Long-term care insurance pays for nursing home, assisted living, and in-home care that Medicare does not cover. The best LTCI companies in 2026 are Mutual of Omaha, New York Life, Lincoln Financial, Transamerica, Northwestern Mutual, Genworth, and Nationwide — compared by coverage, cost, and financial strength.
Long-term care insurance (LTCI) pays for nursing home care, assisted living, memory care, and in-home aide services that Medicare does not cover. The best long-term care insurance companies in 2026 are Mutual of Omaha, Transamerica, New York Life, Lincoln Financial, Northwestern Mutual, Genworth, and Nationwide. Premiums average $1,500–$3,500/year for a healthy 55-year-old, depending on benefit amount and elimination period.
Last updated: May 2026 | YMYL content — consult a licensed insurance professional before purchasing | Reviewed annually
The U.S. Department of Health and Human Services estimates that 70% of Americans turning 65 today will need some form of long-term care during their lifetime. The median annual cost of a private nursing home room in 2026 is approximately $108,000 — and Medicare only covers a limited period of skilled nursing care after a hospital stay. Without LTCI, most of these costs fall on personal savings or family caregivers.
Planning ahead matters: LTCI premiums are significantly lower when purchased in your 50s versus your 60s or 70s, and health underwriting becomes more restrictive with age. A person in good health at 55 pays roughly half what a comparable applicant at 65 would pay.
We evaluated 12 carriers across five criteria:
| Criterion | Weight | What We Measured |
|---|---|---|
| Financial strength | 30% | A.M. Best rating and long-term solvency track record |
| Policy flexibility | 25% | Benefit triggers, inflation protection options, elimination periods |
| Claims experience | 20% | NAIC complaint ratio, claims approval rate |
| Pricing stability | 15% | Historical premium increase frequency and magnitude |
| Coverage breadth | 10% | In-home care, assisted living, memory care, international coverage |
Mutual of Omaha's MutualCare Secure Solution offers strong coverage flexibility, stable pricing history, and an A+ A.M. Best rating. It's the top pick for most buyers seeking traditional standalone long-term care coverage with a straightforward claims process.
Transamerica offers benefit periods from 2 to 5+ years and a strong partnership with leading care coordinators. Their TransCare III product is designed for buyers who want precise control over their daily benefit amount and benefit period length.
New York Life holds the highest possible financial strength ratings and offers a non-forfeiture benefit that returns a portion of paid premiums if you lapse the policy. For buyers who prioritize carrier security above all, New York Life is the gold standard.
Lincoln MoneyGuard is a hybrid universal life insurance policy with an LTC rider — if you never need long-term care, your heirs receive a death benefit. This solves the "use it or lose it" objection that stops many buyers from purchasing traditional LTCI.
Northwestern Mutual's long-term care solutions integrate with their broader wealth management approach, making them ideal for clients with existing Northwestern Mutual life insurance or investment relationships. Their financial strength rating rivals New York Life.
Genworth was a market leader in LTCI but has significantly curtailed new policy sales in most states due to pricing challenges. For existing Genworth policyholders, maintaining coverage is recommended. For new buyers, Genworth is generally not the first choice in 2026.
Nationwide's CareMatters II is a linked-benefit fixed annuity that doubles or triples your annuity value if you need long-term care. Unlike traditional LTCI, it does not require health underwriting as strict, and unused funds pass to beneficiaries as a death benefit.
| Company | A.M. Best | Type | Sample Annual Premium* | Best For |
|---|---|---|---|---|
| Mutual of Omaha | A+ | Traditional | $1,800–$2,400 | Overall best value |
| Transamerica | A | Traditional | $2,000–$2,800 | Custom benefit periods |
| New York Life | A++ | Traditional | $2,200–$3,000 | Maximum financial security |
| Lincoln Financial | A+ | Hybrid Life/LTC | Lump sum $50K+ | No use-it-or-lose-it |
| Northwestern Mutual | A++ | Traditional/Hybrid | $2,400–$3,200 | High-net-worth clients |
| Genworth | B++ | Traditional | Varies | Existing policyholders only |
| Nationwide | A+ | Hybrid Annuity/LTC | Lump sum $50K+ | Asset repositioning |
*Sample premiums for 55-year-old female in good health, $3,000/month benefit, 90-day elimination period, 3-year benefit period. Your premium will vary significantly.
The Genworth Cost of Care Survey (2025 data) shows national median costs:
Understanding what in-home care actually costs is critical context before purchasing — see our detailed breakdown of in-home care costs. For the relationship between long-term care, Medicaid, and assisted living, our guide on Medicaid and assisted living eligibility by state explains when and how Medicaid becomes relevant. And if you're also evaluating your Medicare coverage gaps, see our Medicare Supplement Insurance (Medigap) guide — Medigap does not cover long-term care, making LTCI a separate and important planning layer.
Does Medicare cover long-term care?
No — not in the way most people expect. Medicare covers up to 100 days of skilled nursing facility care after a qualifying 3-day hospital stay, and only for skilled care (nursing, therapy). It does not cover custodial care (help with bathing, dressing, eating) — which is the majority of long-term care. Medicaid covers nursing home care for those who qualify financially, which typically requires spending down to very low asset levels.
How much long-term care insurance do I need?
A common starting point is covering 50–70% of expected LTC costs, assuming your income (Social Security, pension, retirement accounts) covers the remainder. For a nursing home cost of $9,000/month, a $5,000/month benefit with a 3-year benefit period provides $180,000 in coverage — a meaningful financial backstop without overinsuring.
What age should I buy long-term care insurance?
The optimal purchase window is ages 52–64. Buying in your 50s means lower premiums and easier health underwriting. After 70, many applicants cannot qualify due to health conditions. The American Association for Long-Term Care Insurance recommends applying before age 60 if LTCI is part of your plan.
What triggers long-term care insurance benefits?
Benefits trigger when you cannot perform 2 or more Activities of Daily Living (ADLs: bathing, continence, dressing, eating, toileting, transferring) — or when you have a cognitive impairment such as Alzheimer's or dementia. After a waiting period (the elimination period, typically 90 days), benefits begin paying.
Can long-term care insurance premiums increase?
Yes — traditional LTCI policies are not guaranteed fixed-premium. Carriers can (and have) raised premiums with state regulatory approval. Genworth's significant increases are the most well-known case. Hybrid policies (life/LTC or annuity/LTC) typically have fixed or more predictable costs. When comparing policies, ask the carrier for their historical rate increase data.
Is long-term care insurance tax-deductible?
Premiums for tax-qualified LTCI policies may be deductible as medical expenses above 7.5% of AGI. The deductible amount is limited by age (2026 limits: age 71+: $5,880; ages 61–70: $4,710; ages 51–60: $1,790; ages 41–50: $890). Business owners may deduct premiums as a business expense. Consult a tax professional for your specific situation.
What is the elimination period in long-term care insurance?
The elimination period is the deductible period — the number of days you must pay for care out-of-pocket before benefits begin. Common options are 30, 60, 90, or 180 days. The 90-day elimination period is the most common balance between premium savings and manageable out-of-pocket exposure.
What's the difference between traditional LTCI and hybrid policies?
Traditional LTCI is a standalone policy with an ongoing premium — benefits are paid if LTC is needed, but premiums are lost if you never claim. Hybrid policies combine LTCI coverage with life insurance or an annuity — if you never need LTC, heirs receive a death benefit or you retain annuity value. Hybrids cost more per dollar of LTC coverage but eliminate the "use it or lose it" concern.
Disclaimer: Long-term care insurance is a complex product. Coverage, premiums, and eligibility vary significantly by state, age, health status, and carrier. This article is for informational purposes only and does not constitute insurance advice. Consult a licensed, independent insurance professional before purchasing. Premium estimates are illustrative approximations and not actual quotes.
Author: SeniorSimple Editorial Team — senior living and insurance specialists with expertise in Medicare, long-term care, and retirement planning, reviewed by licensed insurance professionals.
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