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Last updated on Jan 15, 2020

The Best Long-Term Care Insurance

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How We Found the Best Long-Term Care Insurance Companies

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8 insurance providers vetted

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4 key coverage points

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4 standout companies

The Best Long-Term Care Insurance Companies

Long-term care insurance (or “LTC”) covers costs associated with a long-term illness or disability. That might include assisted living, at-home care, or nursing home expenses. These things typically aren’t covered by health insurance, Medicare, or Medicaid, which makes coverage especially critical — otherwise, extended care can take a huge toll out of pocket.

LTC, like all insurance, is highly personal; coverage and premiums depend on your individual circumstances. Factors like location, your health and age, the policy’s benefit period, the maximum benefit, the elimination period and optional riders, such as inflation protection, will all affect the cost of your premium. Because of this, it’s best to get quotes from a few companies and compare the coverage options that matter most to you. Our top picks are a great place to get started.

The 4 Best Long-Term Care Insurance Companies

    The Best Long-Term Care Insurance: Summed Up

    Mutual of Omaha
    Transamerica
    MassMutual
    New York Life
    Best for
    Robust coverage
    Affordable policies
    Extended care
    Simpler policies
    States licensed
    49
    50
    39
    50
    A.M. Best rating
    A+
    A+
    A++
    A++
    S&P Global rating
    AA-
    AA-
    AA+
    AA+
    Moody’s rating
    A1
    A1
    Aa3
    Aaa

    Data as of Dec. 17, 2019.

    Mutual of Omaha — Best for Robust Coverage


    Best for Robust Coverage
    Mutual of Omaha
    Mutual of Omaha


    Pros

    Flexibility
    Quick access to benefits
    Independent home caregivers covered

    Cons

    Complex range of options

    Why we chose it

    Flexibility

    In choosing our top picks, we prioritized flexibility — from designing a policy to total benefit amounts and how they’re dispersed. All four of our picks excel, but none more than Mutual of Omaha, which offers benefit periods of two to five years, as well as the alternative “pool of money” model (up to $500,000). This gives policyholders more choice in their policy design than with any of our other finalists.

    Quick access to benefits

    Mutual of Omaha is our only top pick to count its Elimination Period in calendar days instead of service days, which means policyholders can get access to their benefits faster. (What is an Elimination Period? Read our answer below.) It’s a thoughtful touch that’s standard with the company.

    Independent home caregivers covered

    Your caregivers don’t need to be from an expensive agency in order to receive payment from Mutual of Omaha. Home care services (such as health aide visits) are also not subject to the Elimination Period at all — they’re covered as soon as you need them. And Mutual of Omaha’s “cash alternative” payout can also be up to 40% of your policy’s maximum monthly benefit, which is 10% higher than our other finalists’. That means if your care costs are low in a given month, you can opt for a check equal to 40% of your policy’s monthly maximum in lieu of other benefits. You can spend that cash on anything, not just covered services — another nice measure of flexibility.

    Points to consider

    Complex range of options

    In addition to the company’s vast repertoire of plan options, you also have premium and payout specifics to decide on. While this range of options is something we loved about the company, Mutual of Omaha’s spread of services may leave you feeling overwhelmed if you’re not insurance-savvy. If this is the case, it may be time to turn to a broker. An independent agent is often the best way to make sure you thoroughly compare your options. The Society of Financial Service Professionals can help you find one you can trust.

    Transamerica — Best for Affordable Policies

    Best for Affordable Policies
    Best for Affordable Policies
    Transamerica
    Transamerica


    Pros

    Small benefit amounts
    “Pool of money” model
    Competitive cash alternative

    Cons

    Requires agency caregivers

    Why we chose it

    Small benefit amounts

    Transamerica is a solid option for long-term care insurance, and it’s an especially good choice if you are looking for a modest policy — one to supplement, not shoulder, future financial burdens when it comes to healthcare. The company offers total benefit amounts as small as $18,250. Small benefits means greater affordability.

    ‘Pool of money’ model

    Transamerica uses the flexible “pool of money” model to define its policies’ benefits instead of years of care. This means that if a debilitating injury or surgery requires more intensive care one year and much lighter care the next, the pool of money can be drained as needed without yearly caps.

    Competitive cash alternative

    While Transamerica’s standard features are slightly less generous than Mutual of Omaha’s, it too boasts a zero-day waiting period for home care, reimbursing those costs as soon as you first have a need for them. And its monthly cash alternative caps at 30% of the policy’s maximum monthly value, not much less than Mutual of Omaha’s 40%.

    Points to consider

    Requires agency caregivers

    Transamerica requires that you receive in-home care from agency-affiliated caregivers before it pays out. Because agency services are likely more expensive than an independent caregiver would be, this stipulation could drain your benefits more quickly.

    Read our full Transamerica review.

    MassMutual — Best for Extended Care


    Best for Extended Care
    MassMutual
    MassMutual


    Pros

    Long benefit period
    Financial strength
    Independent home caregivers covered

    Cons

    Missing policy options

    Why we chose it

    Long benefit period

    MassMutual offers one of the longest benefit periods of our top four insurers at six years, topped only by New York Life’s seven-year benefit period. While the general rule — shorter benefit period/lower rates, longer benefit period/higher rates — applies, a lengthy plan could prove vital if a late-in-life illness leads to prolonged bed rest. A generous time frame means that paying for the care you need won’t weigh heavy on your mind.

    Financial strength

    MassMutual claims some of the best financial strength ratings of all of our finalists, meaning it has a proven track record of solvency and a confident outlook. You can rest assured that MassMutual will make good on its claims for as long as you need its payouts, and beyond.

    Independent home caregivers covered

    Like Mutual of Omaha, MassMutual will foot the bill for in-home care even if the caregiver you secure isn’t affiliated with a larger agency. This is an important point, since shopping around for independent caregivers could mean getting all the help you need for a more reasonable rate.

    Points to consider

    Missing policy options

    MassMutual fell short of both Mutual of Omaha and Transamerica in terms of useful policy options. The zero-day waiting period for home care (standard with our other top picks) is an optional extra with MassMutual. Additionally, there is no “pool of money” option, and there’s also no “cash alternative” benefit, meaning you have to submit receipts for absolutely everything. One final drawback: The Shared Care rider is only available with the shorter plans (two- and three-year benefit periods). If any of these policy options are especially important, you may be better off with one of our other picks.

    New York Life — Best for Simpler Policies


    Best for Simple Policies
    New York Life
    New York Life


    Pros

    Simple and affordable policies
    Superior financial strength

    Cons

    Lacks online quote tool
    AARP connection won’t help here

    Why we chose it

    Simple and affordable policies

    New York Life recently revealed that it would be making its policies more understandable and affordable by removing elimination periods. This would be done through a new product known as My Care. Dubbed the first of its kind, My Care covers a variety of long-term care needs, such as access to care planners and coverage for in-home support equipment. My Care, like medical coverage, works on deductibles and offers four predesigned levels:

    Bronze
    Silver
    Gold
    Platinum
    Policy lifetime maximum benefit
    $50,000
    $100,000
    $175,000
    $250,000
    Monthly maximum benefit
    $1,500
    $3,000
    $5,000
    $7,000
    One-time deductible
    $4,500
    $9,000
    $15,000
    $21,000
    Monthly reimbursement rate
    80%
    80%
    80%
    80%
    Monthly premium (male, age 55)
    $24.93
    $49.86
    $84.65
    $119.45

    Superior financial strength

    New York Life had the best financial strength ratings of our four top picks, with a Moody’s rating of Aaa tipping the scale. For us, this translated to a financially sound insurance provider you can rely on to have the funds whenever you need to file a claim. The only other provider on our list that even came close to these levels of financial solvency was MassMutual.

    Points to consider

    Lacks online quote tool

    As simple and affordable as New York Life has tried to be, we would have appreciated a little more accessibility. Internet shoppers hoping to get a fast quote online will be disappointed. While there is a tool to help you determine the average long-term care costs in your region, it might not reflect your own particular situation. As a result, the simplicity of the aforementioned My Care tiers is undermined, since you won’t know for certain which level will be best for your needs — at least, not without contacting an agent and risking being upsold.

    AARP connection won’t help here

    While you can get an AARP Life Insurance Program through the New York Life Insurance Company, it won’t help if you’re looking for long-term care. Even if you are an AARP member who opts for long-term care options, they will still be handled by New York Life. AARP only advertises its own term and permanent group coverage.

    Read our full New York Life review.

    How We Chose the Best Long-Term Care Insurance Providers

    Stand-alone long-term care coverage

    Long-term care insurance is actually available in a few different forms. Traditional, stand-alone LTC coverage is the most common, although there are more recent hybrid policies that pair with another insurance product like life insurance. While we explored these hybrid policies, we focused our attention on stand-alone plans, since they are still the most widely used.

    Available to all

    We started with a list of 23 LTC insurers. To ensure our top picks’ relevance and accessibility, we required that providers sell plans in at least 35 states and hold no special eligibility requirements. We also nixed any that didn’t underwrite their own policies, serving instead as middlemen for the policies of other insurers. The best long-term care provider is available to many people and meets all of its policyholders’ needs in-house.

    Financial strength

    An insurance company’s financial strength ratings are the best indicators of its ability to pay out on claims. Of the three largest independent ratings agencies, only A.M. Best rates strictly insurance. We strongly weighted these ratings, requiring a minimum grade of A- (“Excellent”). Then, because the Insurance Information Institute recommends getting ratings from at least two agencies, we also required one of the following: AA- (“Very Strong”) or higher from S&P Global or Aa (“High Quality”) or higher from Moody’s.

    Benefit periods as short as two years

    A long-term care policy’s benefit period is the length of time it will pay for care after you make a claim. Ideally, it lasts as long as you need care, but so-called “lifetime policies” are practically extinct today. Instead, most LTC policies offer a benefit period measured in years (although some use a “pool of money” model in which benefits are gradually subtracted from a lifetime amount with no set time period). The longer the benefit period, the more expensive the policy, sometimes prohibitively so. Because smaller policies can still be useful, potentially saving you from having to sell assets to pay for care, we required that companies offer benefit periods as short as two years.

    ‘Waiver of Premium’ as a standard provision

    “Long-term care insurance policies typically include the option to add a waiver of premium, in which the insurance company waives the premium payments for each month you or your spouse are receiving care. The waiver of premium applies to the type of care covered by the long-term care policy (for example, nursing facilities, assisted living facilities, continued or in-home care can be covered by the policy). All insurance policies are a contract of adhesion, so make sure to check what portion of your premium is waived.”

    Steve Sexton

    Financial consultant and CEO of Sexton Advisory Group

    Long-term care insurance typically kicks in at a time when most people are on a fixed, limited income, and “waiver of premium” removes the burden of paying premiums once your claim is approved. It’s not standard with every policy, but it is a wise inclusion and one we wanted to see in all of our top picks.

    ‘Shared Care’ rider option

    Shared Care enables couples to pool their coverage so that one person’s unused benefits are available to the other. “Shared Care saves couples money by letting them each buy shorter policies than they would otherwise buy separately,” explains Mickey Batsell, board member at National Insurance Marketing Executives. Partners can each purchase a shorter, more affordable benefit period (say three years) but keep their partner’s identical benefits on reserve should they end up needing them (allowing each the potential for six years of care). The risk: The first person to need care could exhaust the entire benefit. Still, the option of adding a Shared Care rider means greater flexibility and value, so we required that our picks include it as an option.

    How to Shop for Long-term Healthcare Insurance

    Consider future need

    We all need help as we get older, though how much help is impossible to predict. The U.S. Department of Health and Human Services estimates that 70% of all Americans age 65 and older will need some kind of long-term healthcare during their lifetime. The average need for care in the U.S. is currently about three years, but 20% need it for more than five. The most expensive scenario is a nursing home (with average annual costs currently over $90,000 per year), but having weekly or daily assistance in your home can still require tens of thousands of dollars annually. It makes sense to insure yourself for at least two to three years of care, if you can afford it.

    Start early

    Addressing the need for care sooner rather than later can make a huge difference in both your peace of mind and your bank account. The older you get, the more you’ll pay in premiums (and the more likely it is that you’ll develop a condition that makes getting covered more difficult). Lenny Robbins, a licensed life insurance broker with LifeNet Insurance Solutions, suggests, “Your early 50s are an ideal time to investigate your options for long-term care.”

    Choose your policy type

    If you’re worried you might never use the benefits in a traditional long-term care policy, a hybrid that combines LTC with life insurance might be more appealing. Such policies secure a benefit no matter what — either in the form of care for you or cash for your loved ones. There’s also no danger of premiums going up unexpectedly.

    However, there are trade-offs. For one, most hybrid products have a higher upfront cost: They require either a large one-time payment or a shorter set payment term (10 years is typical). And even if you have the cash available (a meaningful LTC benefit will require between $50,000 to $75,000 in total premium), paying it sooner means it’s not available to earn interest elsewhere. If you do end up needing care, the death benefit will decrease as a result, leaving your heirs with less.

    You should address your respective needs for life insurance and long-term healthcare insurance in their order of urgency. If you’re 55 or older and shopping primarily for life insurance, you may want to read our review on the best life insurance for seniors, but keep in mind that the accelerated death benefits we discuss may not cover all of your long-term care needs.

    Decide if you can afford to protect against inflation

    Buying insurance is about removing financial risk from your life, and inflation is a legitimate risk to your policy’s future value. Think of it this way: At 3% annual inflation, the care you can get today for $200,000 will cost $268,783 in 10 years and $361,222 in 20 years. That’s why it’s worth considering a 3% inflation rider.

    Long-Term Healthcare Insurance FAQ

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    About the Authors

    Philip Palermo

    Philip Palermo Lead Senior Editor - For the Home

    Philip Palermo leads the For the Home category at Reviews.com, including smart home and home security services. Since November 2015, he’s worn a number of hats at Reviews.com, but these days, Philip helps manage the day-to-day editorial content workflow. He’s worked at Engadget, The Unofficial Apple Weblog, Big Think, and several local/regional newspapers. Philip's also been known to use a lot of spreadsheets to gauge how much value he's getting out of his various services and subscriptions.