Commonly Asked Questions
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What is long-term care insurance?
Long-term care insurance (LTCI) provides financial protection for extended care services that help
individuals who can no longer independently manage everyday activities due to chronic illness,
disability, or aging. This care can be delivered at home, in assisted living facilities, nursing homes, or
adult day care centers.
How much does long-term care insurance cost?
Average annual premiums vary significantly by age:
- Ages 45-54: $960 annually ($80 monthly)
- Ages 55-65: $1,433 annually ($119 monthly)
- Ages 65+: $3,358 annually ($280 monthly)
For a 60-year-old couple, combined annual costs typically range from $2,600 to $5,800.
What factors affect the cost of premiums?
Several factors influence your premium costs:
- Age at time of purchase (younger = lower premiums)
- Health status and pre-existing conditions
- Amount of coverage selected
- Benefit period length
- Waiting period before benefits begin
- Inflation protection options
- Optional riders
- Gender and marital status
Geographic location
When is the best time to buy long-term care insurance?
It’s recommended to purchase coverage in your 40s or 50s. Buying earlier allows you to lock in lower premium rates and secure coverage while you’re healthy. Waiting until retirement age can result in significantly higher costs or potential denial due to health issues.
What's the difference between traditional and hybrid long-term care insurance?
Traditional LTC Insurance:
- Lower initial premiums
- Premiums may increase over time
- Premiums typically not refunded if care isn’t needed
- More comprehensive long-term care benefits
Hybrid LTC Insurance (Linked-Benefit Policies):
- Guaranteed premiums that won’t increase
- Includes death benefit for beneficiaries
- May offer return of premium options
- Combines LTC coverage with life insurance or annuity
What services are covered by long-term care insurance?
Most policies cover:
- Home health care and skilled nursing
- Physical, occupational, and speech therapy
- Assistance with activities of daily living (bathing, dressing, eating)
- Assisted living and nursing home care
- Adult daycare and respite care
- Some policies include hospice care and home modifications
What triggers benefit payments?
Benefits typically begin when you meet one of these criteria:
- Unable to perform at least 2 out of 6 activities of daily living (bathing, dressing, eating, transferring, toileting, continence) for at least 90 days
- Diagnosed with severe cognitive impairment requiring substantial supervision
- Condition must be certified by a licensed healthcare practitioner
What is a waiting period?
The waiting period (elimination period) is the time you must pay for care out-of-pocket before insurance benefits begin. Common waiting periods are 30, 60, or 90 days. Shorter waiting periods typically result in higher premiums.
How are benefits paid?
Long-term care insurance offers two main payout methods:
Reimbursement: You pay for care expenses and submit receipts for reimbursement up to policy limits
Cash Indemnity: You receive a set monthly benefit amount that can be use for any care-related expenses, including informal care by family members
Does Medicare cover long-term care?
Medicare provides very limited coverage for long-term care, primarily short-term skilled nursing care following a qualifying hospital stay. Medicaid offers broader benefits but requires meeting strict income and asset limitations.
Can I use my Health Savings Account (HSA) for premiums?
What are Long-Term Care Partnership programs?
What should I consider when choosing an insurance provider?
Look for:
- Financial stability and strong ratings
- Good reputation and customer service record
- Policy options that meet your needs
- History of premium increases for traditional policies
- Availability of both traditional and hybrid options
- Top providers include Mutual of Omaha, Nationwide, OneAmerica, Securian, and Brighthouse.
Is long-term care insurance tax-deductible?
For businesses, long-term care premiums may be tax-deductible based on age:
- Age 40 or less: $480
- Age 41-50: $900
- Age 51-60: $1,800
- Age 61-70: $4,810
- Age 71+: $6,020
How much of my income should I spend on long-term care insurance?
A general guideline suggests that premiums should not exceed 7% of your income to ensure long-term affordability.
Should I invest in the stock market instead of buying insurance?
While investing is prudent, long-term care insurance provides a dedicated safety net with defined benefits. Stock market returns aren’t guaranteed and can fluctuate, while insurance provides reliable coverage for potentially substantial and unpredictable care costs. Consult a financial advisor to determine the best approach for your situation.
Should you purchase Long Term Care?
There is no requirement to own a plan to pay for ‘activities of daily living.’ People own an LTC to create an infrastructure of care benefits to have choices. You may then decide about your care, options, and whether family, friends, skilled care services, or a combination.
Are you comfortable having Medicare, Medicaid, the veteran’s administration, or other social services to decide where and how you will receive care services?
Or do you want choices with where you want your care (at home or in a care center), who will be responsible for your care, or do you want a professional health aide, and how will you pay for your care services?
There are 3 criteria:
- Your Health
- Financial suitability and
- What do you want the plan to accomplish to provide enough benefits to transition from an active lifestyle to needing care for daily living activities?
How much does LTC insurance cost?
Before asking about the cost of LTC insurance, there are 3 questions to ask yourself.
- What will happen to your family, money, and lifestyle?
- If I need care services, what assets and personal income will I need to pay for my care services?
- Are you comfortable paying for your activities of daily life care with before or after-tax income?
Most people think about long-term care insurance in their 50s and 60s. Some wait longer. The older you are, the more people are denied benefits because of health, or the premiums are more than they want to spend because they are closer to needing care. People who pay annually get a discount.
People shop for price and then want value. Long-term care insurance is different than shopping for other forms of insurance.
- Once you own a plan, you will own it until you use the benefits or die. People seldom change plans for alternative LTC benefits. The reason is the premiums in the birth year you apply. Services in a plan may be less generous; eventually, the carriers will only allow coverage because of health, age, or premiums).
- People believe they can self-insure, Medicare, veterans benefits, or Medicaid will pay for their care, and all is well. Yes, it will help, but it isn’t what people want. That is where the conversation gets people to realize, “Now I understand what this is about,” or “I never thought about it that way.”
Average cost: $ 2,007 per year *
Low cost: $1,764
High cost: $3,446
* Average Cost (with preferred health discount): $ 1,720 per year
Age 55, standard health rate. The initial policy benefit for EACH is $164,000 based on a Daily benefit of $150 and 3 year benefit period. The coverage value will increase annually because a 3 percent compound cost of living is added to the plan.
Long-Term Care Insurance Rates for Couples Both Age 55
Average Cost: $2,466-per-year (combined)
Low cost: $2,080
High cost: $4,824
Both individuals are age 55, with standard health rate. The initial policy benefit for EACH is $164,000 based on a Daily benefit of $150 and 3 year benefit period. The coverage value will increase annually because a 3 percent cost of living is included.
Long-Term Care Insurance Rates for Couples Both Age 60
Average Cost: $3,381-per-year (combined)
Low cost: $2,794
High cost: $5,637
Both individuals are age 55, standard health rate. The initial policy benefit for EACH is $164,000 based on a Daily benefit of $150 and 3 year benefit period. Coverage value will increase annually because a 3 percent cost of living is included.
Is LTC insurance worth it?
There is no requirement to own a long-term care plan. People own long-term care benefits plan TODAY for Tomorrow’s personal choices with where, when, and how they receive life care activities.
There is no requirement to own a plan. Medicare, Medicaid, and the veteran’s administration are not obligated to provide the caregiving support services that you choose.
There is a benefit that is of value to those who own an LTC plan. With owning a plan, the family can access ‘care support service’ at no additional cost. A licensed healthcare professional helps families assess needs, develop a personal care plan, and arrange daily life services activities.
Additional services provided with no additional fees:
- Caregiving training
- Durable medical equipment
- Home modification
Who pays for seniors' long-term care if they run out of money?
The plans will pay because it is a chronic health situation, and it affects your active lifestyle:
- Bathing and Grooming
- Dressing and Undressing
- Meal Preparation and Feeding
- Functional Transfers
- Safe Restroom Use and Maintaining Continence
- Walking
- Memory Care and Stimulation (Alzheimer’s and Dementia)
Medicaid, family, friends, retirement assets, and cash flow available (after taxes). People believe that they will be lucky and die quickly. The reality is most people do not die soon. In most situations, we transition from an active lifestyle to needing care because daily activities require family and professional care services.
What does long-term care insurance cover?
LTC Insurance covers a broad range of services, including in-home care, assisted living, nursing home stays, adult day care, hospice, and personal care for Activities of Daily Living (e.g., bathing, dressing). It helps cover the costs of care you might need as you age, including in-home and facility-based services.
When can I start using my benefits?
You can begin receiving LTC policy benefits once you meet the policy’s activities of daily living eligibility (e.g., medical issues caused by accidents, illness, frailty, or cognitive impairment) and satisfy the waiting period.
How much coverage do I need?
LTC benefits depend on your budget, the cost of care in your area, the desired daily benefit, and benefit duration. We will advise you on how to adjust your daily benefit and benefit length to manage your premiums effectively.
Does the policy cover home health care?
Yes – depending on the plan you choose, it will include in-home services such as caregivers to assist with eating, bathing, dressing, cleaning, and other activities of daily living, as well as help with doctor visits.
Are there inflation protection options?
Yes—policies offer inflation riders to increase your benefit over time, keeping pace with rising costs. This ensures benefits keep up with growing caregiving expenses.
What are the waiting or elimination periods?
Elimination periods (waiting periods) will be based on calendar days or service days, during which you pay for caregiving services. There are standard options of 30/60/90/180/365 day.
What happens if I don't use my benefits?
If you never use your benefits, standard standalone policies don’t refund premiums. Hybrid or return-of-premium riders may return unused premiums or offer death benefits.
How does LTC insurance differ from health insurance and Medicare?
LTC insurance covers non-medical, custodial care for daily living that health insurance and Medicare do not cover. Medicare does not cover long-term personal care in a home or a care facility. Medicare will cover short-term skilled care when a physician authorizes it as medically necessary.
Can LTC insurance premiums increase?
Yes. LTC policies are guaranteed renewable, meaning the insurer can raise premiums—with state approval—to reflect rising costs or claims experience. Hybrid and other short-term care plans do not have premium increases.
What are my insurance options for covering LTC?
Options include standalone LTC policies, hybrid life/LTC products, group or employer-sponsored LTC, and state programs (e.g., Washington’s WA Cares Fund). Hybrid options and employee benefit plans can also be viable alternatives. There are also short-term care plans and company-sponsored long-term care plans.
How will I receive benefits?
Benefits are paid via reimbursement (you submit care receipts), per-diem indemnity, or lump-sum options, depending on your policy. We recommend customized strategies tailored to meet your specific benefit delivery caregiving needs.
Will I qualify with my health condition?
Underwriting factors include age, medical history, and lifestyle. Pre-existing conditions (e.g., Alzheimer’s disease, heart disease) may result in higher premiums, exclusions, or denial of coverage. You can learn more about LTC insurance with pre-existing conditions here.
How do I choose the right insurance company?
Look for financial strength, clear rate increase history, underwriting, reliable claims servicing, and advisors who tailor plans to your needs. We recommend working with experienced brokers focused on value and personalized service.