Frequently Asked Questions

Yes. You decide the total amount of coverage. Even a small policy can reduce the stress and burden on your family.

Yes, especially under age 65. Premiums vary over 100% between companies — a specialist shops all major carriers for you.

Most states have rate stabilization rules. Some companies offer single pay or limited pay options that lock in your rate.

Most policies pay for all levels of long-term care including care in your own home.

Yes, benefits are tax-free. You may qualify for deductions or credits. HSA funds can pay your premium.

No. Policies cannot be canceled unless you stop paying. Benefits are available anywhere in the US and US territories.

You should generally have at least $75,000 in savings and investments outside of your home. If you have more than $3,000,000 you should consider unlimited total asset protection policies.

The best time to plan is when you are in your 40s or 50s. If you are over age 70 your options may be more limited. Those over 80 have very few, if any, options available.

Underwriting criteria differ with every company. You ideally want to obtain coverage when you enjoy good health. A specialist can help determine your eligibility based on your health history.

Being a caregiver is very difficult and can adversely impact your children's families, careers and health. A Long-Term Care policy ensures access to quality care without burdening loved ones.

Many policies offer spousal discounts and shared benefits. This provides additional savings and flexibility that should be discussed with your specialist.

45 states offer special Partnership Long-Term Care Insurance policies which provide additional dollar-for-dollar asset protection, even if you exhaust all policy benefits.

Long-term care is help with everyday activities you can no longer do on your own — things like bathing, dressing, eating, and getting around. It's not medical treatment. It's personal care and supervision, usually needed because of aging, chronic illness, or cognitive decline like Alzheimer's. Most people think of nursing homes, but long-term care happens in many settings: your own home, an assisted living community, an adult day program, or a skilled nursing facility. About 70% of people who receive long-term care get at least some of it at home.

Very likely. Someone turning 65 today has roughly a 70% chance of needing some form of long-term care in their remaining years. Women face higher odds — they tend to live longer and need care for an average of 3.7 years, compared to 2.2 years for men. About 20% of people over 65 will need care for more than five years. Only about a third will never need any long-term care at all.

More than most people expect. Based on 2025 national medians: in-home health aide costs roughly $80,000/year for full-time care, assisted living averages about $74,400/year, a semi-private nursing home room averages about $115,000/year, and a private nursing home room costs nearly $130,000/year. A three-year nursing home stay in a private room costs approximately $389,000 at today's rates — and costs continue to rise.

Activities of Daily Living are the six basic self-care tasks used to measure whether someone needs long-term care: bathing, dressing, eating, toileting, transferring (getting in and out of a bed or chair), and continence. Insurance benefits are triggered when you can't perform at least two of these six activities without help — or when you need supervision due to cognitive impairment like dementia.

No — and this is one of the most common misconceptions in retirement planning. Medicare covers limited skilled nursing care after a qualifying hospital stay: up to 20 days fully covered, then a copay for days 21–100. After day 100, Medicare pays nothing. That's rehabilitative care — short-term recovery. Medicare does not cover the ongoing custodial care that most people think of as long-term care.

Medicaid does cover long-term care and is actually the largest payer for nursing home care in the US. But Medicaid is a needs-based program — you have to spend down most of your assets to qualify. In most states, the asset limit for an individual is $2,000. Medicaid also applies a five-year look-back period on asset transfers. For people who've spent decades building savings, Medicaid eligibility essentially means spending their way to poverty first. That's the gap long-term care insurance fills.

There are four main settings: home care (a caregiver comes to your home — where about 70% of long-term care happens), adult day care (daytime programs providing social activities and health services — the most affordable formal option), assisted living (residential communities with personal care, meals, and some health services — averaging about $6,200/month), and nursing homes (24-hour care including medical supervision — the highest level and most expensive, averaging $315–$355/day).

Family members provide the majority of long-term care in the US — an estimated 53 million Americans serve as unpaid caregivers. Spouses and adult children shoulder most of this burden, often while managing their own careers, families, and health. One of the most important reasons to plan for long-term care is to give your family a choice. Without a plan, the default caregiver is usually an adult child — which can strain their career, finances, health, and relationships.

You pay regular premiums in exchange for a pool of money that becomes available if you ever need long-term care. When you qualify for benefits — typically by being unable to perform at least two Activities of Daily Living, or having a cognitive impairment — the policy pays a daily or monthly amount toward your care costs. Key terms include: elimination period (a waiting period, usually 90 days, before benefits begin), benefit period (how long the policy pays, typically 2–5 years), daily benefit (the maximum paid per day), and inflation protection (automatic annual increases to keep pace with rising costs).

It depends on your age, health, gender, and the coverage you choose. For traditional policies with a $165,000 initial benefit pool and 3% compound inflation protection, a 55-year-old couple pays roughly $5,050/year combined, while a 60-year-old couple pays roughly $5,800/year. Women pay more — typically 40–70% more than men for identical coverage — because they statistically live longer and are more likely to need care. The biggest factor in cost is when you buy — a policy bought at 55 can cost 40–50% less than the same policy at 65.

Traditional policies work like most insurance: you pay annual premiums, and if you need care, the policy pays benefits. If you never need care, the premiums are gone. Hybrid policies combine long-term care coverage with life insurance or an annuity — if you need care, the LTC benefit pays; if you never need care, your beneficiaries receive a death benefit. Hybrid premiums are typically paid as a lump sum and are guaranteed never to increase. Traditional premiums are lower per year but can increase with state approval. Most new policies sold today are hybrids.

Yes. Unlike health insurance, long-term care insurance involves medical underwriting. Denial rates increase with age: roughly 12% of applicants in their 40s are denied, 17–23% in their 50s, 25–35% in their 60s, and nearly half of applicants over 70. Many common conditions — controlled high blood pressure, managed diabetes, cancer in remission — often don't disqualify you, though they may affect your rate class. A specialist knows which carriers are favorable for specific health profiles.

Inflation protection automatically increases your benefit amount each year so it keeps pace with rising care costs. Without it, a policy that covers $200/day today might fall far short 20 years from now. The most commonly recommended option is 3% compound — your benefits grow like compound interest. A $200/day benefit with 3% compound inflation grows to about $362/day after 20 years. For anyone under 65, compound inflation protection is almost always worth the premium difference.

When you need care, you contact your insurance company's claims department. A licensed health care practitioner must certify that you meet a benefit trigger: inability to perform at least two of six Activities of Daily Living without substantial help (expected to last at least 90 days), or the need for supervision due to severe cognitive impairment. You submit a plan of care, then the elimination period begins (usually 90 days). Once the elimination period ends, benefits start flowing. Most policies pay for care in any licensed setting.

With a traditional policy, the premiums don't come back — similar to any other insurance you carry. With a hybrid policy, this concern essentially disappears: if you never need care, your beneficiaries receive a life insurance death benefit, often equal to or greater than the premiums you paid. Some hybrid policies also let you surrender for cash value. This "either way" value is the main reason hybrid policies have taken over the market.