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Long-term care questions, answered

Straight answers to the questions people ask most when they start planning for long-term care. No jargon, no sales pitch.

  • Does Medicare cover long-term care?

    No. Medicare covers only limited, short-term skilled care — not the ongoing custodial care most people need.

  • Does Medicaid pay for long-term care?

    Yes, but only after you have spent down most of your assets to qualify. Medicaid is the largest payer of long-term care in the U.S.

  • What is the average cost of long-term care?

    In 2025, roughly $80,000/year for home care, $74,000 for assisted living, and $115,000+ for a nursing home.

  • At what age should I buy long-term care insurance?

    Most people buy in their 50s or early 60s, while they are healthy enough to qualify and premiums are lower.

  • What does long-term care insurance cover?

    Help with daily activities across settings — home care, adult day care, assisted living, and nursing homes.

  • What is the difference between traditional and hybrid long-term care insurance?

    Traditional is standalone "use-it-or-lose-it" coverage; hybrid combines care with life insurance or an annuity.

  • Can I get long-term care insurance if I have health problems?

    It depends. Coverage is medically underwritten, and some conditions make traditional policies unavailable.

  • What happens if I never use my long-term care insurance?

    With traditional coverage, premiums are not returned. Hybrid policies pay your family instead.

  • What are activities of daily living (ADLs)?

    The six basic self-care tasks — bathing, dressing, eating, toileting, continence, and transferring.

  • Is long-term care insurance worth it?

    It depends on your assets, income, health, and goals — it protects savings, but only if you can afford the premium long term.

  • How much does long-term care insurance cost at age 60?

    A healthy 60-year-old typically pays about $1,500 to $2,500 a year for a traditional long-term care policy — less for men, more for women — though premiums vary widely by health, benefits, and carrier.

  • How much does long-term care insurance cost at age 50?

    At age 50, a healthy person typically pays about $1,000 to $1,700 a year for traditional long-term care insurance — less than at 60, because younger, healthier buyers lock in lower rates.

  • How much does long-term care insurance cost for a couple?

    A healthy couple in their late 50s or early 60s typically pays about $3,000 to $5,000 a year combined for traditional long-term care insurance, helped by spousal discounts of roughly 15% to 30%.

  • Why do women pay more for long-term care insurance?

    Women pay more for long-term care insurance — often 30% to 50% more than men — because they live longer and file substantially more claims, so most insurers have used sex-distinct pricing since about 2013.

  • What factors affect the cost of long-term care insurance?

    Long-term care insurance cost is driven mainly by your age and health when you buy, the benefit amount and benefit period, the elimination period, inflation protection, and your sex and marital status.

  • Can long-term care insurance premiums increase after I buy?

    Yes — traditional long-term care policies are "guaranteed renewable," so the insurer can raise premiums for an entire class of policyholders (not you individually), and many have. Hybrid policies usually have fixed premiums.

  • What discounts are available on long-term care insurance?

    The biggest long-term care insurance discounts are the spousal/couples discount (about 15% to 30%), a preferred-health discount for good health, and group or association discounts.

  • How much does long-term care cost without insurance?

    Without insurance you pay out of pocket at 2025 national rates of about $80,000 a year for home care, $74,000 for assisted living, and $115,000+ for a nursing home — until you spend down to qualify for Medicaid.

  • What does long-term care insurance not cover?

    It generally does not cover care from your own family (unless the policy allows it), medical and hospital bills that health insurance or Medicare handle, or care excluded by the policy — such as injuries from substance abuse or, often, care received outside the U.S. Exclusions vary by policy.

  • Does long-term care insurance cover in-home care?

    Yes — most modern policies cover in-home care, including help with daily activities from a home health aide, and it is the most-used benefit. Older or nursing-home-only policies may not, so check the policy.

  • Does long-term care insurance cover assisted living?

    Usually yes. Most comprehensive long-term care policies cover assisted living and memory care up to your daily or monthly benefit amount. The facility generally must be licensed and meet the policy definition.

  • Does long-term care insurance pay family caregivers?

    Sometimes. Traditional reimbursement policies usually pay only licensed providers, but cash or indemnity policies pay a set monthly benefit you can use however you want — including paying a family member. Check whether yours reimburses expenses or pays cash.

  • What is an elimination period in long-term care insurance?

    It is the waiting period — like a deductible measured in days — between when you qualify for benefits and when the policy starts paying. Common choices are 30, 60, or 90 days, during which you pay for care yourself. A longer elimination period lowers your premium.

  • What triggers long-term care insurance benefits?

    Benefits typically start when you cannot do at least two of the six activities of daily living without help, or you have severe cognitive impairment such as dementia. A licensed professional must certify it, and the need must be expected to last at least 90 days.

  • What is hybrid long-term care insurance?

    A hybrid policy combines long-term care coverage with life insurance or an annuity. If you need care, it pays for care; if you never do, it pays a death benefit to your family — solving the "use it or lose it" worry of traditional coverage.

  • What is a shared care rider in long-term care insurance?

    A shared care rider lets a couple share one pool of long-term care benefits, so if one spouse uses up their coverage, they can draw on the other's. It hedges against one partner needing far more care than expected.

  • What is inflation protection in long-term care insurance?

    Inflation protection automatically grows your daily or monthly benefit over time so it keeps pace with rising care costs. Because care costs climb for decades before most people claim, it is one of the most important features on a policy — often 3% compound.

  • What is return of premium on a long-term care policy?

    A return-of-premium feature refunds your premiums — to you or your heirs — if you never use the policy. It is built into most hybrid policies as a death benefit and addresses the "what if I never need care" concern of traditional coverage.

  • Should I choose simple or compound inflation protection?

    Compound inflation grows your benefit on an ever-increasing balance, while simple grows it by a flat amount based on the original benefit. Compound costs more but pulls far ahead over time — usually the better choice for buyers under about 65.

  • What is a benefit period in long-term care insurance?

    The benefit period is how long your policy will pay — commonly 2, 3, or 5 years. Combined with your daily benefit, it sets your total pool of money. Longer periods cost more, and most claims last under three years.

  • What is short-term care insurance and how is it different?

    Short-term care insurance works like long-term care insurance but covers a shorter period — typically up to about a year. It has easier underwriting and lower premiums, making it an option for people who cannot qualify for or afford traditional coverage.

  • What is a long-term care partnership program?

    A Long-Term Care Partnership Program is a joint federal-state program that lets a qualified policy protect your savings from Medicaid spend-down. For every dollar the policy pays in benefits, you can keep an extra dollar of assets and still qualify for Medicaid.

  • Does my state have a long-term care partnership program?

    Probably. The large majority of U.S. states have a Long-Term Care Partnership Program — only a handful do not. Because the list can change, confirm your state's status with your state insurance department or an independent agent.

  • How does long-term care insurance protect assets from Medicaid?

    Two ways: by paying for care so you never have to spend down your savings, and — with a Partnership policy — by letting you keep a matching amount of assets and still qualify for Medicaid if your coverage runs out.

  • Is long-term care insurance regulated by the state or federal government?

    Primarily by the state. Long-term care insurance is regulated by each state's insurance department, guided by national NAIC model rules. Federal law adds a layer — tax rules for "tax-qualified" policies, the Partnership program, and the separate federal-employee program.

  • What is the Federal Long-Term Care Insurance Program (FLTCIP)?

    The FLTCIP is a long-term care insurance program for federal and postal employees, retirees, active and retired military, and their families, run by the U.S. Office of Personnel Management. Note: it is not accepting new applications during a suspension in effect through December 2026.

  • Is the Federal Long-Term Care Insurance Program still accepting applications?

    No. The U.S. Office of Personnel Management suspended new FLTCIP applications on December 19, 2022, and has extended the suspension through December 19, 2026. During the suspension, no new applicants can enroll and current enrollees cannot increase their coverage.

  • What are the alternatives to long-term care insurance?

    The main alternatives are self-funding from savings, a hybrid or life-insurance policy with a long-term care rider, short-term care insurance, Medicaid (after spend-down), and — for those who qualify — VA benefits. Each trades cost, certainty, and coverage differently.

  • What is a life insurance policy with a long-term care rider?

    It is a permanent life insurance policy with a rider that lets you draw on the death benefit to pay for long-term care while you are alive. If you use it for care, it reduces what your heirs receive; if you do not, they get the full death benefit.

  • What is crisis Medicaid planning?

    Crisis Medicaid planning is arranging your finances to qualify for Medicaid quickly when a loved one already needs care and did not plan ahead. Done with an elder-law attorney, it uses legal tools to protect some assets — but options are far more limited than planning early.

  • Can veterans get help paying for long-term care?

    Yes, some can. The VA offers long-term care services and the Aid & Attendance pension — an added monthly benefit for wartime veterans and surviving spouses who need help with daily activities and meet service, income, and net-worth rules.

  • How do you file a long-term care insurance claim?

    You contact the insurer to open a claim, then it confirms you meet the benefit triggers — needing help with two of six activities of daily living, or cognitive impairment — through medical records and an assessment, and approves a plan of care. Then the elimination period runs before benefits begin.

  • How long does it take for a long-term care insurance claim to pay out?

    Initial approval usually takes a few weeks to a couple of months while the insurer verifies you meet the benefit triggers, then benefits begin after your elimination period. Complete paperwork and prompt medical records speed it up.

  • Can I cancel my long-term care insurance policy?

    Yes, you can cancel any time by stopping payments or notifying the insurer, and new policies have a 30-day "free look" for a full refund. But canceling a traditional policy usually means walking away with nothing, so weigh the alternatives first.

  • What happens if I stop paying long-term care insurance premiums?

    Your coverage generally lapses and, with a traditional policy, you lose it and the premiums you paid. Some policies include nonforfeiture benefits, and many states require a contingent benefit if premiums rose sharply — so contact the insurer before you stop.

  • How do I check a long-term care insurer's financial strength rating?

    Check the insurer's financial-strength ratings from independent agencies — A.M. Best, Moody's, S&P, and Fitch. Because you may not claim for decades, buy from a highly rated, stable carrier. Ratings are free to look up on each agency's website.

  • Is long-term care insurance tax deductible?

    Sometimes. Premiums for a tax-qualified policy count as medical expenses, deductible on Schedule A only to the extent your total medical costs exceed 7.5% of income — and only up to an age-based limit. Self-employed people and business owners get a far better deal.

  • What are the 2026 tax-deductible limits for LTC insurance premiums?

    For 2026, the IRS eligible-premium limits you can count toward the deduction are, per person: $500 (age 40 or less), $930 (41–50), $1,860 (51–60), $4,960 (61–70), and $6,200 (71 and older). The per-diem benefit limit is $430 per day.

  • Can a business deduct long-term care insurance premiums?

    Often yes, and generously. A C-corporation can typically deduct 100% of tax-qualified LTC premiums for owners and employees with no age cap. Self-employed people and other business owners can deduct up to the age-based limit "above the line," without the 7.5%-of-income threshold.

  • What is a 1035 exchange for long-term care insurance?

    A 1035 exchange lets you move money from an existing life insurance or annuity policy into a long-term care or hybrid policy tax-free. It is a popular way to reposition an underused annuity or old cash-value life policy to fund coverage without a taxable event.

  • How does long-term care insurance affect retirement planning?

    Long-term care insurance protects a retirement plan from its biggest wild card — an open-ended care bill that can drain savings and shift the burden to a spouse or children. Building it in preserves income for the healthy spouse and keeps your estate intact.

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