policies

Hybrid long-term care policies typically combine two types of coverage: a life insurance policy or a qualifying annuity and a long-term care rider.

The advantages of a hybrid life/long-term care insurance policy include:

  • The policy will pay out a death benefit to your beneficiaries if the policyholder doesn't use the long-term care insurance benefits.
  • Premium payments are guaranteed not to increase over the life of the policy.

But hybrid long-term care insurance policies also have drawbacks, at least for some:

  • Premiums can be far higher than those for stand-alone long-term care insurance.
  • Buying life insurance late in life is much more expensive than buying when younger

Ultimately, the choice to purchase a stand-alone policy or a hybrid one will depend on your personal and financial goals. An insurance agent can guide you toward the best option for you.

If you're in the market for a life insurance policy, click here to see our ranking of the best life insurance companies.

How much is long-term care insurance?

In their annual analysis of long-term care insurance costs, the American Association for Long-Term Care Insurance (AALTCI) found that in 2023 a premium for a policy benefit equalling $165,000 would cost a 55-year-old couple $2,080 (combined), while individual policies would cost $900 for a 55-year-old male and $1,500 for a woman of the same age.

However, it’s important to compare the insurance premium to the costs of long-term care itself, as these are rising consistently year after year.

The Projections of a National Health Expenditures study published in 2022, predicts that the average cost of assisted living facilities will show an average 4.7% increase every year until 2030. Meanwhile, home healthcare expenditures will show a steeper rise, at an average rate of 7% each year.

Long-term care costs can vary depending on the services provided and where they are rendered, whether in-home, at an assisted living facility or at a nursing home facility.

According to Genworth's Cost of Care Survey, the daily median cost for homemaker services is $163, while a home health aide costs $169. Assisted living costs are lower, with a daily average of $78 for adult day care and $148 for assisted living facilities.

The average annual cost of various care options is as follows:

  • Homemaker services: $59,488
  • Home health aide: $61,766
  • Adult day health care: $20,280
  • Assisted living facility: $54,000
  • Semi-private room in nursing home: $94,000
  • Private room in a nursing home: $108,405

Long-term care insurance cost factors

The following are some of the many factors that determine your LTC insurance premiums:

Age and health

Planning ahead pays off — the younger you are, the less expensive your premium will be. Moreover, according to data from the 2022 Milliman LTC Survey reported by the AALTCI, nearly half of the individuals who apply for traditional long-term care insurance after age 70 are denied by an insurer. You may need to undergo a medical exam to receive coverage.



The 2021 data released by the National Center for Health Statistics, shows that, on average, women outlive men by almost six years. Since the odds of a woman making a claim are higher than those of a man, premiums for women tend to be more expensive.


Marital status

The cost of long-term care insurance tends to be lower for married couples than for single people.


Insurance company

Prices vary depending on how the insurer prices risk and the benefits the policy offers. It's important to compare at least three quotes from different carriers to ensure you’re getting the best price.


Selected coverage

The cost of long-term care insurance also depends on the policy's term length, the amount of coverage you select and whether or not you purchase additional policy riders such as inflation protection or return of premium death benefit.

Is long-term care insurance worth it?

Many people don't like to think about the prospect of needing care later in life, but the likelihood of needing care is high. Research shows that 70% of people aged 65 and older will need some form of long-term care, with women needing 1.5 more years of care than men.

According to financial expert Greg Klingler, "Purchasing insurance is about managing your risk. If you ask someone who has been confined to a long-term care facility if it is worth it, the answer will be a resounding yes. But if you ask someone who never had the need, the answer will be no."

How to choose the best long-term care insurance policy

There isn’t an absolute best long-term care insurance policy because people have different needs and priorities.

When you are ready to buy a long-term care insurance policy, it’s important to consider personal factors that will help narrow down the best options for you. Most long-term care is provided at home by family and friends. If family care is unavailable, paid assisted living may be your best option. Different policies may cover different types of long-term care services.

When evaluating costs, remember that insurance premiums will likely increase over time. Your financial situation may also change. Consider present and future sources of income and how they may impact your ability to afford higher premiums. Here are some additional factors to keep in mind:

  • Establish a timeline: Experts suggest buying long-term care insurance in your 40s or 50s before age-related health conditions increase premiums.
  • Research the lender’s stability: You’ll want to buy insurance from a financially stable company. All plans must also comply with state and consumer protection laws.
  • Understand the elimination period: This is how long you must wait before receiving benefits. Most wait times range from 0 to 365 days, with longer periods resulting in lower premiums.
  • Compare different policies from multiple insurers: Some insurers offer discounts that can lower your monthly payment. Make sure you are getting the best possible deal.
  • Consider hiring a financial advisor: A financial advisor will help you to assess your situation and find the right policy for you.

What can disqualify you from long-term care insurance?

Insurance companies price risk differently, which means some may be more lenient than others when it comes to certain risk factors. In general, long-term care insurers will pay special attention to your medical history and any family history of debilitating illness.

Being in poor health or needing help with daily living activities could make it harder to get approved for coverage or qualify for lower premiums.

Alternatives to long-term care insurance

If private insurance isn’t the right solution for your long-term care insurance needs, there are a few alternatives available.

Medicare and Medicaid

As a joint federal and state public insurance program for low-income Americans, Medicaid is the largest public payer for long-term care services, but not all nursing homes accept it.

Eligibility for Medicaid is strictly needs-based. However, if you haven’t qualified for the program in the past, you may qualify now (or in the future) if you spend a significant portion of your assets paying for care. For more information on the coverage in your state, contact your state’s Medicaid office.

Medicare, on the other hand, doesn’t cover most long-term care expenses, offering coverage for short-term skilled nursing care only — applicable in case of illness or injury and if you meet certain conditions, primarily if you need skilled services or rehabilitative care.

Veterans Health Administration

The Veterans Health Administration and other state-run assistance programs offer aid to cover long-term care expenses to qualifying veterans.

Among other benefits, it offers The Veterans Aid & Attendance Pensions Benefit, a federal program that provides long-term care assistance coverage for veterans and their spouses.

The benefit is tax-free and can be used for in-home care, assisted living or in paying for a private nursing home facility.

To qualify, the veteran must meet receive a VA pension, meet certain financial criteria and meet at least one of the following requirements:

  • Needs help in performing daily living activities
  • Has to stay in bed (or spend most of the day in bed) due to an illness
  • Is a patient in a nursing home due to a disability
  • Has limited eyesight even with glasses or contact lenses


People who have plenty of money saved for retirement can likely bear the costs of long-term care without help.

This is especially true if you own the house you live in, are willing to sell it to cover any long-term care costs (and have someone who can help facilitate the sale and help you move into an assisted living facility.)

The best tools to build a retirement nest are long-term investment plans such as a 401(k) or an IRA, but a savings account may come in handy if you need an additional safety net to withdraw from at will. Check out our reviews for best savings accounts and best high-yield savings accounts to see which offers the best benefits.

Additionally, if you have a health savings account (HSA), you may be able to claim a large portion of medical expenses associated with long-term care, thus allowing you to tap into the pre-tax benefits associated with HSA accounts. In fact, those who are 55 and older are allowed an additional $1,000 for “catch-up” contributions above the 2023 HSA individual contribution limit of $3,850.

Obviously, self-funding isn't an option for those who lack such resources, or who prefer not to risk depleting savings to pay for long-term care, perhaps because it's a priority for them to pass along their wealth to heirs.

Latest News About Long-Term Care Insurance

Working Americans are saving less for retirement in the current economic climate, according to a recent Fidelity report. That said, the savings rate varies between generations — millennials and boomers decreased their savings rate while members of Gen X increased it by 1.4%.

Out-of-pocket costs have been rising rapidly in recent years, which could prove particularly difficult for retirees who live on fixed incomes. AARP recently analyzed the out-of-pocket costs for people enrolled in traditional Medicare and found that the average Medicare recipient pays over $6,500 out of pocket for health care annually. This includes monthly premiums, co-pays, coinsurance, deductibles and other services not covered by traditional Medicare.

If you suffer from a long-term illness or injury that prevents you from working, long-term disability insurance can provide financial support. To learn more about the best long-term disability insurance companies available, check out our roundup of the top five options.

Long-Term Care Insurance FAQ

What happens to unused long-term care insurance?


A typical long-term care insurance policy is commonly called a "use it or lose it" policy. The benefits will go unused if you die before making a claim and you won't get any money back if you cancel the policy, either.

One way to recoup the value of long-term care coverage is to get a policy with shared spousal benefits. This way, the coverage benefits are transferred to the surviving spouse. Another alternative is to get a return of premium benefit. Your heirs would receive all the premium payments you made over the life of the policy, minus any benefits you might've claimed while still living.

The third option is a hybrid policy that adds two assets unique to life insurance: a death benefit and cash value. Your beneficiaries can claim the death benefit if you die prematurely. And if you're strapped for cash, you can borrow against the policy's cash value to cover expenses unrelated to long-term care.

When should I buy long-term care insurance?


Most people will need some form of long-term care, but not everyone is a prime candidate for an LTC policy. Buying long-term care insurance is recommended for healthy people between the ages of 55 and 65.

You'll find that premiums are lower for younger people; however, get the insurance too soon, and you'll be paying premiums a long time before you collect the benefits. That being said, you shouldn't wait too long to make a long-term care plan – almost half of the applications for insurance were declined for those aged 70 or older.

What is long-term acute care?

Long-term acute care (LTAC) facilities provide specialized, intensive care for patients with serious health conditions. Most patients in these facilities have been transferred from Intensive Care Units (ICUs) and still need 24-hour care, often with specialized equipment.

How much does Medicare pay for long-term nursing home care?

Original Medicare does not cover long-term nursing home care; however, it could cover short-term skilled care at a nursing home or in your own home, provided you meet certain criteria. If you or your loved one is enrolled in a Medicare Advantage Plan (Part C) or other Medicare health plan, you should ask the plan directly whether they'll cover nursing home costs.

How We Chose The Best Long-term Care Insurance Companies

To select the best long-term care insurance companies of 2023, we looked into the company’s financial strength, as evidenced by AM Best's ratings.

We also considered the customer satisfaction ratings from J.D. Power’s 2022 Individual Life Insurance Study and the complaint index reported by the National Association of Insurance Commissioners (NAIC), a regulatory organization that gathers complaint reports from state health departments.

Summary of Money’s Best Long-term Care Insurance of June 2023