Long-Term Care Insurance Companies: What to Look for Before You Buy

You probably already know someone who needed help with everyday tasks like bathing, dressing, or getting around the house. Maybe it was a parent, a spouse, or a close friend. What you may not know is how quickly that kind of extended care can drain a family's finances and energy. It’s a physical, emotional, and financial whirlwind that touches every part of life.

That is exactly why Long-Term Care Insurance exists, and why knowing how to evaluate a company and policy matters so much.

In this guide, we will walk through why people buy Long-Term Care Insurance, what comprehensive coverage actually includes, how it protects families from the burden of caregiving, what to compare among companies, and how you can apply.

Why People Consider Long-Term Care Insurance

Federal research estimates that about 56 percent of Americans turning 65 will need some form of long-term services and supports during their lifetime, according to the U.S. Department of Health and Human Services.

That statistic reflects individuals whose need for extended care fits the federal definition of long-term care. Tax-qualified Long-Term Care Insurance policies pay benefits once you need substantial help with at least two of six activities of daily living, such as bathing, dressing, or eating, or you require supervision due to severe cognitive impairment, such as Alzheimer's disease. Understanding this benefit trigger, separate from the broader utilization statistic, is an important first step in evaluating any policy.

Learn More: Federal Long-Term Care Insurance Regulations

Despite the real risk of needing long-term care, many people mistakenly believe Medicare will cover it. It will not, at least not in the way most families need.

Medicare can cover medically necessary skilled nursing facility care for up to 100 days per benefit period, and only after a qualifying hospital stay and as long as the patient continues to need skilled care. Medicare also covers certain qualifying home health services on a limited, medically necessary basis. What Medicare does not cover is ongoing custodial care, meaning help with daily living activities or supervision due to cognitive decline, simply because someone needs that kind of help over the long term.

Learn More: Why Medicare Falls Short on Long-Term Care

That gap leaves families with a few options: pay out of pocket, rely on unpaid family caregivers, or spend down assets to qualify for Medicaid. None of those options protect your retirement or your loved ones the way Long-Term Care Insurance can.

People typically consider Long-Term Care Insurance for a few key reasons:

• Protecting retirement savings and income so a spouse or partner is not left financially vulnerable.
• Preserving choice over where and how care is delivered, whether at home, in assisted living, or in a nursing facility.
• Reducing the emotional and physical burden placed on adult children and other family caregivers.
• Locking in affordability while healthy, since premiums are based largely on your age and health at the time you apply.

Research from LTC News shows most people apply for Long-Term Care Insurance between the ages of 47 and 67, when they are typically still insurable and can lock in lower premiums before health issues develop.

Key Features and Benefits of Comprehensive Long-Term Care Insurance

Not every policy is built the same way. A comprehensive Long-Term Care Insurance policy generally should include the following features.

• Broad Coverage Across Care Settings

Comprehensive coverage should extend across the full continuum of care, including in-home care, adult day care, assisted living, memory care, and skilled nursing facilities. This flexibility matters because most people prefer to receive care at home for as long as possible before transitioning to a facility.

• Meaningful Benefit Amounts

Look for a strong monthly or daily maximum benefit, along with a lifetime maximum benefit that reflects the true cost of care in your area. Many top carriers now offer monthly benefit structures rather than daily limits, giving you more flexibility to pay multiple caregivers or providers within the same month without worrying about exceeding a daily cap.

In most cases, the applicant chooses the benefit levels. Because most LongTerm Care Insurance claims begin with inhome care, and because many people will still have income in retirement from sources like Social Security or investment earnings, you and a qualified LongTerm Care Insurance specialist can decide to select a smaller monthly benefit. This keeps premiums lower while still giving you access to quality care services without placing a burden on the people you love.

• Inflation Protection

Because the cost of care rises every year, an inflation rider is one of the most important features in a comprehensive policy. Compound inflation options, typically ranging from 1 percent to 5 percent, help your benefits keep pace with rising care costs decades into the future.

Most experts consulted by LTC News for this article say that depending on future benefit increase riders alone can be costly. Generally, you want inflation benefits to be factored as part of the base premium. Always consult with a qualified Long-Term Care Insurance specialist to decide which option is best in your situation.

• Elimination Period

Your elimination period is the waiting period between when your claim is approved and when benefits begin, usually between zero and 100 days. Comprehensive policies clearly define how this period is calculated and, in some cases, pay benefits retroactively once it is satisfied. Some insurance companies allow a zero-day elimination period for in-home care, but usually at extra cost.

• Shared Care for Couples

Many comprehensive policies allow spouses or partners to share benefits. If one person uses all their benefits, they can draw from their partner's unused benefits, adding valuable flexibility for couples planning together. Some companies offer a third benefit account that each spouse can draw on in addition to their own.

• Care Coordination Services

Leading insurers include access to a care coordinator, typically a nurse or social worker, who helps you and your family identify quality care providers and manage the claims process once you need care.

• Partnership Protection

Partnership-qualified policies, currently available in most states, can provide asset disregard protection under each state's Medicaid rules. In general, this means a certain amount of assets can be protected from Medicaid spend-down requirements, tied to the benefits your policy actually pays out.

Partnership rules and estate recovery provisions vary by state, so this protection should not be assumed to shield all assets in every circumstance. A specialist can explain how Partnership rules apply where you live.

Learn More: What is a Partnership Certified LTC Insurance Policy?

Traditional vs. Hybrid Long-Term Care Insurance Companies

Before comparing specific companies, it helps to understand that Long-Term Care Insurance generally falls into two categories.

• Traditional Long-Term Care Insurance is designed primarily to provide long-term care benefits and is generally the first choice for most consumers and specialists. It generally offers more long-term care benefit leverage for each premium dollar spent, but it does not return any value if you never need care, aside from optional riders like return of premium.
• Hybrid Long-Term Care Insurance, also called asset-based or linked-benefit insurance, combines a life insurance policy or an annuity with qualified long-term care benefits. If you never need long-term care, your beneficiaries generally receive a death benefit, or you may retain access to cash value, depending on the product.

Hybrid Long-Term Care Insurance policies that meet federal guidelines (Federal Code 7702(b)) still provide solid consumer protections and tax benefits. However, some products contain "critical illness riders," and these products can be problematic if your goal is to have long-term care protection.  

Learn More: What is Section 7702(b)?

Neither category is universally better. The right choice depends on your health, your budget, whether paying more for a death benefit makes sense, and how much long-term care benefit you are trying to secure.

How Comprehensive Long-Term Care Insurance Protects Families

Long-Term Care Insurance does more than protect retirement assets. It can also help families preserve choices about care and reduce the pressure placed on unpaid caregivers.

The caregiving burden is already widespread and impacting American families. AARP and the National Alliance for Caregiving reported in 2025 that about 63 million Americans provide ongoing care for a loved one. For families dealing with an aging parent, those responsibilities can affect work, finances, health, and family relationships.

Without LTC Insurance, the responsibility of caregiving often falls to adult children, particularly daughters and daughters-in-law, who may need to reduce work hours, leave jobs entirely, or manage full-time care alongside raising their own families. This dynamic has become common enough that it has a name: the Sandwich Generation, referring to adults simultaneously caring for aging parents and their own children.

Comprehensive coverage helps families in several concrete ways:

• It funds professional caregivers, so family members can remain in a supportive role rather than becoming full-time, unpaid caregivers.
• It reduces family conflict over how to pay for care or which sibling should shoulder the responsibility.
• It preserves inheritance and shared assets that might otherwise be spent down on care costs.
• It gives you a say in your own care, rather than leaving decisions to whichever family member has the time or resources to step in.

Put simply, Long-Term Care Insurance allows your family members to remain your spouse, your son, or your daughter, instead of becoming your full-time caregiver.

Companies Offering Traditional or Hybrid Long-Term Care Insurance

Several insurers currently offer traditional or hybrid Long-Term Care Insurance with broad benefit options. The right company for you depends on your age, health, state, desired benefits, and budget. Underwriting differences between companies can matter just as much as product differences, since one insurer may approve an applicant that another declines. LTC News maintains detailed, independent rankings of Long-Term Care Insurance companies that are updated annually and go into far more depth on each carrier.

Learn More: What are LTC Insurance Underwriting Guidelines?

Traditional Long-Term Care Insurance Companies

• Mutual of Omaha offers comprehensive traditional policies with a monthly benefit structure, benefit amounts up to $15,000 per month, inflation buy-up options, shared care for couples, and international coverage extending to the United Kingdom and Canada.
• Thrivent Financial provides comprehensive coverage built around a monthly, pool-of-money benefit design, multiple compound inflation options, a cash rider, and strong shared spousal benefits. However, membership is limited to Christians and their spouses as it is a fraternal organization.
• NGL (formerly National Guardian Life) offers a distinctive third-pool shared care design for couples, giving partners access to their own individual benefits plus a jointly shared pool.

Hybrid Long-Term Care Insurance Companies

• Nationwide Financial offers several hybrid options, including CareMatters, CareMatters Together, and CareMatters Annuity. Its cash-indemnity designs can provide greater flexibility in how qualified long-term care benefits are used, without requiring monthly bills or receipts after a claim qualifies, subject to policy terms. CareMatters Together provides shared benefits for two insureds, while the annuity-based option offers another underwriting path for some applicants.
• OneAmerica Financial offers hybrid policies that can be funded using qualified retirement funds, along with an option for unlimited long-term care benefits, a rare feature in the hybrid marketplace.
• Brighthouse Financial pays long-term care benefits entirely in cash, along with full international coverage for policyholders who travel or retire abroad.

Learn More: About LTC News and Our Mission

Look Beyond the Premium

Because Long-Term Care Insurance may not produce a claim for 20 or 30 years after you buy it, price alone should never be the deciding factor. Before choosing a company, compare:

• Financial-strength ratings from agencies such as AM Best, S&P Global, and Moody's can provide insight into an insurer's financial condition and ability to meet long-term obligations, although ratings are not guarantees of future performance.
• Claims process and policyholder support, including how claims are initiated, what documentation is required, and whether care-coordination assistance is available.
• Benefit definitions, including how care settings and benefit triggers are defined in the contract.
• Inflation options and how much they cost relative to the protection they provide.
• Shared-care provisions for couples.
• Home-care provisions, since not all policies treat home care the same way as facility care.
• Elimination-period rules, including how the waiting period is calculated.
• International benefits, if you plan to travel or retire abroad.
• Premium guarantees or the potential for future premium increases, since some traditional policies can be repriced with regulatory approval.
• Underwriting suitability, since your health history may make you a stronger candidate with one company than another.

A qualified Long-Term Care Insurance specialist who represents multiple carriers can help you weigh these factors against your specific situation, rather than starting from price alone.

What If You Cannot Qualify for Comprehensive Coverage?

Not everyone qualifies for traditional or hybrid Long-Term Care Insurance due to health history. Short-term care insurance, also known as short-term cash indemnity insurance, is a separate type of product that can serve as an alternative for some of these applicants.

These policies are not comprehensive Long-Term Care Insurance and should not be treated as a replacement for it. Short-term care insurance generally offers more lenient underwriting, cash benefits paid directly to you, and up to one to two years of coverage, with some policies paying over $200,000 in total benefits. It can also help cover gaps such as an elimination period under a separate policy.

Companies such as Aetna, Manhattan Life, and Guarantee Trust Life offer short-term care insurance products with broader underwriting guidelines than traditional or hybrid policies, along with added features like prescription drug indemnity benefits in some cases.

Learn More: Short-Term Care Insurance - Don't Be Fooled by the Name

If you are exploring this option because of a health condition, a Long-Term Care Insurance specialist can review your situation and tell you honestly whether comprehensive coverage may still be available through another carrier before considering a short-term alternative.

How to Apply for Long-Term Care Insurance

Applying for Long-Term Care Insurance involves a few clear steps.

• Work with a qualified specialist. A Long-Term Care Insurance specialist, unlike a general insurance agent or financial advisor, focuses specifically on long-term care planning and typically represents multiple insurance companies rather than just one.
• Pre-screen your health before submitting a formal application. An experienced specialist should review your medications, diagnoses, past surgeries, and relevant family health history before deciding which company should receive your application. This step matters because underwriting standards differ substantially among insurers. A health condition that results in a decline with one company might be acceptable to another, making carrier selection an important part of the application strategy. However, some companies will not consider an application from someone who has been declined by another company. While an agent can appeal a decline, it is always best to try to get it right the first time.
• Compare quotes from multiple companies. Pricing, underwriting standards, and benefit design vary significantly between insurers, so comparing several options helps you find the best combination of coverage and affordability. Since rates are regulated, a qualified Long-Term Care Insurance specialist can show you all major products fitting your age and health.
• Complete a health questionnaire. Most applications begin with a detailed review of your medical history, current medications, and family health history. Usually, an LTC insurance specialist will ask you detailed questions about your health and family history before you apply.
• Undergo underwriting review. Depending on the company and product, this may include a phone interview, a review of medical records, or a cognitive screening, particularly for older applicants.
• Receive your offer and select your benefits. Once approved, you will choose your monthly or daily benefit amount, benefit period, inflation protection, and any additional riders.
• Finalize your policy. After you accept your offer and your first premium is processed, your coverage becomes active.

Learn More: How to Apply for Long-Term Care Insurance

The process typically takes anywhere from a few weeks to a couple of months, depending on the complexity of your health history and the insurer's underwriting process. Applying for Long-Term Care Insurance while you are younger and healthier generally leads to easier approval and lower premiums.

Get Expert Help

Talk to an experienced Long-Term Care Insurance specialist about your options. Many LTC Insurance specialists hold professional certifications in long-term care and related areas. Some have decades of experience, including processing claims.

Choosing the right Long-Term Care Insurance company depends on your health, your budget, your family situation, and your long-term goals. What works well for one family may not be the best fit for another.

Resource Tools Available on LTC News

Have you thought about who would care for you or your spouse if you needed help with daily living, and how that care would be paid for? Maybe a parent or older family member needs extended care now. The LTC News Caregiver Directory is often your first stop.

The directory has over 80,000 caregivers, home health agencies, adult day care centers, senior communities, assisted living, memory care, rehab, and nursing homes that are searchable by city, town, or ZIP.

👉 LTC News Caregiver Directory

If you are ready to compare Long-Term Care Insurance options, use the LTC News Cost of Long-Term Care Services Calculator to see what care costs in your area, and the projected cost of extended care in the decades ahead. The LTC News cost of care data is the most trusted and comprehensive, surveying the actual cost of services being paid by families today, not just retail costs from specific companies or care organizations.

👉 LTC News Cost of Long-Term Care Services Calculator

Before you start shopping, a little education can be helpful. You can

explore the LTC News LTC Insurance Learning Center to learn more about how policies work, and how to plan for the costs and burdens of aging.

You can also find pre-screened LTC Insurance specialists through LTC News for a free, no-obligation quote comparison.

NOTE: If you or a loved one already has an LTC policy, LTC News also offers free assistance with Long-Term Care Insurance claims to help families put an existing policy to work. LTC News partners with Amada Senior Care to provide free claim support with no cost or obligation.

Long-Term Care Insurance can be an affordable way to address longevity and the rising cost of long-term care services many of us will need in the years ahead. However, don't delay your research until you age or health makes options limited, more costly, or even unavailable.

This article is for informational purposes only and is not intended as financial, insurance, or legal advice. Long-Term Care Insurance policy features, pricing, and availability vary by state and company, and applicants must qualify through underwriting. Consult a licensed Long-Term Care Insurance specialist before purchasing a policy.