Best Long-term Care Insurance for Seniors

Comparing the Best LTC Insurance Companies

While the number of long-term care insurance providers has reduced over the years, there are still many companies providing coverage. We sorted through the data for you. Our in-depth long-term care insurance analysis dives deep to evaluate offerings that are important to seniors as well as customer feedback. 

• Shortest elimination period: Lincoln Financial
• Highest max issue age: OneAmerica *(80 years old)
• Longest benefits period: OneAmerica (lifetime) and Nationwide (7 years)
• Coverage amounts: Lincoln Financial and Nationwide ($500,000)
• Highest rated on Retirement Living: LTC Consumer

Our Experience Evaluating LTC Insurance Companies

The online shopping experience for seniors looking for long-term care insurance policies will be a bit more complex than shopping for life insurance. This is because most providers don’t allow for quotes for estimates online. Instead, you must call a representative for more details. 

However, the providers we named as the best long-term care insurance companies for seniors offer product guides available for download. For example, Mutual of Omaha offers a free product brochure that provides LTC insurance estimates. At 48 pages long, Retirement Living deems it the most helpful. For reference, National Guardian Life’s brochure was less detailed and 12 pages long.

What Customers Say About Their LTC Insurance Experience

Retirement Living analyzed three years’ worth of customer ratings of long-term care insurance companies posted on our site and found that 68% of reviews were four stars or higher. People who rate their experience getting long-term care insurance as high were most likely to mention customer service representatives by name and the ability to compare plan types to their needs. 

One reviewer from Lafayette, California says, “It was always clear that she was working to get a policy that made the most sense for us, with an eye toward keeping costs manageable, while at the same time getting the features that were most helpful for our situation.”

Here are other key takeaways from our analysis of more than 430 online customer reviews:

• The ability to get fast access to their benefits seems to be the biggest concern for customers. More than 46% of negative reviews referenced significant delays in getting benefits approval. 
• Our analysis shows that the medical exam process for determining eligibility is an important factor to consider. Customers who underwent long underwriting processes were more likely to rate their experience as poor.
• Long-term care insurance companies can better serve the community by providing better, more comprehensive service to existing customers. While most reviewers experienced pleasant interactions when signing up for LTC insurance, feedback skews much more negatively for those who want to use their insurance. 

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Long-term Care Insurance Companies, Reviewed

Based on our analysis, here are the five best long-term care insurance companies for seniors: LTC Consumer, Mutual of Omaha, OneAmerica, National Guardian Life, Lincoln Financial, and Nationwide.

LTC Consumer Review 

LTC Consumer was created by one of the country’s top long-term care planning firms, MasterCare LLC. Its team of long-term care specialists can help you understand the different types of LTC policies and how they can help take the burden off your family if you need care in the future. LTC Consumer has a network of companies offering some of the highest-rated long-term care insurance for seniors. 

You can access free LTC resources on its website and get a free, no-obligation quote after filling out a form and speaking with an LTC Consumer specialist, who can match you with the best company and plan to meet your budget and future care needs.

• AM Best rating: NR
• Issue age: 30 – 80+
• Elimination period: Varies by company
• Coverage amount(s): Varies by company
• Maximum benefits period: Varies by company

To receive an LTC Consumer quote, visit their long-term care insurance website or call 877-959-1270.

Read our full LTC Consumer review for more details.

Mutual of Omaha Review

Mutual of Omaha has offered top-rated long-term care insurance for seniors for over 100 years. Its MutualCare Custom Solution plan provides a wide range of customization to tailor the policy to your specific needs, including whether you want cash benefits or reimbursement. 

MOO’s standout feature is that it provides estimates online for its stand-alone LTC policies, but you’ll need to speak with a licensed insurance agent to get a quote and complete the application.

• AM Best rating: A+
• Issue age: 30 – 79
• Elimination period: 0 – 365 days
• Coverage amount(s): $1,500 – $10,000 monthly
• Maximum benefits period: 2 – 5 years

To receive a Mutual of Omaha quote, visit their long-term care insurance website or call 877-882-7556.

Read our full Mutual of Omaha Long-Term Care Insurance review for more details.

OneAmerica Review

OneAmerica offers hybrid LTC policies underwritten by The State Life Insurance Company. Benefits are available for a single person or couple to pool their benefits together. The hybrid life insurance with Asset-Backed LTC benefits policy offers a death benefit and LTC coverage in one policy. You can also purchase a single-premium annuity to fund LTC expenses using a CD, annuity, or savings. 

OneAmerica offers multiple discounts, including discounts for young applicants, non-tobacco users, paying annually, and practicing safe hobbies. You must speak with a OneAmerica agent to receive a quote.

• AM Best rating: A+
• Issue age: 35 – 80
• Elimination period: 0 – 90 days
• Coverage amount(s): $50,000 minimum 
• Maximum benefits period: 25, 33, 50 months, or lifetime

To receive a OneAmerica quote, visit their long-term care insurance website or call 888-671-8789.

Check out our full OneAmerica review for more details.

National Guardian Life Review

Although National Guardian Life’s issue age range is smaller than some of its competitors, it offers shorter-than-average elimination periods starting at 30 days. Its EssentialLTC policy has optional plan benefits to tailor your policy to your individual or couple’s needs, including a lifetime benefit option, inflation protection, and limited return or premium riders to provide a death benefit to your beneficiary. You must contact NGL to get a quote and apply for an LTC policy.

• AM Best rating: A
• Issue age: 40 – 79
• Elimination period: 30, 90, or 180 days
• Coverage amount(s): $50 – $300 in $10 increments
• Maximum benefits period: 3 years

Lincoln Financial Review

Lincoln Financial offers individuals and couples a hybrid universal life and LTC product. The policy provides a guaranteed death benefit, even if you exhaust your LTC benefits, or a higher death benefit if you die without collecting benefits. The policy is unique because there is no elimination period to receive benefits. Once your claim is approved, you can begin to receive benefits. 

You can also include a host of riders, including a benefit period extension of up to 7 years, a no-lapse guarantee to prevent the policy from lapsing, and a return of premium benefit. 

• AM Best rating: BBB+
• Issue age: 40 – 79
• Elimination period: None
• Coverage amount(s): $50,000 – $500,000 lifetime benefit
• Maximum benefits period: 3 years

Nationwide Long-Term Care Review

Nationwide offers long-term care coverage for individuals or couples through a linked benefit product called CareMatters. Either way, you preserve a death benefit for your beneficiary, even if you use the LTC benefits. You have flexible payment options, too, paying a lump sum for five or 10 years or until age 65 or 100. LTC benefits are payable for up to 7 years, and you can add inflation protection to keep up with the rising healthcare costs. 

Once your claim is approved, you get a cash reimbursement, so you can use the money however you like without submitting receipts or bills. You can also add an LTC rider to a Nationwide universal life insurance policy.

• AM Best rating: A
• Issue age: 30 – 75
• Elimination period: 90 days
• Coverage amount(s): $60,000 – $500,000
• Maximum benefits period: 7 years

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Additional Companies

New York Life: New York Life uses a face-to-face consultation with highly-trained insurance professionals instead of finalizing long-term care insurance policies online. Read our full New York Life long-term care insurance review.

GoldenCare: GoldenCare is part of National Independent Brokers, Inc. and is an insurance brokerage firm offering long-term care insurance and other plans from a variety of insurance providers. In the Western part of the country, GoldenCare operates under the name American Independent Marketing. Read our full GoldenCare review.

Transamerica: Transamerica Long-term Care has helped build more secure futures for more than 571,000 individuals; Paying in excess of $5.7 Billion in claims as of December 2018. Read our full Transamerica review.

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Methodology

We evaluated 12 long-term care insurance companies and found the six best choices. We carefully considered cost, coverage, reputation, and our own experience evaluating insurance carriers. 

Based on our expert consultations and research, we determined the following factors to be important for seniors when shopping for long-term care insurance:

• Premiums
• Higher issue ages
• Nationwide availability
• Customization options, such as riders and hybrid policies
• Claims process and elimination periods
• Medical exam and approval requirements
• Customer service
• Online user experience, such as online quote features and calculators
• Reputation, as determined by financial strength and consumer complaints

The Retirement Living editorial team prioritizes timely updates and edits to our buying resources, which ensures our readers are provided with the latest information. We routinely revise inaccurate information, cross-reference sources, and review our content to identify relevant changes.

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How Does Long-term Care Insurance Work?

Long-term care (LTC) insurance pays for expenses related to the care you need long-term after becoming disabled or having a chronic illness. Your health insurance typically won’t cover the costs for care at an adult daycare center, nursing home, assisted living center, or in your own home.

There are two main types of long-term care insurance policies for the elderly:

• Hybrid long-term care insurance policies: A linked benefit LTC policy provides long-term care insurance and life insurance in one product. If you receive LTC benefits, it lowers your beneficiary’s death benefit. If not, your beneficiary receives the entire death benefit when you pass away.
• Stand-alone long-term care insurance policies: A stand-alone policy only provides long-term care benefits. You can usually include riders to modify or increase coverage, such as a cost of living adjustment (COLA) rider.

You can also include an LTC rider on some life insurance policies, which can be a cheaper alternative to a hybrid policy. However, you usually won’t get as much coverage. Critical illness insurance can also pay a lump sum if you are diagnosed with a critical illness listed on the policy, which you can use to pay for long-term care costs.

How Benefits are Paid

Benefits start when you experience a benefit trigger, which varies by policy. You may become cognitively impaired, get a recommendation from a doctor, or need assistance with two or more activities of daily living (ADLs) for at least 90 days, like eating, toileting, or transferring.

Once your benefit triggers, your policy will start paying, but only after the waiting period, or elimination period, ends. The waiting period will vary by insurer but is usually between 30 and 90 days. However, some policies offer up to 365 days to offset higher LTC policy premiums. 

Benefits will continue until you no longer need or qualify for long-term care or reach your benefit limit.

You will receive long-term care insurance benefits through one of three methods:

• Disability basis: Provides the total daily benefit amount after meeting the eligibility criteria, even if you aren’t receiving long-term care.
• Expense-incurred basis: Pays the policy or expense amount, whichever is less.
• Indemnity basis: Pays the benefit dollar amount.

Maximum LTC Insurance Benefits

The maximum LTC insurance benefits a policy pays depends on the policy, type of service, and your coverage selections. For example, most policies pay a set dollar amount per day, week, or month until you reach the lifetime maximum. Others, like critical illness insurance, pay a lump sum. Married couples who purchase LTC policies may be able to share coverage, so if one spouse reaches their policy limit, they can draw from their spouse’s long-term care coverage.

If your plan includes nursing and home care, the home care coverage may be capped at a percentage of your nursing care coverage. 

Inflation Protection

Inflation can devalue the cash benefits you receive for LTC services as care costs rise. Adding a long-term care rider for inflation protection to your policy can automatically increase your benefit amount to align with future care costs. The rider usually provides a 2%, 3%, or 5% increase for a set amount of years or the life of the policy.

Riders can increase the cost of LTC insurance, which itself isn’t cheap. Working with a licensed life insurance agent, broker, or financial planner can help determine how much coverage to purchase and whether a rider like an inflation guard makes sense.

What Does Long-term Care Insurance Cover?

If you require long-term care assistance in a facility or at your home, a long-term care insurance policy can cover:

• Adult daycare centers
• Home health aides
• Assisted living and Alzheimer’s care facilities
• Occupational, physical, rehabilitation, and speech therapy
• Nursing home, respite, and hospice care

It can also cover personal care services, such as assistance with bathing or dressing. 

Policies can have limitations or exclusions that vary by insurance provider. For instance, some policies might not cover you if you receive assistance in a personal care or rest home facility but will cover care received in a state-licensed facility. 

What Long-term Care Insurance Does Not Cover

You usually can’t use long-term care insurance for:

• Self-inflicted injuries
• War-related injuries or illness
• Alcohol or drug addiction
• Nervous or mental health disorders, except Alzheimer’s disease and dementia
• Treatment received in a government facility or paid for by the government 
• Long-term care treatment you receive outside the United States

Some long-term care plans provide coverage in Canada and the UK. Read the fine print carefully to understand what each plan covers and doesn’t.

How Much Does Long-term Care Insurance Cost?

Your long-term care insurance plan cost depends on factors like your age, marital status, benefit amount, and whether you select the inflation protection rider. 

LTC is one of the few insurance products that cost more for women than men since women have a longer life expectancy and a greater chance of needing long-term care. 

The tables below, provided by the American Association of Long-Term Care Insurance (AALTCI), show long-term care insurance costs for seniors at ages 55, 60, and 65, and how rates differ by gender and marital status.

Benefit amount	55-year-old female	55-year-old male	55-year-old couple
$165,000 level benefit	$1,500	$950	$2,080
$165,000 benefit with 2% annual increase	$2,800	$1,750	$3,875
$165,000 benefit with 3% annual increase	$3,700	$2,075	$5,025
$165,000 benefit with 5% annual increase	$6,400	$3,690	$8,575

*Table reflect annual costs.

Benefit amount	60-year-old female	60-year-old male	60-year-old couple
$165,000 level benefit	$1,900	$1,200	$2,600
$165,000 benefit with 2% annual increase	$3,325	$2,060	$4,500
$165,000 benefit with 3% annual increase	$4,400	$2,585	$5,800
$165,000 benefit with 5% annual increase	$6,700	$3,690	$3,800

*Tables reflect annual costs.

Benefit amount	65-year-old female	65-year-old male	65-year-old couple
$165,000 level benefit	$2,700	$1,700	$3,750
$165,000 benefit with 2% annual increase	$4,230	$2,600	$5,815
$165,000 benefit with 3% annual increase	$5,265	$3,135	$7,150
$165,000 benefit with 5% annual increase	$7,225	$4,200	$9,675

*Tables reflect annual costs

The cost of waiting to buy long-term care until you’re older can be substantial. You’ll pay around 50% if you wait to buy a policy at 65 instead of purchasing the same policy at 55. Plus, your chance of being turned down or missing out on the couple rate reduction goes up if you or your spouse aren’t healthy enough to qualify for coverage.

When you buy long-term care insurance, you lock in level premiums that won’t increase due to your age or health. However, if the insurance company can prove that it needs to increase premiums for all policyholders to pay future claims, your policy premium could increase.

Factors That Affect the Cost of LTC Insurance

• Your age, gender, and marital status
• Your health 
• The policy type you choose
• The state you live in
• Benefit amount
• Elimination period
• Insurance company
• Add-ons you include

Benefit plan options and policy costs vary significantly by long-term care insurance provider, according to the AALTCI. If you’re looking for affordable long-term care insurance over 60, it’s best to work with a licensed long-term care insurance specialist who can help you determine the plan type and coverage that best fits your future care needs.

Average Long-term Care Costs

Type of Care	Average Cost (Without Insurance)
Nursing Home	$9,872 per month
Assisted Living	$5,132 per month
Home Health Aide	$24 per hour
Adult Daycare	$85 per day

How to Buy Long-term Care Insurance

You can buy long-term care insurance from a financial planner, insurance agent, employer or state partnership program. 

When you apply for long-term care insurance, you’ll 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.

In my experience, you may get the best rate through an employer since they negotiate a group rate, and the health underwriting may be more relaxed. Your spouse and other immediate family members may also be eligible for group rates. Employers are required by law to allow portability, or the option to take your LTC plan with you if you change jobs or retire.

Purchasing through your state’s partner program can help if you have to go on Medicaid later. The amount you receive in benefits is protected from the asset spend down rule required to be eligible for Medicaid coverage. For example, if you receive $100,000 in benefits on a partnership-qualified policy, you can keep $102,000 of assets instead of the standard $2,000.

Can You Be Denied Long-term Care Insurance?

Yes. Your health is a major factor in determining your eligibility and premium. Being in good health increases your chances of getting an affordable long-term care insurance rate and not being denied. The older you get, the more likely you are to develop health problems and be declined coverage, as shown in the table below.

Applicant Age	Average Denial Percentage
40 – 49	12%
50 – 59	20%
60 – 64	30%
65 – 69	38%
70 – 74	47%

Source:  American Association of Long-Term Care Insurance

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Related Long-term Care Insurance Resources

Readers of this Long-term Care Insurance guide also found these related articles helpful.

• 7 Factors to Consider Before Buying Long-Term Care Insurance
• The Pros and Cons of Long-Term Care Insurance
• Types of Long-Term Care Insurance
• Best Long-term care companies in Washington State

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FAQs: Long-term Care Insurance

Why do I need long-term care insurance if Medicare covers nursing home care?

Medicare Part A will only cover nursing home care for short stays of 100 days or less if you require care to perform the activities of daily living (ADLs), and only after an in-patient hospital stay of three or more days. The benefit is payable for up to 100 days per benefit period, requiring a daily copay after the 20th day. Medicare Part B can cover medically necessary long-term services like physical therapy or part-time skilled nursing care. You cannot depend on Medicare to cover most of your needs like you can with long-term care insurance if you require nursing home care.

Does Medicaid cover nursing home care?

Medicaid will cover skilled nursing, rehabilitation, or long-term care services in a Medicaid-certified nursing home after you spend down all your assets to meet your state’s Medicaid limits. The definition of nursing facility services and responsibilities can vary by each state’s Medicaid plan, so be sure to familiarize yourself with your state’s benefits and services outside of the federal requirements.

What is the elimination period for LTC insurance?

The LTC elimination period is the time between when you trigger a benefit and when the policy starts paying. Most long-term care policies offer an elimination period of 30, 60, or 90 days. You are responsible for the full cost of long-term care services you receive before the elimination period is over.

What are long-term care insurance state partnership plans?

Most states partner with Medicaid and long-term care insurance companies to provide incentives to people who buy an LTC policy. The LTC partnership program can protect some of your assets from being counted in Medicaid’s asset limit if you apply for benefits, helping you keep more money as an inheritance for your family. All states except Alaska, Hawaii, Mississippi, Utah, and Washington, D.C. have partnership plans.

When should you buy long-term care insurance?

According to the American Association of Long-Term Care Insurance, the best time to buy long-term care insurance is between 55 and 65. The healthier and younger you are the better your long-term care insurance premium. Your approval odds also decrease as you age, especially if you develop health issues.

Can you use an annuity to pay for long-term care?

Yes, you can use an annuity to pay for long-term care expenses in three ways. Some insurance companies offer the option to include a lifetime income rider with a long-term care benefit rider. Deferred annuities often come with a penalty waiver if you access funds for long-term care costs. You can also purchase a long-term care annuity to pay for future expenses.

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Concluding Thoughts on Long-term Care Insurance

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Bottom Line: Take the time to make sure you’re purchasing a long-term care insurance policy that fits your exact needs. Medicare only covers a portion of your stay in long-term care facilities, so comparing the insurance providers we feature on this list is a financial necessity.

	Long-term Care Insurance Company	Best For
1	LTC Consumer	Great for comparing policies
2	Mutual of Omaha	Great for custom plans
3	OneAmerica	Great for older adults
4	National Guardian Life	Great plan benefits
5	Lincoln Financial	Great for fast approvals
6	Nationwide	Great for LTC riders