Best Long-Term Care Insurance Companies Of 2024

• Bankers Life – Best for Maximum Issue Age
• National Guardian – Best for Maximum Benefits Period
• Thrivent Financial – Best for Minimum Issue Age

Long-term care (LTC) insurance is a policy that covers expenses related to long-term care. Most LTC insurance policies cover services like adult day care, hospice, nursing home stays and help with activities of daily living (ADLs), like dressing and eating.

The average cost of a private room in a nursing home is $7,698 a month and a home health aide costs more than $20 an hour on average, according to the Association for Community Living (ACL).

Having an LTC insurance policy can dramatically reduce what you have to pay for long-term care.

Stand-alone long-term care insurance isn’t widely available anymore. Only about a dozen private insurance providers offered long-term care insurance policies in 2020 and that number has dwindled even more over the past two years. The American Association for Long Term Care Insurance (AALTCI) says only six companies currently sell standard long-term care insurance policies:

• ​​Bankers Life
• Mutual of Omaha
• National Guardian Life
• New York Life
• Northwestern Mutual
• Thrivent

Types of Long-Term Care Insurance

There are multiple ways to get long-term care insurance.

• Stand-alone long-term care insurance policy: This type of coverage provides only long-term care insurance. You can generally add an inflation rider that increases benefits over the years, such as by 3% or 5%. Putting that rider on a LTC policy will likely increase your cost since it bumps up the policy’s value.
• Linked benefit life insurance: A combination life insurance policy, also called a hybrid life insurance policy, is life coverage combined with long-term care insurance. Using the policy for LTC services reduces the death benefit. If you don’t need LTC, your survivors get the full death benefit when you die.
• Life insurance policy with LTC rider: You can often buy life insurance coverage with a long-term care rider. Life insurance riders don’t typically offer as much coverage as a hybrid life insurance/LTC policy, but is likely more affordable than a hybrid policy.
• Critical illness insurance: Critical illness insurance can be used to to pay for long-term care if you’re diagnosed with a specific illness that’s listed in the policy, such as cancer or a heart attack. These types of policies pay a lump sum, such as $25,000 or $30,000. Critical illness policies don’t continue to pay over a benefits period, like LTC insurance does, so they don’t offer as much coverage as other options.

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LTC insurance benefits can only be used when you experience a benefit trigger. These triggers will be listed in the policy. LTC insurance policies have benefit triggers such as:

• Needing assistance with at least two ADLs for 90 days (personal hygiene or grooming, dressing toileting, eating and transferring, which means the ability to move from a bed to chair or wheelchair).
• Experiencing a cognitive impairment.
• Recommendation from a medical doctor.

Before LTC benefits begin, you might have a waiting period, called an elimination period. The waiting period might be anywhere from 20 to 100 days before the policy starts paying for long-term care. Once the waiting period ends, your insurance company covers costs.

The length of time LTC benefits are in effect varies by policy. Some long-term care insurance policies cover only qualifying expenses for a few years or until you reach a maximum benefit limit. Other policies provide coverage for your lifetime.

How Long-term Care Insurance Benefits Are Paid

Long-term care insurance payments work in one of three ways:

• Expense-incurred: Pays the lesser of either the expense or policy’s value amount.
• Indemnity method: Pays solely based on a set dollar amount.
• Disability method: Pays the full daily benefit amount if you meet the benefit eligibility criteria regardless of whether you’re receiving long-term care.

Maximum LTC Benefits

Long-term care insurance policies generally have a maximum benefit limit, which is the most the policy will pay out if you need services. Policies may limit coverage for a number of years, while others have a dollar ceiling. Long-term care policies often pay benefits by day, week or month, though some policies may pay one time for single events.

Long-term care policies let you choose a benefit amount for nursing care, but they may also pay for home care coverage. Home care coverage may pay at the same level as nursing care or may be capped at a percentage of nursing care coverage, such as 50%.

Inflation Protection

Inflation can play a role in how much your policy pays. If the benefits don’t increase over time from when you buy the policy, it may not offer enough protection decades later when you need long-term care. That’s why long-term care insurance policies often offer inflation protection.

Inflation protection keeps long-term care payments at pace with inflation. Automatic inflation protection increases benefit amounts each year without a higher cost to policyholders. This feature may increase by a fixed amount each year, such as 3%, for a limited time or for the life of the policy.

Another option for inflation protection is to increase long-term care benefits every few years. This special offer option may require that you prove your health hasn’t deteriorated. Going this route will likely increase your long-term care insurance costs. The specific increase depends on your age and how much you increase benefits.

Long-term care insurance covers many expenses commonly associated with long-term care, whether you need assistance at home or in a facility, such as:

• Nursing home care
• Hospice care
• Home health aides
• Respite care
• Adult daycare centers
• Physical therapy
• Occupational therapy
• Speech therapy

It’s important to check the policy for exclusions before you buy it. For example, some long-term care insurance policies may only pay for care in a state-licensed facility, while others will only cover care in specific state-licensed facilities. Some policies may exclude coverage for care received in a facility considered a rest home or personal care home.

Long-term care insurance can’t be used in some situations, such as:

• Mental health or nervous disorders (besides dementia)
• Alcohol or drug addiction
• War-related illnesses or injuries
• Self-inflicted injuries
• Treatment in a government facility
• Treatment that has already been paid for by the government
• Long-term care treatment outside the U.S. except some policies that cover care in Canada and the United Kingdom.

• The average LTC insurance cost is $1,900 a year for a 60-year-old female.
• The average cost is $1,175 a year for a 60-year-old male.
• The average cost for a 60-year-old couple is $2,600 annually, combined.

Those averages are for long-term care insurance policies with $165,000 level benefits, according to the American Association for Long Term Care Insurance (AALTCI).

You can also add a policy provision that increases the benefits by a percentage, such as 3% each year, to offset inflation.

Average Annual Costs for Long-Term Care Insurance

Benefits	Cost per year for a 60-year-old female	Cost per year for a 60-year-old male	Cost per year for a couple age 60
$165,000 level benefits	$1,900	$1,175	$2,600
$165,000 benefits with 1% increase yearly	$2,550	$1,600	$3,525
$165,000 benefits with 2% increase yearly	$3,300	$2,000	$4,525
$165,000 benefits with 3% increase yearly	$4,300	$2,525	$5,800
$165,000 benefits with 5% increase yearly	$6,600	$3,800	$8,750
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Source: American Association of Long Term Care Insurance.

Although long-term care insurance can be expensive, it may be worth the cost when considering the prices of common long-term care services.

Average Long-Term Care Costs

How much does long-term care cost with insurance? That depends on the specific policy. Here’s an example.

Imagine you have an LTC insurance policy that provides $5,000 per month for nursing home care and your nursing home expenses are $7,800 per month. In this case, your LTC insurance policy would cover the first $5,000, leaving you to pay $2,800 out-of-pocket.

LTC insurance premiums are unique to each individual. When you apply, the insurance company reviews multiple factors to determine how much you should pay. If you’re shopping for the best long-term care insurance, these factors will typically be used for pricing.

Age and Health

Your age and health has a big impact when you purchase LTC insurance. You may not qualify for LTC insurance if you have pre-existing health conditions.

Older buyers pay more for coverage. But there’s a catch—buying a policy at a younger age, such as when you’re in your 50s, means you will likely pay premiums for a longer time until you need care.

There’s also a chance you’ll get denied coverage if you try to get long-term care in your 70s. AALTCI estimates that 47.2% of LTC applicants between the ages of 70 and 74 were denied coverage in 2021.

Percentage of Long-Term Care Insurance Applicants Denied by Age

Gender

Women tend to pay higher rates for long-term care insurance because women statistically live longer than men, and therefore may need LTC coverage for a longer period.

Women also tend to experience more chronic health problems than men. Insurance companies price LTC policies higher for women to prepare for the increased likelihood of a benefit trigger during their lifetime.

Individual or Joint LTC Policy

If you’re married and apply for a joint long-term care insurance policy, the premium is usually cheaper than the cost of separate polices for two individuals. The AALTCI estimates that the average cost of a joint LTC insurance policy for a healthy 55-year-old couple is $2,080 per year for benefits of $165,000.

By comparison, the average cost for an individual male is $950 per year and $1,500 per year for females of the same age. A couple buying two individual policies can expect to spend more than $2,450 a year, so going with a joint policy can save money.

Type of Coverage

The cost of long-term care coverage also depends on the specific policy and coverage. This may include a policy’s:

• Pre-set daily limit.
• Maximum benefits, such as lifetime or for a limited time, such as up to two years.
• Elimination period, which is usually between 30 and 90 days.
• Riders you add like inflation protection, which increases long-term care benefits each year based on inflation.

Insurance Company

Insurance companies use different rating systems to calculate premiums. To find the best LTC insurance cost, it’s a good idea to get quotes from a few different long-term care insurance companies.

The AALTCI noted in its 2023 Long-Term Care Insurance Price Index report that prices for the same level of coverage vary significantly. “In some cases, one insurer literally charges more than twice the cost of another for virtually identical coverage,” Jesse Slome, AALTCI director, said in a statement. “I am not sure what accounts for such a significant difference but it reinforces our belief that consumers should do comparison shopping before making a decision.”

Increases in Cost of Care

Long-term care insurance premiums aren’t always fixed, so your rate can increase in the future. These rate increases are often tied to the rising cost of long-term care expenses over time. This can make it hard to budget for the future.

Not everyone can buy LTC insurance. You may not be able to find an LTC insurance policy if:

• You’re currently receiving long-term care services.
• You are in poor health.
• You have pre-existing conditions.
• You are over age 80.

When you apply for long-term care insurance, you need to answer health-related questions to determine your eligibility. You may still qualify for LTC insurance with minor medical conditions, but you will probably pay a higher premium.

If you don’t think you’ll be able to afford long-term care when you’re older, LTC insurance may be a good investment. Long-term care expenses can add up quickly and deplete your savings, especially if you need permanent care in a nursing home or assisted living facility.

You might also consider long-term care insurance if you don’t want to burden your family with long-term care costs as you age. If your children or surviving loved ones can’t afford to pay for your long-term care, LTC coverage can provide financial peace of mind as you age.

There are several alternatives to LTC insurance. Here are a few ways you can pay for long-term care without purchasing insurance.

Annuity with a Long-term Care Rider

Some annuity contracts offer the option to add a long-term care rider, which provides coverage for qualifying long-term care expenses. An annuity with an LTC rider can be a good option if you want to supplement your income during retirement but don’t want to use your savings to pay for long-term care expenses.

Continuing Care Retirement Community

Continuing care retirement communities allow people to live independently as they age while providing on-site medical care when their medical needs advance. Depending on the community, some residents must purchase long-term care insurance to pay for their future medical care while living in the community.

Personal Savings

Rather than investing in an annuity or an insurance policy, some people prefer to pay for their long-term care expenses entirely out-of-pocket. Although long-term care can be expensive, paying insurance premiums for decades before the benefits are needed can also be a major expense.

If you choose to rely on savings for LTC expenses, make sure to have a solid financial plan going into retirement.

Veterans Affairs Health Care

If you served in the military and are enrolled in VA health care, you can access long-term care through the VA. Many of the services covered by the VA are the same ones covered by long-term care insurance, like nursing home stays, pain management, help with ADLs, adult daycare programs and physical therapy.

Medicare

Medicare doesn’t automatically cover long-term care, but some forms of assistance are covered if you meet the requirements. For example, Medicare Part A may cover short-term skilled nursing care based on a qualifying hospital stay. However, don’t rely on Medicare for long-term care needs due to the limited circumstances it covers.

Medicaid

If you qualify for Medicaid, you can get access to long-term care benefits, but you must meet the income requirement. This often means spending down most of your assets before Medicaid will take over the payments. Medicaid usually pays for nursing homes and some home health and community health services.

Some states have a partnership with long-term care insurance companies. If you live in one of these states, buying a “partnership policy” prevents you from having to spend down your assets to qualify for Medicaid once you cannot pay for long-term care on your own.

For example, imagine you’re using your long-term care insurance to pay for a nursing home and the insurance company has already paid $70,000 in benefits. Under a state partnership program, you could keep that $70,000 in savings (or investments) and still qualify for Medicaid if your income allows. This is called reciprocity.

To find the best long-term care insurance companies, we evaluated stand-alone LTC policies. Our evaluation was based on:

Premiums for a 60-year-old female and 60-year-old couple (50% of score): We used long-term care insurance rates for a policy without annual benefit increases for the most common rating class with $100 per day benefits or the weekly/monthly equivalent and a 90-day elimination period.

Lowest elimination period (20% of score): We compared each policy’s lowest elimination period, which is the time before you can use long-term care insurance benefits.

Maximum benefits period (20% of score): We looked at each policy’s maximum benefits period, which is how long you’re able to use long-term care insurance benefits.

Maximum issue age (10% of score): We evaluated each policy’s maximum issue age for buying the policy.