What Is Long-Term Care Insurance?

Quick answer

Long-term care (LTC) insurance is a type of insurance policy that helps cover the costs associated with extended or long-term care, whether it takes place at home, in a nursing home, adult daycare or an assisted living facility.

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Table of contents

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How does long-term care insurance work?

Long-term care insurance works in much the same way as health insurance. You pay a premium, most often in regular installments for stand-alone policies (while many hybrid policies are funded with a lump sum or limited-pay schedule), and the insurer guarantees a payout or reimbursement amount to cover the costs of care when you need it.

Unlike health insurance, however, LTC insurance benefits are generally triggered when a licensed health-care practitioner certifies you have a “severe cognitive impairment” that requires substantial supervision or you require substantial assistance with at least two activities of daily living (ADLs) for at least 90 days (a common trigger standard for federally “tax-qualified” LTC policies). These include:

• Dressing
• Bathing
• Eating
• Toileting (or using the bathroom)
• Transferring (like moving from a bed to a wheelchair)
• Continence (bladder/bowel control)

Benefits may be paid daily, weekly or monthly, depending on the plan. The mode of payment also varies. For example, some policies work on an indemnity model, where the plan sends you a check for the fixed benefit amount and you pay for the services you want. Other plans work on a reimbursement model or pay the care facility or provider directly. For tax-qualified policies, benefits are generally intended to be received tax-free; however, cash/indemnity payments may be subject to special tax rules (including an IRS per-diem limit—$430 per day in 2026—when benefits exceed actual qualified costs).

Most LTC policies cover custodial/personal (non-medical) care and supervision, which can take place at home (home health care), in assisted living facilities, nursing homes or adult daycares. Some policies also cover skilled care by licensed professionals.

The best long-term care insurance policies may also cover alternative care options such as hospice care, respite care, home modifications, medical equipment and even custodial care training for family members.

Types of long-term care insurance policies

There are two main long-term care insurance options: stand-alone long-term care insurance and hybrid life and long-term care insurance. While they have some common elements, they each work differently and are priced accordingly.

Stand-alone long-term care insurance

With stand-alone LTC policies, your premium payment is ongoing and goes toward maintaining the policy, which will provide a maximum benefit during a benefit period (typically lasting two to five years). Once you require care, you’ll need to wait a certain number of days (called the elimination period) before benefits are paid out.

Here are some general details about stand-alone policies:

• Premiums are generally more affordable, as the policy offers no other financial benefit. However, they may be subject to rate increases.

• If you end up not needing long-term care, the policy lapses and you don’t get a return on your investment.

• Similarly, if you can’t keep up with premium payments, the policy is canceled.

• You may add insurance riders such as inflation protection, which increases your benefit each year by a fixed percentage.

Hybrid life and long-term care insurance

Hybrid or linked benefit policies combine a life insurance policy — most commonly universal life insurance — or an annuity with long-term care benefits. Most policies guarantee a percentage will be paid out to the policy’s beneficiaries upon the policyholder’s death, even if they used the policy to cover long-term care.

Here are some general details about hybrid LTC policies:

• With hybrid policies, you pay a fixed premium for a predetermined number of years, typically 10 to 20. You can access long-term care benefits once you meet the policy’s benefit triggers (such as ADLs/cognitive impairment), regardless of whether you’ve finished paying premiums.

• Because of this long-term care component, hybrid policies tend to be the more expensive option.

• As these are generally life insurance policies, you can always surrender the policy and get a cash surrender value (your cash value minus surrender charges) if you can no longer afford your premium.

Pros and cons of having long-term care insurance

As with any type of policy, there are pros and cons to buying long-term care insurance.

From the costs of premiums to the waiting periods before the policy kicks in, each factor will play a role in figuring out if LTC insurance is the right choice for you.

Pros of long-term care insurance

There are several benefits to having long-term care insurance. These include:

• Paying for care: Most people who live into their 70s, 80s and beyond expect to need some form of long-term care, and having LTC insurance can help cover a variety of costs related to that care. That includes the costs of in-home care, adult day care, assisted living and nursing home care.

• Protecting your assets: An LTC policy can help protect money and assets, such as a home or investments, from being depleted to cover long-term care costs.

• Safeguarding your family’s assets: In addition to protecting your own assets, long-term care insurance can also help protect your family’s assets if you run out of money and need financial assistance to pay for the care you need.

• Reimbursing family members: Some policies offer reimbursement for family members who provide care. This is an excellent option for those who choose to have family members serve as primary caregivers.

Cons of long-term care insurance

There are also several potential downsides to buying an LTC policy. These include:

• Elimination period: Stand-alone policies have a waiting period or elimination period before the policy begins to pay out. That means there will be a time when you are receiving long-term care but the policy won’t cover it.

• Cost: Premiums for LTC policies may be cost-prohibitive for some. According to AALTCI, 2025 Price Index examples show a single 55-year-old man in “select health” paying about $950 per year and a single 55-year-old woman about $1,500 per year for a $165,000 level-benefit policy (pricing varies by state, insurer and benefit design).

• Pre-existing conditions: Some providers are very strict about pre-existing conditions and may deny coverage if you have certain medical issues that existed prior to purchasing the policy.

• Limits on types of care: Some policies have limitations on the types of care they cover. For example, some policies may only cover care in a nursing home and not at home. With that in mind, read the policy carefully to ensure it will cover the type of care you want.

Who needs long-term care insurance?

The least affluent retirees may qualify for Medicaid, while the most affluent are able to turn to other options to pay for care. That makes long-term care insurance best suited to those in the middle.

According to Jesse Slome, executive director of the AALTCI, couples with assets above $500,000 are strong candidates for insurance, while those with liquid assets of $1 million will likely be able to self-insure and cover the cost of long-term care with savings. Others recommend $2 million or more in assets for self-insurance.

A policy can even make sense if your assets are modest, especially if you live in a state that has a Partnership for Long-Term Care program (these programs exist in many states, but eligibility and asset-protection rules vary by state). The partnership program allows you to get credit for benefits received from an LTC policy if you eventually require care under Medicaid.

For every dollar the long-term care partnership policy pays in benefits, you can forgo spending down a dollar of your assets on care if the policy’s benefits are exhausted. So, if you received $50,000 in benefits from an LTC policy, you’d be allowed to retain up to $50,000 of the assets you’d be required to “spend down” to be eligible for Medicaid.

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What affects the cost of long-term care insurance?

The following are some of the most important factors that affect the cost of long-term care insurance for adults:

Age You’ll lock in lower premiums if you buy coverage when you’re younger and healthier. That’s because there’s a lower risk of you needing long-term care in the immediate future. Health If you are in poor health, you may not be able to purchase coverage, or your premiums could be higher. Conversely, being in better health will result in lower premiums. Gender Women’s longer life expectancy increases their likelihood of eventually requiring long-term care. Marital status Many insurers offer a discount to married couples who purchase coverage together. Insurance company Insurance companies assess risk differently, so they may charge different premiums for similar policies. Amount of coverage Policies with higher benefit amounts and coverage limits generally cost more. Optional coverage Some long-term care providers offer add-ons or riders that augment or modify coverage, such as inflation protection and waiver of premium. These riders can provide additional peace of mind but will also increase your monthly premium. Waiting or elimination period This is the period after you need care but before the coverage kicks in, and it serves the same function as a deductible in other policies. You can typically choose between 0 and 365 days (common options include 30, 60, 90 and 180 days). The shorter the waiting period, the more expensive the policy.

If your policy is “tax-qualified,” part of your premium may count as a medical expense (and in some cases for the self-employed health insurance deduction) up to IRS age-based limits. For tax year 2026, the limit is $500 (age 40 or under), $930 (41–50), $1,860 (51–60), $4,960 (61–70), and $6,200 (71+). Qualified LTC premiums can also be paid from an HSA up to those same age-based limits.

When to buy long-term care insurance

The timing of your LTC insurance purchase impacts both the cost of the policy and your eligibility. Purchasing too early will mean paying premiums for years when the likelihood of needing long-term care is low. Conversely, waiting too long risks you being disqualified for coverage due to health issues.

While some experts say you can wait until you’re in your 60s to buy long-term care insurance, the AALTCI recommends getting a policy when you’re in your mid-50s. Applicants in their 50s have only about a one in five likelihood of rejection for LTC insurance due to health issues. That refusal rate jumps to 30% for folks in their 60s and 44% for those in their 70s.

How to choose the right policy and coverage amount

1. Compare daily benefits to the cost of care in your area. LTC policies have a lifetime benefit maximum, which can be expressed in different ways (daily dollar limit, time limit, or total maximum spending). To assess a policy’s usefulness, compare its daily benefits to the average local cost of care, as you may need to pay the difference.

2. Have a contingency plan. If you had to pay out of pocket for long-term care, what non-insurance sources would you have at your disposal? Speak to your financial advisor about using other funding sources such as savings or assets.

3. Err on the side of caution. It’s recommended to err on the side of over-insuring, as it’s easier to decrease coverage than increase it, especially if your health declines.

4. Comparison shop. Compare plans from several long-term care insurance companies before choosing, even if your employer offers seemingly affordable group LTC coverage. Employer-sponsored plans may be best for those who are ineligible for individual coverage. Couples and relatively healthy individuals might benefit from individual policies.

Alternatives to long-term care insurance

If private insurance isn’t the right solution for you, there are a few other long-term care alternatives available:

• Medicare: Medicare does not cover extended nursing home stays but will help pay for up to 100 days of rehabilitation or skilled nursing care after a major health issue, based on a doctor’s recommendation. In 2026, you generally need a qualifying 3-day inpatient hospital stay and a Medicare-certified skilled nursing facility; you pay $0 for days 1–20, then a daily coinsurance (e.g., $217/day for days 21–100 in 2026), and Medicare does not cover ongoing custodial care.

• Medicaid: Medicaid is the largest public payer of long-term care services. Eligibility for the program is strictly needs-based. If you didn’t qualify for it in the past, you may qualify now or in the future if you spend a significant portion of your assets paying for care.

• U.S. Department of Veterans Affairs (VA): The VA offers a Veterans Aid & Attendance Pensions Benefit, which provides qualified veterans and surviving spouses an additional monthly amount on top of their pension if they are housebound or require help with ADL. VA financial eligibility rules also include a net worth limit that changes over time (for example, $163,699 from December 1, 2025, to November 30, 2026, for Survivors Pension).

• Life insurance with accelerated death benefits: Adding an accelerated death benefit (ADB) rider to your life insurance policy allows you to access a portion — typically up to 50% — of the death benefit while you are living to cover long-term care expenses. Whatever you receive will be subtracted from the money disbursed to your beneficiaries upon your death.

• Savings: People with plenty of money saved for retirement can likely cover long-term care costs without help. According to Jay Zigmont, Ph.D., CFP® and Founder of Childfree Wealth, “In general, if you have $3 million or more in net worth you may want to consider self-insuring.”

• Short-Term Care Insurance: Short-Term Care Insurance covers a limited period, often a year or less, with many insurers offering immediate benefits without an elimination period. It’s beneficial for those ineligible for long-term care insurance due to age, and for women, who pay the same rates as men despite longer life expectancies (a costlier factor for insurers).

• State programs: Washington’s WA Cares Fund is a public long-term care insurance program, with benefits becoming available July 1, 2026. Eligible participants can access an earned benefit of up to $36,500 (indexed to inflation) to pay for covered long-term services and support.

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Summary of Money’s What Is Long-Term Care Insurance?

• Long-term care insurance can protect your assets (and those of your loved ones) should you require extended care later in life.

• There are two main types of long-term care policies: stand-alone or traditional LTC and linked benefit or hybrid policies.

• Stand-alone policies are less expensive but won’t provide you a return on your investment if you end up not needing care.

• Hybrid policies generally guarantee your loved ones will receive a minimum death benefit upon your death, even if you require long-term care.

• Long-term care insurance is best suited for those who wouldn’t qualify for long-term care benefits under Medicaid but don’t have enough savings to self-insure.

• Recent national-median long-term care costs are typically well into the five figures per year and vary by setting: for example, 2024 medians were about $70,800/year for assisted living, $127,750/year for a private nursing home room, and roughly $75,504–$77,792/year for in-home care (homemaker vs. home health aide).

• Long-term care isn’t something you should ignore until it becomes imminent. If you’re already retired or near retirement, long-term care planning should be a priority.