Im going to be 70 soon and am wondering if it is a good idea to obtain long-term care insurance. Two of my friends who are the same age as me just did so. After being on this site for several years I’m skeptical about it.
I think I am going to spend a lot of money for essentially nothing. I’d love to hear thoughts about this with pros and cons.
Long term care insurance is expensive and usually has limitations - read all that fine print. Only get your insurance from reliable companies that have been in business for many, many years. You will need that insurance in your (hopefully) distant future. Check the status of the company with the Better Business Bureau and any review companies you trust.
If you are still in good health, you may want to find out what the rates are and start saving at least that much each year. This way you at least have something to work with when you have decisions to make. If you are one to live a long life, you still have 30 years until you are 100!
My husband and I bought LTC insurance almost 30 years ago when we were in our 60s. For quite a few years the premiums were somewhat reasonable. However, over the last several years--just when we may need it !--the premiums have skyrocketed. They are now at a jaw-dropping level (think generous percentage of a down payment on a house) and likely will continue to rise. We are caught in a bind of possibly finding the premiums unaffordable on a moderate fixed income. I'm not sure that I would buy it again, but not all people earn enough and/or are disciplined enough to save consistently for something that seems very far in the future for younger folks, so there's that. . .
I guess my point here is to say you'll likely have trouble finding a company to insure you at your age. And even if you did, the policy might be junk, never pay out when needed, and have lots of loopholes. If you are willing to pay a lot of money, I would suggest you go through a brokerage that has a good reputation.
Retired over 15 years, now Dad has heart issues, had procedure done, tried to climb out of bed and fell 2 days afterward, breaking his hip! Mom has him home, as his sole Caregiver. Within 4 months is already burned out, yet refuses to use the LTC policy to get aides or housekeeping help, claiming, "No strangers in my house." Dad wants a male aide for help bathing, Mom says NO. Dad is a very big guy, Mom is petite. She could never pick him up the next fall...Why pay so much and not use his LTC policy? It makes no sense at all.
My friend is baffled and worried. She's a full time high school teacher, with 3 adult kids. They've been driving 8 hrs to visit parents, with stubborn Mom running the show. Dad wants aides, Mom refuses. A waste of all that money, which could have been put into savings instead.
Commissions are how insurance products are mostly done. It is what it is. But you should be aware of this. Just sayin’….
HUGE exiting of LTCI companies 2000-2015: Nationwide 2001, RiverSource 2003, Aetna 2006, UNUM individual 2009 & group 2012. 2010 MetLife, John Hancock individual, Equitable, all exiting. Prudential individual 2012. Plus many many smaller insurers. Even Genworth, the market leader for LTCI forever, had challenges and stopped new underwriting in 2019. If you have one of these LTCI policies, it’s still in force but the Company does no new policies & servicing usually by outside company. The worst cases scenario is that the insurer enters receivership and your States Guaranty Association takes over. It’s rare.
Why? Welcome to my Ted Talk…. to start, let’s go back last millennium. LTCI created late 1960s to deal with what newly created Medicare did not cover. It’s why LTCI initially started at 100 days as 100 is endpoint for Medicare rehab benefit, and also why LTCI was abt skilled nursing care and those staffing standards as 3 day hospital stay needed for Medicare to cover rehab. Big idea that LTCI did was it covered custodial care which Medicare did not AND skilled beyond Medicare’s 100. LTCI filled this gap. LTC = being in a NH. Insurers were able to project an endpoint for LTCI as it’s a 2 - 2.5 yrs avg from NH entry to death & abt 50% died before ever qualifying for LTCI. Maybe 50% would ever file & those that did abt 800 days of policyholder payout (Medicare did first 100). A definable risk & profitable. Policies sold uncapped (long tail) or 5-6 years coverage as probability was only half ever would even start payout. Risk totally fine.
HOWEVER….
1980/1990 Medicare & Medicaid changed from NH focused to having AL + community based programs as well. LTCI followed and covered inhome + AL. Problem was old risk equation didn’t work anymore. Rates had to go up and assessment got tighter. Often when LTCI asked a State Insurance Commissioner for increase they were able to get it perhaps less than the requested, but done, Then in 1996 HIPAA passed. It’s not just the privacy statement that’s “HIPAA” but was Health Insurance Portability & Accountability Act which required standardizations for all LTCI policies. All insurers had to review all products and adjust accordingly.
With this as a backdrop, big insurance co had to take a serious look at the LTCI division as to if worthwhile. 1990 380K individual policy sold, in 2000 755K sold. # seem good even if folks were living longer and more regulations. Then the recession hit: lower interest rates & voluntary lapse rates fell. State Insurance Commissioners didn’t easily allow for rate increases, which the insurance companies needed to be level funded. Plus HIPPA and dealing with independent insurance agents. (fwiw for independent agents they get 40-60% of first year premium then 5-15% for all subsequent years on average). All signs moving in the wrong direction to keep doing new LTCI policies. Majority stopped all new underwriting.
NWMutual, NYlife, MassMutal still sell LTCI. Realistically just how they have their policy options and terms and if that can work for you and you can afford it, is really something to suss out with your financial advisor imho. The current trend is “Hybrid policies” a type of whole life with a LTCI component. They seem to be structured around a doing a single large sum to set up the policy which can be used later for paying for care or left to your beneficiaries if you predecease needing a facility. I know someone who has gotten one, he had a company buy out so got a pile of cash so putting $$$$ into a hybrid with no future premium due was fine as not needed for living costs. If you are on a fixed income, it may be challenging to afford LTCI premiums over time. Good luck in your decision making!
This type of coverage is intended to protect assets for beneficiaries when their users pass away. But the users are likely have very large sums in the bank and great income in order to pay their policy premiums. Also, those interested in a policy who are not healthy or with their family history in bad health will not get coverage, even if those interested in buying a policy are only in their 50s or 40s.
Look at the pros and cons:
https://smartasset
.com/retirement/long-term-care-insurance-pros-and-cons
fwiw the hybrids are NOT - again not - LTC Medicaid compliant. So there better be a crap ton of $ in them so that the $ outlives you and there never ever is a thought to having to file for LTC Medicaid. If that was to happen, there might can be a work around and it’s imo CELA level of elder law attorney work to do….. in that primary beneficiary for the life insurance is changed to be State Medicaid division. Ditto for the annuity for its end beneficiary plus the $ from the annuity - in payout mode- is income that has to be paid to the NH ea mo due to Medicaid required Share of Cost. Income max is $2901 (for most States) so if income - between their SSA $ and annuity $ - take them over the $2901, that poses problems for LTC Medicaid eligibility. Again it’s not DIY but work with an attorney situation.
To me, if you are just not a HNWI / High Net Worth individual, you have to be really careful in all this. Imho a lot of smoke & mirrors with insurance products. Folks often hear what they want to hear and it ends up being a problem.
Dealing with the LTC insurance company during my husband's illness has been a nightmare. They delay and delay, hoping the insured will die before they have to pay. It was only for a total of $15,000. That didn't even pay for two months of his memory care facility.
Medicare does not pay for nursing homes or Assisted Living but if you have no money you can apply for Medicaid for nursing home but not for Assisted Living. Poor people get much more benefits than people with money. I suggest you see an Elder Attorney for advice. If I cancel my insurance I will lose everything I paid into it.
if I had to first take it out now I definitely would not but I don’t want to lose everything I put into it. Most insurance companies discontinued selling these policies because people are now living longer and they are losing money.
Medicare does not pay for nursing homes or Assisted Living but if you have no money you can apply for Medicaid for nursing home but not for Assisted Living. Poor people get much more benefits than people with money. I suggest you see an Elder Attorney for advice. If I cancel my insurance I will lose everything I paid into it.
if I had to first take it out now I definitely would not but I don’t want to lose everything I put into it. Most insurance companies discontinued selling these policies because people are now living longer and they are losing money.
I bought into a plan some time in my 40's and it was paid up shortly after I retired. I'm now 80 and the insurance is now picking up the roughly $10K a month charges for my wife's care; my savings could easily run out otherwise.
MYTH: The One Big Beautiful Bill “cuts Medicare.”
FACT: Medicare has not been touched in this bill— absolutely nothing in the bill reduces spending on Medicare benefits. This legislation does not make a single cut to welfare programs—it safeguards and protects these programs for all eligible Americans.
Medicare never paid for long term care anyway, btw.
MYTH: The One Big Beautiful Bill “kicks American families off Medicaid.”
FACT: As the President has said numerous times, there will be no cuts to Medicaid. The One Big Beautiful Bill protects and strengthens Medicaid for those who rely on it—pregnant women, children, seniors, people with disabilities, and low-income families—while eliminating waste, fraud, and abuse. The One Big Beautiful Bill removes illegal aliens, enforces work requirements, and protects Medicaid for the truly vulnerable.
It helps to get your facts straight, which you can here:
https://www.whitehouse.gov/articles/2025/06/myth-vs-fact-the-one-big-beautiful-bill/
That can save the insurance company from having to pay for assisted living , as most don’t have RN’s always on duty.
This results in some only covering SNF care in some areas depending on where you live. This is by design by the insurance to get out of paying .
Make sure you read the contract . I’m sure some don’t cover home care and others do as well .
I’ve also heard of some insurance closing ( went out of business ) , people lost coverage they paid for . Do your research .
If you have the finances to afford a whopping LTC insurance policy I would get good financial advisor to help you find the best kind. They vary widely.
These decisions are very dependent on your assets and how much you wish to preserve them for the next generation.
But the long and the short of it was that it didn't kick in until after a "vetting" period - which was 90 days after initial care started. For facility care, that would have been 3 months of course. My grandfather was long since passed, but my grandmother needed in home care - which was covered - but after the same vetting period - and she only needed care a couple of days a week to give my mom a break. So 90 days would have taken longer than she actually lived once she needed that level of 24/7 care. We opted instead for me to work from my grandmother's house on the days mom needed to get out of the house.
It was a shame because they invested so much into it and got nothing in return.
Make sure you know the rules and requirements and whether or not they meet the needs you might potentially have. I think that is the most critical point to make sure it even does what you need it to do when you are ready to use it.