According to the most recent CareScout (Genworth) Cost of Care Survey (2025 data, released March 2026), a semi-private nursing home room costs a national median of about $114,975 per year and a private room about $129,575 per year. Assisted living runs about $74,400 per year, and full-time in-home caregiving (44 hours/week) runs about $80,080 per year. Medicare covers almost none of this. Without long-term care insurance, these costs come directly from your savings — and roughly 70% of Americans turning 65 will need some form of long-term care, according to the Administration for Community Living.
This guide compares the best long-term care insurance companies, what they cost at different ages, and how to decide between traditional and hybrid policies.
Best Long-Term Care Insurance Companies at a Glance
The premium figures below are illustrative industry-typical estimates for a 55-year-old applicant, not live quotes. Actual pricing depends on your state, health, and the specific policy design — request quotes directly from carriers or an independent broker.
| Company | AM Best | Policy Type | Illustrative Annual Premium (55, $150/day, 3-yr) | Rate Increase History | Best For |
|---|---|---|---|---|---|
| Mutual of Omaha | A+ | Traditional LTC | ~$2,400 | Moderate | Buyers who want a widely available standalone traditional LTC policy |
| Northwestern Mutual | A++ | Traditional + hybrid | ~$2,800 | Low | Buyers prioritizing top-tier financial strength ratings |
| Lincoln Financial | A+ | Hybrid (life + LTC) | ~$3,200* | N/A (hybrid) | Buyers who want a hybrid life + LTC combination |
| Nationwide | A+ | Hybrid (life + LTC) | ~$3,000* | N/A (hybrid) | Buyers who want a hybrid policy with flexible payout options |
| Securian (Minnesota Life) | A+ | Traditional LTC | ~$2,500 | Moderate | Buyers accessing group/employer LTC offerings |
| Brighthouse Financial | A | Hybrid (annuity + LTC) | Lump sum | N/A (hybrid) | Buyers funding LTC coverage with an annuity-based lump sum |
| Pacific Life | A+ | Hybrid (life + LTC) | ~$3,400* | N/A (hybrid) | Buyers who want a higher death benefit alongside LTC coverage |
Hybrid premiums shown as illustrative annual cost of the underlying life insurance policy. AM Best ratings and premium estimates should be independently confirmed with the carrier, as both change over time. Inclusion in this table is not a recommendation.
Traditional vs. Hybrid Long-Term Care Insurance
| Feature | Traditional LTC | Hybrid (Life + LTC) |
|---|---|---|
| How it works | Pay premiums → get LTC benefits if needed | Pay premiums for life insurance → LTC rider accelerates death benefit |
| If you never need care | Premiums lost (no benefit) | Death benefit paid to beneficiaries |
| Premium stability | Can increase (and often does) | Fixed/guaranteed premiums |
| Cost | Lower initial premiums | Higher initial premiums |
| Benefit amount | Based on daily/monthly benefit | Based on death benefit amount |
| Tax treatment | Premiums may be tax-deductible | Generally not tax-deductible |
| Best for | Buyers who want maximum LTC coverage per premium dollar | Buyers who want their premiums returned as a death benefit if care is never needed |
The Rate Increase Problem with Traditional LTC
The biggest risk with traditional LTC insurance: rate increases. Insurers can raise premiums on existing policyholders, and many have — some by 50–100%+ over the life of the policy. Major rate increases have hit policyholders from Genworth, John Hancock, and other major carriers.
| Company | Historical Rate Increases | Current Status |
|---|---|---|
| Genworth | 50–150% cumulative | Still selling, but reputation damaged |
| John Hancock | 40–80% cumulative | Stopped selling traditional LTC in 2016 |
| MetLife | Varies | Exited LTC market in 2010 |
| Mutual of Omaha | Moderate (10–30%) | Still selling, more conservatively priced |
| Hybrid policies | None (premiums guaranteed) | Growing market share |
This is why hybrid policies are gaining popularity. Premiums generally can’t increase, and if you never need care, your beneficiaries get the death benefit. The trade-off: hybrid policies cost more upfront and provide less LTC coverage per premium dollar.
Long-Term Care Insurance Costs by Age
The tables below are illustrative, industry-typical premium ranges — not quotes. Get actual quotes from carriers before making a decision.
Traditional LTC Policy ($150/Day Benefit, 3-Year Benefit Period, 3% Inflation Protection)
| Age at Purchase | Single Male (Annual) | Single Female (Annual) | Couple (Annual, Each) |
|---|---|---|---|
| 45 | $1,200 | $1,800 | $900 |
| 50 | $1,600 | $2,400 | $1,200 |
| 55 | $2,100 | $3,200 | $1,600 |
| 60 | $3,200 | $5,000 | $2,500 |
| 65 | $5,500 | $8,500 | $4,200 |
| 70 | $9,000+ | $14,000+ | $7,000+ |
Why women typically pay more: Women live longer on average and use long-term care services more frequently and for longer periods. The premium difference is commonly cited as 40–60%.
Why couples often save: Shared-care policies let couples share a pool of benefits. If one spouse uses less, the other can use more. Couple discounts also apply even if only one spouse buys coverage.
Hybrid Policy Costs ($200,000 Death Benefit / $400,000 LTC Pool)
| Age at Purchase | Annual Premium | Total Premiums (to 85) | Death Benefit | LTC Pool |
|---|---|---|---|---|
| 50 | $3,000 | $105,000 | $200,000 | $400,000 |
| 55 | $3,500 | $105,000 | $200,000 | $400,000 |
| 60 | $4,200 | $105,000 | $200,000 | $400,000 |
| Lump sum (any age) | — | $80,000–$120,000 | $200,000 | $400,000 |
Hybrid policies can be funded with annual premiums or a single lump sum (often from a CD or savings account that’s earning less than the policy’s guaranteed growth).
How Long-Term Care Insurance Works
What LTC Insurance Covers
| Service | Covered? | Median Annual Cost (2025 data, CareScout/Genworth) |
|---|---|---|
| Nursing home (semi-private) | ✓ | $114,975 |
| Nursing home (private room) | ✓ | $129,575 |
| Assisted living facility | ✓ | $74,400 |
| In-home caregiver (44 hrs/wk) | ✓ | $80,080 |
| Adult day health care (5 days/wk) | ✓ | $24,700 |
| Routine doctor visits | ✗ | Covered by Medicare |
| Prescription drugs | ✗ | Covered by Medicare Part D |
| Short-term rehab (after hospital) | ✗ | Covered by Medicare (up to 100 days) |
Key Policy Terms
| Term | What It Means | Typical Options |
|---|---|---|
| Daily/monthly benefit | Maximum the policy pays per day/month | $100–$400/day |
| Benefit period | How long the policy pays | 2, 3, 5 years, or lifetime |
| Elimination period | Days you pay out of pocket before benefits start | 30, 60, 90 days |
| Inflation protection | How benefits grow over time | 3% simple, 3% compound, 5% compound |
| Waiver of premium | Premiums waived while receiving benefits | Usually included |
| Nonforfeiture benefit | Reduced benefit if you lapse after years of payments | Optional rider |
How Benefits Add Up
| Policy Configuration | Monthly Benefit | Benefit Period | Total Pool |
|---|---|---|---|
| $150/day, 3 years | $4,500 | 36 months | $162,000 |
| $200/day, 3 years | $6,000 | 36 months | $216,000 |
| $250/day, 5 years | $7,500 | 60 months | $450,000 |
| $300/day, lifetime | $9,000 | Unlimited | Unlimited |
Assumes the daily benefit is used in full each day of care; actual usage and total payout depend on the level of care needed. Compare the total pool to the cost figures above to see how many years of care a given policy would realistically cover.
Inflation Protection: The Most Important Feature
Long-term care costs have risen faster than general inflation in most recent years (the CareScout 2025 survey showed nursing home costs up roughly 1–2% year over year, while home care and adult day care rose more sharply). A policy that covers $150/day today may cover meaningfully less of the actual cost in 15–20 years without inflation protection.
| Inflation Option | $150/Day Benefit After 20 Years (illustrative) | Premium Impact |
|---|---|---|
| No inflation protection | $150/day | Lowest premium |
| 3% simple inflation | $240/day | Moderate |
| 3% compound inflation | $271/day | Higher |
| 5% compound inflation | $398/day | Highest premium |
Illustrative projections assuming the stated fixed inflation rate applied consistently for 20 years; actual care cost inflation varies by year and region and is not guaranteed to match these assumptions.
Buyers under 65 often prioritize compound inflation protection over simple inflation protection, since simple inflation falls further behind actual costs the longer the policy is held before a claim.
Long-Term Care Costs in 2026: What You’re Actually Insuring Against
Long-term care insurance exists because the cost of care is financially significant for most families. Here are the most recent available median annual costs by care type:
| Care Type | Median Annual Cost | Monthly Cost | Notes |
|---|---|---|---|
| In-home non-medical caregiver (44 hrs/wk) | $80,080 | $6,673 | Based on $35/hour median rate |
| Adult day health care (5 days/wk) | $24,700 | $2,058 | Based on $95/day median rate; lowest cost option |
| Assisted living facility | $74,400 | $6,200 | Median cost |
| Nursing home (semi-private room) | $114,975 | $9,581 | Based on $315/day median rate |
| Nursing home (private room) | $129,575 | $10,798 | Based on $355/day median rate; most expensive setting |
Source: CareScout (Genworth) Cost of Care Survey, data collected July–November 2025 and released March 2, 2026 — the most recent edition available as of September 2026. Costs vary significantly by state; check the survey’s state-level tables for your specific location before planning.
The duration risk: Long-term care episodes vary widely in length, and industry research commonly cites a meaningful share of people who need care requiring it for 5+ years. For a 5-year nursing home stay at the current semi-private median of roughly $114,975/year, total costs would reach approximately $574,875 — enough to significantly strain or deplete most middle-class retirement savings.
State Partnership Programs: Medicaid Asset Protection
Most states offer Long-Term Care Partnership Programs — a collaboration between private insurers and state Medicaid that provides a powerful incentive to buy LTC insurance:
How it works: For every dollar your LTC policy pays in benefits, you can protect an equal dollar of assets from Medicaid spend-down. Without a partnership policy, you must spend down assets to your state’s Medicaid limit (commonly $2,000 for an individual applicant in most states) before Medicaid kicks in.
Example: You have a $300,000 partnership LTC policy that pays $300,000 in benefits before being exhausted. Under a partnership program, you can then qualify for Medicaid while keeping $300,000 in personal assets above your state’s normal asset limit.
Partnership policies are available in most states and are offered by many major LTC insurers. When shopping, specifically ask whether the policy qualifies for your state’s partnership program — it can significantly change the value calculation for middle-class buyers.
Who Might Consider Long-Term Care Insurance
| Asset Level | LTC Insurance? | Why |
|---|---|---|
| Under $100,000 | Often not a priority | Medicaid will typically cover care after assets are spent down |
| $100,000–$500,000 | Frequently considered | A multi-year nursing home stay could deplete these savings |
| $500,000–$1 million | Frequently considered | Can help protect retirement savings from care costs |
| $1 million–$2 million | Sometimes considered | Some choose to partially self-insure with a shorter benefit period |
| Over $2 million | Often self-insure | Some can absorb care costs from assets, though LTC insurance can still help protect an estate |
This table describes common patterns, not individual recommendations — your right choice depends on your full financial picture.
Alternatives to Long-Term Care Insurance
| Alternative | How It Works | Pros | Cons |
|---|---|---|---|
| Self-insure | Pay from savings/investments | No premiums, full control | Risk of depleting retirement savings |
| Medicaid | Government pays after assets spent | Covers nursing home | Must spend down to state asset limit |
| Hybrid policy | Life insurance + LTC rider | Money back if no claim | Higher premiums, less LTC coverage |
| Short-term care policy | Covers 6–12 months | Lower premiums | Doesn’t cover extended care |
| Home equity | Sell home or use HELOC | Large funding source | May not cover full care cost |
| Family caregiving | Relatives provide care | No direct financial cost | Enormous personal and financial burden for the caregiver |
How to Buy Long-Term Care Insurance
| Step | Action | Notes |
|---|---|---|
| 1 | Determine if you need LTC insurance | Review asset level table above |
| 2 | Decide: traditional vs. hybrid | Traditional = lower cost, hybrid = guaranteed premiums |
| 3 | Get quotes from 3+ companies | Consider an independent broker who represents multiple carriers |
| 4 | Compare benefit amount, period, and inflation protection | Don’t just compare premiums |
| 5 | Review insurer’s rate increase history | Ask for the last 10 years of rate actions |
| 6 | Apply (health underwriting required) | Most rejections happen after age 70 |
| 7 | Review policy during your state’s free-look period | Typically 10–30 days to cancel for a full refund; confirm your state’s specific period |
Note: An independent broker who represents multiple carriers can compare rates across several insurers, rather than being limited to one company’s products.
For more on LTC costs and whether you need coverage, see our long-term care insurance guide.
Frequently Asked Questions
Does Medicare cover long-term care?
Medicare covers only short-term skilled nursing care (up to 100 days after a qualifying hospital stay, with a daily coinsurance of $217 starting on day 21 in 2026). It does not cover custodial care — the help with daily activities like bathing, dressing, and eating that makes up the majority of long-term care needs.
Can I be denied long-term care insurance?
Yes. LTC insurance requires health underwriting. Common reasons for denial: Alzheimer’s/dementia diagnosis, Parkinson’s, recent stroke, certain cancers, insulin-dependent diabetes, and needing assistance with daily activities. This is why many advisors suggest applying at 50–55, before health conditions develop.
What happens if I can’t afford the premiums anymore?
Many policies have a nonforfeiture benefit option that provides reduced coverage if you stop paying after several years. Without this rider, you may lose all benefits if you lapse. Some policies offer a “paid-up” option after 10+ years of payments — check your specific contract.
Sources
- Administration for Community Living. “What Is Long-Term Care?” acl.gov/ltc/basic-needs/what-is-long-term-care
- CareScout (Genworth). “Cost of Care Survey 2025.” genworth.com/aging-and-you/finances/cost-of-care.html
- Centers for Medicare & Medicaid Services. “Medicare Program Information.” medicare.gov
The content on Wealthvieu is for informational purposes only and should not be considered financial, tax, or investment advice. Consult a qualified professional before making financial decisions. Full disclaimer · Editorial policy