70% of people over the age of 65 will require some form of long-term care and support later in life, according to LongTermCare.gov.
Long-term care insurance can help you pay for the costs associated with your long-term care as you get older and need help with everyday activities —such as bathing, dressing and eating— or care related to diseases like Alzheimer's, Parkinson's and dementia.
Read on to learn about the best companies offering long-term care insurance products.
Our Top Picks for the Best Long-Term Care Insurance Companies
- Nationwide: Best for Customer Satisfaction
- Pacific Life: Runner-up for Customer Satisfaction
- Mutual of Omaha: Best for Discounts
- Golden Care Insurance: Best Marketplace
- New York Life: Best for Financial Stability
- Northwestern Mutual: Runner-up for Financial Stability
Best Long-Term Care Insurance Reviews
- Offers universal and variable universal life insurance policies with LTC rider
- Choose between reimbursement and cash indemnity benefits
- Quotes available online
- Rider not available in every state
- A.M. BEST RATING
- J.D. Power Rating
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 2021 U.S. Life Insurance Study. As a well-known national insurer, Nationwide's reputability adds an extra layer of assurance for customers looking to invest in financially secure products.
Nationwide sells universal life insurance policies with long-term care riders. The rider is not available in any state, and coverage varies depending on your location. Generally, however, it offers two plans: reimbursement, which requires you to submit your long-term care bills every month, and cash indemnity, which pays out a monthly benefit and doesn’t require you to submit invoices.
- 100% return of premium benefit if LTC funds are never use
- Expert care coordinators available for arranging long-term care
- Application not available online
- Products not available in all 50 states
- A.M. Best Rating
- J.D. Power Rating
Pacific Life sells life insurance, annuities and mutual funds. It offers three whole life insurance policies that include long-term care benefits, giving consumers a range of options from which to choose.
One of our favorite features about Pacific Life is the expert care coordinators that help you to arrange long-term care, process claims and find caregiver courses for your loved ones to care for you, among other services.
Pacific Life is also among the highest rated companies in J.D. Power’s Life Insurance Study and is rated A+ in financial stability by A.M. Best.
- Offers a discount of 30% for couples who purchase the same policy
- Offers a discount of 15% to individuals in good health
- Choose your benefit payment method from month to month (cash or reimbursement)
- Couples discount is only available if married or if living together for 3 years
- A.M. Best Rating
- J.D. Power Rating
Mutual of Omaha offers three types of discounts that amount to 30% in potential savings. It also came in fifth place for customer satisfaction in J.D. Power’s 2020 U.S. Life Insurance Study and has a strong financial strength rating.
Mutual of Omaha offers 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
- Specializes in critical care, life and long-term care hybrid policies, life insurance and annuities
- Doesn't offer policies directly but connects customers with insurance carriers instead
- A.M. Best Rating
- J.D. Power Score
As an online insurance broker, Golden Care partners with industry leaders to help customers find the best options for their long-term care needs.
The company assigns clients a long-term care specialist that will work with them on their care plan and guide them toward the insurer that best aligns with their situation.
Golden Care partners with Mutual of Omaha, Transamerica, Aetna, Thrivent, Securian Financial, OneAmerica and National Guardian Life Insurance Company.
- Policies can cover 100% of care costs
- Premiums are guaranteed not to increase on combination policies
- Benefit period options and covered benefits may vary by state
- Offers a money-back guarantee for hybrid policies if the insured doesn't use the policy
- A.M. Best Rating
- J.D. Power Score
New York Life is our top 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.
New York Life offers two types of long-term care insurance options: traditional stand-alone policies and combination long-term care and life insurance policies. Maximum daily benefits range from $50 to $400 per day and waiting periods between 90 and 180 days. You can choose a benefit period of 2, 3, 5 or 7 years.
- Premium Payment option waives premium if you become eligible for benefits
- Long-term care policies are "participating" policies, eligible for dividends
- Offers a Caregiver Training Benefit equal to 20% of the Maximum Monthly Limit
- Doesn't provide online quotes
- Only two benefit periods: three or six years of protection
- Only covers care services from providers approved by the plan
- A.M. Best Rating
- J.D. Power Score
Northwestern Mutual makes our list thanks to its superior financial strength and above-average customer service rankings. It also has a remarkably low complaint index for long-term care policies, according to the NAIC’s National Complaint Index Report.
Northwestern's QuietCare traditional long-term care policy lets you select a maximum monthly benefit from $1,500 to $12,000 in $100 increments. And it offers four elimination period alternatives: 6, 12, 25 or 52 weeks.
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.
Other companies we considered
While these companies didn’t make our list of top insurers, they offer coverage and features some consumers might find attractive.
- 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 A.M. 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
- Receive 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. It’s 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, its extremely high NAIC complaint ratio (16.31) automatically disqualified it from our main list.
- 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 is allows policyholders to customize their long-term care insurance coverage based on the price range they can afford. However, it’s low J.D. Power score and high NAIC complaint ratio kept it out of our main list.
LTC Resource Center
- Works with different carriers
- Offers hybrid life and LTC, state partnership, and tax-qualified policies, among others
- Information on the site is scarce
LTCResourceCenters.com is an independent managing general agency. The company has authority from an insurer to underwrite and price policies, administer programs and settle claims. The lack of information about plans on its site kept the company from making our top 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
Long-term care insurance isn’t as widely known as other types of insurance. Below, we’ve compiled the most important information you need to know to understand and purchase a long-term care insurance policy.
What is long-term care insurance?
Long-term care insurance provides coverage for home health care or facility care if you can no longer perform at least two of the six basic activities of daily living: personal hygiene, dressing, using the toilet, ambulation/transferring, continence and eating.
Many people erroneously believe that Medicare will cover all of these costs when the time comes. However, there are limitations to what Medicare and other government programs will cover when it comes to long-term care, and half of the patients end up paying for these costs privately. Long-term care insurance is a dedicated product that can help cover expenses related to long-term care.
How does long-term care insurance work?
A long-term care insurance policy can give you and your loved ones the financial security required to pay for professional care later in life. Still, the policy will only go into effect after the elimination period (the period of time between when the policy is bought and when it comes into effect) and when your benefits are triggered.
Depending on your policy, specific triggers make your coverage come into effect. These typically include having a cognitive impairment or not being able to perform between two to six activities of daily living.
The elimination period, also known as the deductible or waiting period, is the amount of time you must wait before you start receiving long-term care insurance benefits.
“Benefits are paid either monthly or daily, with traditional LTC insurance reimbursing the actual cost of the care up to policy maximums,” says Greg Kingler, director of wealth management at the Government Employees’ Benefit Association.
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 home, an assisted living facility or an adult daycare center.
There are two main kinds of long-term care insurance policies:
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 insurance provides flexibility concerning the kind of care you receive, when and where you receive it and for what duration.
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 combine two types of coverage, typically a life insurance policy or 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 guaranteed death benefit if the policyholder doesn't use long-term care insurance.
- Premium payments are guaranteed not to increase over the life of the policy.
- Underwriting is less strict, and pricing for women could be lower.
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 may not be the best financial move, according to many planners.
Ultimately, the choice to purchase a stand-alone policy or a hybrid one will depend on your personal and financial goals. An insurance agent will be able to guide you towards 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?
Before we go into how much a long-term care insurance policy could cost you, it’s important to put into perspective the costs of long-term care itself, as these are rising exponentially.
Between 2019 and 2020, the average cost of assisted living facilities increased by 6.15%, homemaker services by 4.44% and home health aide services by 4.35%.
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 2020 Cost of Care Survey, the daily median cost for homemaker services is $147, while a home health aide costs $150. Assisted living costs are lower, with a daily average of $74 for adult daycare and $141 for assisted living facilities.
The annual cost of various care options are as follows:
- Homemaker services: $53,768
- Home health aide: $54,912
- Adult day health care: $19, 240
- Assisted living facility: $51,600
- Semi-private room in nursing home: $93,075
- Private room in a nursing home: $105,850
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 in consequence.
As for the coasts of long-term care insurance, the American Association for Long-Term Care Insurance (AALTCI) says that, in 2019, the average annual premium for a 55-year-old couple was $3,050, while individual policies were $2,050 for a 55-year-old male and $2,700 for a female of the same age.
The following are some of the many factors that determine your LTC policy premiums:
- Age and health: The younger you are, the less expensive your premium will be, so planning ahead pays off. According to a study by the AALTCI, the highest percentages of applicants whose requests for coverage were denied were those in the 60 to 79 age bracket. You may need to undergo a medical exam to receive coverage.
- Gender: According to data from the Administration on Aging, on average, women outlive men by about five 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 for the coverage you need.
- Selected coverage: The cost of long-term care insurance will also depend on the policy's term length, the amount of coverage you select and whether or not you purchase additional coverage through a policy rider such as inflation protection.
Alternatives to long-term care insurance
If long-term care insurance isn’t the right solution for you, there are a few alternatives available, such as government programs and your own savings.
Medicare and Medicaid
As a joint federal and state public insurance program for low-income Americans who need healthcare, Medicaid is the largest public payer for long-term care services and supports, but not all nursing homes accept it. Medicare, on the other hand, only covers limited long-term services and supports.
If you buy private long-term care insurance coverage, you run the risk of “spending down” your benefits while at a nursing home. If this happens, you could qualify for Medicaid, so make sure the nursing home is eligible for this program.
In contrast, Medicare only offers very limited coverage for short-term care for an illness or injury if you meet certain conditions, primarily if you need skilled services or rehabilitative care.
These programs vary by state, and eligibility is based on your income and assets. Some states have higher income limits for nursing homes, for example.
If you haven’t qualified for Medicaid in the past, you may while receiving skilled nursing home care. For more information on the coverages in your state, contact your state’s Medicaid office.
Veterans Health Administration
The Veterans Health Administration and other state-run assistance programs offer aid to cover long-term care expenses to qualifying veterans and low-income communities.
The Veterans Aid & Attendance Pensions Benefit is another 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, community and assisted living or paying for a private nursing home facility. However, it does have some requirements. Veterans must be unable to perform at least one ADL, have served during wartime and need financial assistance.
People who are very well-funded for retirement can likely bear the costs of long-term care without help.
Such self-funding is especially viable 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 move you.
Obviously, this 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.
Although people put off purchasing long-term care insurance policies due to the potentially high cost of premiums, long-term care insurance specialist Carol Burk suggests looking into the coverage when you're in your early fifties.
For couples looking for coverage, the sweet spot is around 55 years old. Beginning to shop at this time increases the odds of buying before your health declines and your premiums rise. The younger and healthier you are, the more likely you are to get the lowest rates.
Many people put off thinking about the prospect of needing care later in life or who will provide it, 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."
Also, if you have sufficient resources, you may want to forego long-term care insurance and instead rely on tapping those assets if you indeed require such care later in life.
According to LongTermCare.gov, there's a common misconception that medical insurance will cover most of the costs of long-term care. Most private health insurers and health maintenance organizations (HMOs) exclusively cover skilled, short-term, medically-required care. Many private health insurers do not cover custodial care.
Disability income insurance, on the other hand, is designed to replace your income in the event an illness or injury renders you unable to work, not to cover long-term-care expenses. In the event your disability also requires long-term care services, the cost of care may add up.
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 to qualify for lower premiums.
Many states have partnerships with long-term care insurance companies that incentivize people to purchase long-term care. Participating insurance companies agree to specific provisions in their partnership policies that financially protect policyholders who exhaust their benefits and want to request Medicaid.
Before Medicaid starts paying benefits, it will require you to exhaust most of your assets — the specific amount varies by state. Partnership programs protect your assets up to the equivalent of your long-term care policy's total benefit amount.
For example, if your state requires you to spend your assets down to $1,500 and you have a long-term care insurance benefit that is partnership-approved for $500,000, you would be able to maintain up to $501,500 in assets and still qualify for Medicaid.
How We Chose The Best Long-term Care Insurance Companies
To select the best long-term care insurance companies of 2021, we considered the customer satisfaction ratings from J.D. Power’s 2021 Individual Life Insurance Study.
We also looked into financial strength as evidenced by A.M. Best's ratings for each company, along with the number of complaints filed against them with the National Association of Insurance Commissioners (NAIC).