According to government estimates, 70% of people over the age of 65 will require some form of long-term care and support later in life.
Long-term care insurance (LTC) can help you pay for the costs associated with your care as you get older and need help with everyday activities — such as bathing, dressing and eating — or care related to Alzheimer's disease, 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
- 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
- After the elimination period, Nationwide CareMatters pays the first three months' LTC benefit retroactively along with the first benefit payment
- Inflation protection available on their CareMatters policies
- Informal caregivers permitted
- Quotes available online
- No online chat available at this time
- 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 two long-term care options: as an LTC rider (an add-on to another policy) and a hybrid policy that includes both life insurance and LTC benefits called CareMatters.
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. You can also use your benefits to pay for care from informal caretakers, such as family members.
Note that coverage for the LTC rider isn’t available in Montana or U.S. territories.
- Offers a discount of 15% for partners who purchase the same policy
- Offers a discount of 15% to individuals in good health
- Policy includes a care coordinator
- 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: 15% for 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). Discounts are stackable, with premium discounts applied to the total premium amount and additional discounts applied to the remainder.
Mutual of Omaha also came in fifth place for customer satisfaction in J.D. Power’s 2020 U.S. Life Insurance Study and has a solid financial strength rating of A+.
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 some of the most prominent companies in the market to help customers find the best options for their long-term care needs. It partners with 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 that will work with them on their care plan and guide them toward the insurer that best aligns with their situation.
- Policies can cover 100% of care costs
- Premiums are guaranteed not to increase on hybrid (life/LTC) 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
- 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 two, three, five, or seven years.
- 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
- 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. 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.
Other long-term care insurance 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.
- 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. Its relatively high NAIC complaint ratio and low financial strength rating kept it out of our main list.
- 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) 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 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.
- 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 general agency. The company is authorized 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 list.
- 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
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.
Here's important information you need 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 have a chronic health condition, cognitive impairment and/or 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 all of these costs 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 or 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.
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.
What does long-term insurance cover?
Long-term care insurance covers medical and non-medical care in a wide variety of settings including assisted living facilities, nursing homes or at home. It may also cover specialized services such as hospice, respite or Alzheimer's and dementia care. Some policies will include benefits for family member training, equipment and home modifications.
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, potential recipients’ income and assets must be under 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.
Types of long-term care insurance
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.
Read on for more information about the two main kinds of LTC 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 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 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.
- 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 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 might 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?
The American Association for Long-Term Care Insurance (AALTCI) says that, in 2022, the average annual premium for a policy benefit equalling $165,000 would cost a 55-year-old couple $2,080 (combined), while individual policies would cost $950 for a 55-year-old male and $1,500 for a woman of the same age.
However, it’s important to compare this to the costs of long-term care itself, as these are rising exponentially.
Between 2020 and 2021, the average cost of assisted living facilities increased by 4.65%, homemaker services by 10.64% and home health aide services by 12.50%.
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 2021 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 are 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
As for the costs of long-term care insurance, the American Association for Long-Term Care Insurance (AALTCI) says that, in 2022, the average annual premium for a policy benefit equalling $165,000 would cost a 55-year-old couple $2,080 (combined), while individual policies would cost $950 for a 55-year-old male and $1,500 for a woman of the same age.
Long-term care insurance cost factors
The following are some of the many factors that determine your LTC policy premiums:
Age and health
Planning ahead pays off — the younger you are, the less expensive your premium will be. According to a study by the AALTCI, most of the 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.
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.
The cost of long-term care insurance tends to be lower for married couples than for single people.
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.
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 or return of premium death benefit.
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 to 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 only coverage for short-term care — applicable only 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.)
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 2022 individual contribution limit of $3,650.
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
- Our article, Medicare Open Enrollment Just Started, and Here’s What’s New for 2023 highlights important changes for Medicare’s new enrollment period.
- Medicare premiums are decreasing. Read more about these savings in Medicare Premiums Are Decreasing for the First Time in Over a Decade.
- Healthcare expenses keep rising for retirees. Find out more in Health Care Expenses in Retirement Average $67,000 — Even With Medicare Coverage.
- If you’re interested in learning more about whether long-term care insurance is right for you, check out our article, Will You Really Need Long-Term Care? The Odds Are Higher Than You Might Think.
- If you’re worried about Social Security funds running dry, our article The Year Social Security Will Run Out of Money Just Changed (for the Better) could give you some peace of mind.
- People who have difficulty performing activities of daily living but who still desire to live independently may benefit from having a medical alert system. Our list of the best medical alert systems can help you find the right one for you.
Long-Term Care Insurance FAQ
Is long-term care insurance worth it?
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."
Who should 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.
When should I buy long-term care insurance?
What is long-term acute care?
How much does Medicare pay for long-term nursing home care?
How We Chose The Best Long-term Care Insurance Companies
To select the best long-term care insurance companies of 2022, 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).