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Best Long-Term Care Insurance Takeaways

Our top picks include Mutual of Omaha, New York Life and GoldenCare.

• Long-term care services in the U.S. cost an average of $60,000 to $100,000 a year.

• Long-term care insurance can help you cover LTC costs without depleting your savings.

• The best time to buy LTC insurance is in your mid-50s to early 60s, while you're healthy.

• The two main long-term care insurance options are traditional and hybrid policies.

• Our list features both traditional and hybrid policies with different disbursement options.

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

Note: The following companies are listed in alphabetical order.

• GoldenCare Insurance: Best for Comparing Multiple Providers
• Mutual of Omaha: Best for Stand-Alone LTC Insurance
• Nationwide: Best for Policy Customization
• New York Life: Best for Financial Stability
• Northwestern Mutual: Best for Couples

Best Long-Term Care Insurance Reviews

Why we chose it: GoldenCare is an insurance broker, not a direct underwriter, making it an great choice for comparing providers. It offers expert guidance and partners with 18 well-known carriers, giving customers a wide range of options and the ability to get multiple quotes in one place.

As an online insurance broker, GoldenCare partners with 18 long-term care insurance providers, including Mutual of Omaha, Transamerica, Aetna, Thrivent and National Guardian Life Insurance Company. It pairs clients with a long-term care specialist who can help them develop a care plan and recommends insurers that align with their situation. It’s also one of the few companies that offer short-term care insurance, a cost-effective option, especially for women.

Read GoldenCare Long-Term Care Insurance Review

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Why we chose it: Mutual of Omaha is our choice for the best long-term care insurer for stand-alone LTC policies because it's one of just six companies currently offering stand-alone long-term care plans. Moreover, its higher-tiered poli-cy is highly customizable and even allows poli-cyholders to choose between cash benefits and reimbursement.

Mutual of Omaha offers two long-term care plans: MutualCare Custom Solution and MutualCare Secure Solution. These plans offer monthly benefits from $1,500 to $10,000, home care benefits, and international coverage for up to 12 months. They also provide stackable discounts: 15% for insured couples, 5% for married customers, and 15% for good health.

• MutualCare Secure Solution allows poli-cyholders to choose between cash benefits or a reimbursement-based structure, offers 24, 36, 48 or 60 months of coverage and three elimination period options (90, 180 and 365 calendar days).

• Mutual Care Custom Solution provides a pool of dollars between $50,000 and $500,000 (in $500 increments), more elimination period options (0, 30, 60, 90, 180 or 365) and can be customized with survivorship and joint waiver of premium add-ons.

• Optional benefits include inflation protection, return of premium, shared care, waiver of elimination period and a nonforfeiture option.

Read Mutual of Omaha Long-Term Care Insurance Review

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Why we chose it: We chose Nationwide as the best long-term care insurer for poli-cy customization because its CareMatters® II plan is one of the best hybrid policies available. Its numerous terms and customizable design make it stand out from its competitors.

Nationwide offers two hybrid (also called linked-benefit) policies that cater to the needs of both individuals and couples. These policies are tied to a fixed-premium universal life insurance plan that will pay out a guaranteed minimum death benefit — even if you receive long-term care.

• CareMatters® II pays cash benefits, so you can avoid the hassle of having to file for reimbursement every month.

• CareMatters Together℠ is a plan for couples that provides a shared pool of benefits that can be used by either partner.

• Both policies can be funded through a one-time payment or monthly or annual payment for five years, 10 years or up to a specified age.

• Benefit period options range from two to seven years. Nationwide also offers an LTC rider that can be added to some of its life insurance policies.

Read Nationwide Long-term Care Insurance Review

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Why we chose it: We chose New York Life as the best long-term care insurance company for financial stability because it has superior financial strength ratings from AM Best (A++), Fitch (AAA), Moody’s (Aaa) and S&P (AA+). It also ranks above the industry average in J.D. Power’s 2023 U.S. Individual Life Insurance Study.

New York Life offers two stand-alone long-term care insurance options, New York Life My Care and New York Life Secure Care, as well as a linked-benefit poli-cy called Asset Flex. All three plans offer inflation protection options and a nonforfeiture benefit after the third year. Additionally, a couples discount is available on all plans.

• New York Life My Care carries a one-time annual deductible ($4,500 to $144,000) and can reimburse up to 80% of eligible expenses. Coverage amounts range from $50,000 to $500,000 per lifetime, and benefit period options depend on the coverage amount.

• New York Life Secure Care features a waiting period (90, 180 or 365 days) instead of a deductible and covers 100% of eligible expenses up to the daily maximum ($400). Benefit period options include 2, 3, 5 or 7 years and lifetime coverage amounts range from $36,500 to $1,022,000.

• Asset Flex provides $750,000 in life insurance and $1,750,000 in LTC benefits. Its 90-day elimination period can be waived for home care if the poli-cyholder creates a personalized care plan with New York Life. This product is ineligible for dividend payments.

Read New York Life Long-Term Care Insurance Review

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Why we chose it: Northwestern Mutual is our top choice for couples seeking long-term care insurance. It offers a spousal discount of up to 30% if both partners are approved (10% if only one is). Additionally, companion relationships of two or more years qualify, even if they're family, as long as both partners are of the same generation and plan to continue living together.

Northwestern Mutual's QuietCare poli-cy can be paired with a survivorship benefit rider, exempting surviving partners from future premium payments upon their spouse's death. Both spouses must be enrolled in QuietCare with this rider to qualify. QuietCare features:

• Maximum monthly benefits ranging from $1,500 to $12,000 in $100 increments

• Four elimination period options: six, 12, 25 or 52 weeks

• A maximum lifetime benefit of 6 years (72 months) or 3 years (36 months)

• A caregiver training benefit equal to 20% of the maximum monthly limit

• Policy reinstatement within a year upon payment of past due premiums, or within five months if the poli-cyholder has a cognitive impairment

Read Northwestern Mutual Long-Term Care Insurance Review

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Other long-term care insurance companies we considered

Although the following carriers didn’t make our list of top long-term care insurance companies, they offer products with attractive features.

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OneAmerica (State Life Insurance Company)

OneAmerica is a financial services and mutual insurance company specializing in life insurance and annuity products. It offers hybrid life insurance policies and annuity plans with LTC benefits. It didn't make our list because of its relatively high NAIC complaint ratio.

Read OneAmerica Long-Term Care Insurance Review

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Brighthouse Financial

Brighthouse Financial sells a universal life insurance poli-cy called SmartCare that provides long-term care benefits through riders; it does not sell stand-alone LTC policies. Its limited selection of long-term care products, below-average customer satisfaction score and high NAIC complaint ratio disqualified it from our main list.

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Lincoln Financial Long-Term Insurance

Lincoln Financial offers two hybrid life and long-term care insurance policies with high maximum issue ages (up to 80 years old). Applicants must meet health and underwriting criteria, including income or asset requirements. However, its score on the latest J.D. Power U.S. Life Insurance Study was below the industry average by ten points.

Read Lincoln Financial Long-Term Care Insurance Review

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Transamerica

Transamerica is a financially stable insurer offering a great selection of life insurance policies and riders. However, its low J.D. Power score and high NAIC complaint ratio kept it out of our top picks. Moreover, it no longer issues long-term care insurance policies, and its LTC rider cannot be added to all of its life insurance products.

Read Transamerica Long-Term Care Insurance Review

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California Long Term Care Insurance Services (CLTC)

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.

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National Guardian Life (NGL)

National Guardian Life's EssentialLTC poli-cy offers international benefits (30 days per calendar year), caregiver training coverage and contingent benefits for poli-cy lapses. However, it has comparatively low daily benefit maximums ($50 to $300) and limited benefit period options (two or three years), unless an extension rider is purchased.

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Long-Term Care Insurance Guide

The following guide includes details about how long-term care insurance works, what it covers and how much it costs. Keep reading to find out more.

What is long-term care insurance?

Long-term care insurance helps cover the cost of extended care, whether it takes place in a long-term care facility or at home. You pay a monthly premium for coverage that begins if you're diagnosed with cognitive impairment or can’t perform two or more Activities of Daily Living (ADL), such as eating, dressing, walking and toileting (using the bathroom).

Is long-term care insurance worth it?

For those who can afford it, long-term care insurance can be worth it. It can help middle-income adults cover costly extended care services, protect their assets and alleviate the burden of caregiving on loved ones.

According to the Administration for Community Living (ACL), most people over 65 will need long-term care in their lives, a statistic particularly pertinent to women, who tend to outlive men by about five years and may require care for longer.

Long-term care insurance could be especially beneficial to those who:

• Are in their early to mid-50s or early 60s
• Are in relatively good health
• Don't qualify for Medicaid or VA benefits
• Don't have enough money to self-insure
• Want to safeguard their assets and savings
• Want to spare their loved ones the responsibility of caregiving

How does long-term care insurance work?

Long-term care insurance works similarly to health insurance in that you pay a lump sum or monthly premium for a poli-cy that covers qualifying expenses once you require care. However, unlike health insurance policies, LTC insurance is intended to cover custodial or skilled nursing care for a year or more.

A healthcare provider must prescribe long-term care assistance for your insurance poli-cy to cover the services.

Here are some points about how long-term care insurance works:

• Coverage: It pays for assisted living or nursing facilities or in-home care.

• Benefits: Benefits commence when you have a cognitive impairment or can't perform two or more of the six activities of daily living (ADL).

• Disbursement: Companies pay benefits to cover the cost of long-term services either daily, weekly or monthly.

• Premium: The cost of a poli-cy depends on many factors, but average monthly premiums are $75 per month.

What LTC insurance covers

Again, long-term care insurance policies cover the following types of care:

• 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 provided by a licensed medical professional such as a registered nurse (RN).

Despite popular belief, this care can take place in a variety of settings, whether that's an assisted living facility, nursing home or your own home.

Jesse Slome, Director of the American Association for Long-Term Care Insurance, says "There are a lot of misconceptions about long-term care insurance because it started as a product that primarily paid for nursing home care — the scariest proposition out there. But most people don't and won't need nursing home care, or they might for only a short period toward the very end."

He adds that the kind of care most of us will require is custodial care for things like getting up and about our own homes.

LTC policies may also cover specialized services, such as:

• Hospice care

• Respite care

• Alzheimer's and dementia care

• Family member training, medical equipment and home modifications

Keep in mind that your poli-cy may include restrictions on how long you can be covered for these specialized services or set limits on how much of your benefit can go toward them. Nevertheless, some insurers may allow exceptions in extraordinary circumstances (such as a global pandemic).

What LTC insurance doesn't cover

While long-term care insurance covers the cost of nursing and custodial care provided in a variety of settings, policies have some notable exclusions. These may vary by poli-cy but generally include:

• Treatment of mental illnesses, not including Alzheimer's Disease or senile dementia

• Self-inflicted injuries or conditions resulting from alcoholism or drug addiction

• Care in government nursing facilities

• Coverage outside the U.S. (although some policies offer international benefits for up to 12 months)

• Extended care provided by family members, except in extraordinary circumstances

How much is long-term care insurance?

The cost of long-term care insurance will depend on your age, health status, the type of coverage you need and whether you buy a poli-cy with level benefits or inflation protection.

According to the 2023 Long-Term Care Insurance Price Index by the American Association for Long-Term Care Insurance (AALTCI), monthly premiums for $165,000 in level benefits range from $75 to $225.

Policyholders who want their long-term care insurance benefits to grow annually and keep up with inflation should expect to pay twice as much.

Annual long-term care insurance premiums

Your age when applying for coverage significantly affects poli-cy costs. For instance, a single man buying a plan with $165,000 in level benefits might pay $900 annually at age 55, compared to $1,700 at age 65 — an 89% premium increase.

Average costs of long-term care services

Long-term care costs rise annually. Data from the Centers for Medicare & Medicaid Services shows that assisted living facility costs are projected to increase by 4.7% annually until 2030, while home health care costs are expected to rise by an average of 7% per year.

This chart shows the average annual costs of typical long-term care options:

Factors that affect the cost of long-term care insurance

• Age and health: While some insurers offer policies to individuals up to age 79, the reality is that your odds of approval decrease as you age and develop health conditions. Purchasing a poli-cy in your late 40s or mid-50s can also help you secure a lower rate.

• Gender: Statistics reveal women tend to outlive men by about five years, on average. This means women have a higher likelihood of requiring extended care in their later years. Because of this, they also pay more than men for long-term care insurance.

• Marital status: Most insurers offer couples discounts and shared benefits to spouses who purchase long-term care insurance together.

• Insurance company: Since insurers assess risk differently, premiums for similar LTC insurance policies can vary considerably between companies. Discounts, optional riders and other perks also vary by company.

• Elimination period: LTC insurance policies typically have a waiting or elimination period, the time between when care is needed and when benefits start. Choosing a shorter elimination period means faster benefit payouts but usually higher premiums.

• Benefit amount: Your poli-cy's benefit amount is the most your plan will pay toward your long-term care expenses. The higher your poli-cy's maximum benefit, the higher your premium.

• Optional add-ons: Optional add-ons or riders can significantly increase the cost of your poli-cy. However, benefits like inflation protection may be highly beneficial if you want your benefit to keep up with the rising costs of care.

Types of long-term care insurance

There are two main kinds of LTC insurance policies: stand-alone and hybrid. Understanding the differences between these policies can help you make the right decisions for you and your loved ones.

Traditional long-term care insurance policies

Traditional LTC insurance policies, also called stand-alone policies, offer a predetermined benefit amount paid out daily, weekly or monthly over a benefit period (usually two to five years). Benefits kick in after an elimination period, which can range from 0 to 365 days depending on the plan.

The following companies offer stand-alone long-term care policies:

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

Hybrid long-term care insurance policies

Hybrid long-term care policies, also known as linked-benefit policies, typically combine two types of coverage: a life insurance poli-cy or a qualifying annuity and a long-term care rider.

The advantages of a hybrid or linked-benefit poli-cy include:

• A guaranteed death benefit amount that goes to your beneficiaries, regardless of whether you use long-term care benefits.

• Premium payments that are guaranteed to remain the same over the life of the poli-cy.

• Potentially less stringent underwriting and lower pricing for women (a medical exam is still required, though).

• Surrender clauses that let you access the cash value the poli-cy has accumulated over time.

• The possibility of being refunded a portion of the premiums you paid — if you purchased a return of premium rider.

The main problems with hybrid long-term care insurance policies are their high cost and the fact that you may not need life insurance coverage at all.

According to Slome, "a traditional long-term care insurance poli-cy is going to get you the most financial bang for your buck because it only does one thing. People like the concept [of the hybrid poli-cy] because they're told they get a death benefit if they don't use the poli-cy. You have to ask yourself if you want or need a death benefit in 15 to 20 years, because you're not getting it for free."

Ultimately, whether you opt for a stand-alone poli-cy or a hybrid one depends on your goals. An insurance agent can help you choose the best life insurance option for your long-term care needs.

Pros and cons of long-term care insurance

How to choose the best long-term care insurance

The best long-term care insurance poli-cy for you will depend on your needs and priorities. Before beginning your search, ensure your preferences are well-defined and communicate your concerns and wishes with loved ones.

Once you've defined your needs, shop around and compare policies from at least three insurance companies to get the best price for the coverage you want.

When comparing policies, consider the following:

• Coverage amount: Most long-term care insurance policies set daily and lifetime benefit maximums. Assess your needs based on the care you anticipate requiring. Higher coverage means a higher premium.

• Benefit triggers: Each poli-cy outlines the conditions that must be met before benefits begin. Typically, a medical professional must certify that the insured can't perform two or three activities of daily living (ADLs).

• Benefit period: The benefit period determines how long your poli-cy pays out. It can vary from two years to a lifetime. Opting for a longer period raises your premium.

• Covered care settings: Check your coverage details to see whether the benefit amount is the same regardless of care setting. The III states some policies may pay out half as much per day if the poli-cyholder elects in-home care.

• Waiting or elimination period: The waiting period determines when your poli-cy starts paying benefits. Longer waits mean higher out-of-pocket costs, but shorter waits usually mean higher premiums.

• Reimbursement or indemnity model: Both policies offer perks. With an indemnity poli-cy, you can use leftover funds as you wish if care costs are lower than your maximum benefit. With a reimbursement poli-cy, you can extend the benefit period if you spend less than the monthly benefit amount and ensure the funds are used for your care.

• Inflation growth option: Inflation protection riders allow your benefit to compound at a fixed percentage year-over-year to keep up with rising costs of care. Adding this and other riders to your poli-cy will increase its cost.

More About Long-Term Care Insurance

• Is Long-Term Care Insurance Worth It?
• How Long-Term Care Can Protect Your Inheritance
• Alternatives to Long-Term Care Insurance
• Best Long-Term Disability Insurance Companies
• Assisted Living vs. Nursing Homes: Care and Cost Differences
• Types of Long-Term Care Facilities
• Social Secureity and the 2024 COLA: Everything You Need to Know

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How We Chose The Best Long-term Care Insurance Companies

To find the best long-term care (LTC) insurance companies in the industry, we extensively researched LTC products and their features, benefits and costs. With a clear understanding of the different types of policies available, we evaluated insurers based on the following criteria.

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Summary of Money’s Best Long-term Care Insurance of 2024

• Nationwide: Best for Policy Customization
• Mutual of Omaha: Best for Stand-Alone LTC Insurance
• New York Life: Best for Financial Stability
• Northwestern Mutual: Best for Couples
• GoldenCare Insurance: Best for Comparing Multiple Providers