Who Are the Top 10 Long-Term Care Insurance Providers?

Long-term care insurance (LTCI) serves as a financial planning tool designed to cover the costs associated with long-term care services. These services, which include assistance with daily activities, can be provided in various settings such as home, assisted living facilities, or nursing homes. As healthcare costs continue to rise and lifespans extend, the potential need for long-term care becomes a significant consideration for many individuals. Understanding the options available through different LTCI providers is an important step in preparing for future care needs.

Key Considerations for Provider Selection

Evaluating long-term care insurance providers involves assessing several criteria to ensure a company’s reliability and suitability. Financial strength ratings are a primary indicator of an insurer’s ability to fulfill its long-term policy obligations. Independent agencies such as A.M. Best, Moody’s, and S&P Global Ratings assess an insurer’s financial health and business profile.

A.M. Best assigns ratings from A++ (Superior) to F (In Liquidation), with higher ratings indicating greater financial security. Moody’s uses a letter grade scale from Aaa (Exceptional) to C (Lowest), incorporating numerical modifiers. S&P Global Ratings provides financial strength ratings, with AAA being the strongest. These ratings provide an opinion on the insurer’s creditworthiness and their capacity to pay claims. Reviewing ratings from multiple agencies offers a comprehensive view of a company’s financial stability.

Policy customization and flexibility are also important, reflecting a provider’s ability to offer options that align with diverse needs. This includes various policy types, benefit periods, elimination periods, and optional riders. Riders, such as inflation protection or shared care benefits, can enhance a policy’s value and adaptability. A provider offering customizable features allows policyholders to tailor coverage to their specific financial situation and future care requirements.

Customer service and claims handling reputation provide insight into a provider’s efficiency and responsiveness. Information on service quality can be gathered from consumer reviews and complaint ratios reported by state insurance departments, often compiled by the National Association of Insurance Commissioners (NAIC). A low NAIC complaint index, which compares a company’s complaints to its market share, suggests higher customer satisfaction. A high complaint index may indicate issues with service, underwriting, or claims processes.

A provider’s experience and specialization within the long-term care insurance market is also a valuable consideration. Companies with a long history in this field often demonstrate a deeper understanding of long-term care needs. Their sustained presence may indicate a commitment to the market and a refined approach to product development and service delivery. Selecting a provider with a proven track record in LTCI offers assurance regarding their expertise and reliability.

Leading Long-Term Care Insurance Providers

Several companies lead the long-term care insurance market, offering traditional and hybrid policy options. Their standing reflects strong financial ratings, comprehensive policy features, and established reputations.

Mutual of Omaha is a market leader for traditional long-term care insurance, offering competitive pricing and flexible features. It holds an A+ (Superior) rating from A.M. Best, an A+ from S&P Global Ratings, and an A1 from Moody’s. Their MutualCare Custom Solution is recommended for its flexibility, including adjustable benefit levels and inflation protection choices.

Nationwide offers hybrid long-term care solutions, including its CareMatters® II plan, which combines life insurance with long-term care benefits. This plan offers a monthly cash indemnity benefit, providing flexibility for care expenses. Nationwide holds an A (Excellent) from A.M. Best, an A+ from S&P Global Ratings, and an A1 from Moody’s.

New York Life holds an A++ (Superior) rating from A.M. Best, AAA from Fitch, Aaa from Moody’s, and AA+ from S&P. It offers stand-alone long-term care policies, such as NYL My Care and NYL Secure Care, and a linked-benefit policy called Asset Flex. New York Life also provides options for inflation protection and nonforfeiture benefits.

National Guardian Life (NGL) is a traditional long-term care insurer, noted for its EssentialLTC product and its “third pool” shared care benefit for couples. NGL has an A (Excellent) rating from A.M. Best. Their policies offer flexible payment options, joint policy discounts, and inflation protection.

Northwestern Mutual provides stand-alone and hybrid long-term care policies, including its QuietCare reimbursement-style policy. It offers potential policy dividends to policyholders, reflecting a share of company profits. Northwestern Mutual also offers competitive discounts, particularly for couples.

Thrivent Financial has an A++ (Superior) rating from A.M. Best. Its policies can be a suitable option for younger individuals, with a minimum issue age allowing for earlier purchase. Thrivent’s offerings include comprehensive coverage with flexible benefit periods and elimination periods.

Brighthouse Financial offers the hybrid long-term care policy, SmartCare®, which provides an all-cash benefit and comprehensive international coverage. This policy combines life insurance with long-term care, offering a guaranteed death benefit and protection against market loss. Brighthouse holds an A (Excellent) from A.M. Best.

Lincoln Financial Group offers hybrid long-term care insurance plans, such as MoneyGuard III and MoneyGuard Market Advantage, which combine life insurance with LTC benefits. These policies feature flexible payment options and can include international benefits. Lincoln Financial policies can also have high maximum issue ages, extending eligibility.

OneAmerica, through its State Life Insurance Company, offers asset-based long-term care solutions, combining life insurance or annuities with LTC benefits. Their Asset Care policy series offers guaranteed level premiums and streamlined health underwriting. These hybrid policies provide a death benefit if long-term care is not needed.

John Hancock offers a Universal Life Insurance Policy with a Long Term Care Rider, integrating long-term care coverage with a life insurance death benefit. This hybrid approach provides flexibility and a combined solution for financial protection. John Hancock offers full overseas benefits within its long-term care policy structure.

Understanding Long-Term Care Policy Structures

Long-term care insurance policies are structured as traditional or hybrid. Traditional policies are standalone products designed to cover long-term care expenses. They define a daily or monthly benefit amount used for care services once the policyholder meets specified benefit triggers. Common triggers include the inability to perform Activities of Daily Living (ADLs), such as bathing or dressing, or cognitive impairment.

Traditional policies feature an elimination period, a deductible time (e.g., 30, 60, or 90 days) during which the policyholder pays for care out-of-pocket before benefits begin. The benefit period, ranging from a few years to a lifetime, determines how long the policy pays benefits. Traditional policies are typically reimbursement-based, paying for actual expenses incurred up to the daily or monthly maximum, though some may offer cash indemnity benefits.

Hybrid policies, also known as linked-benefit policies, combine long-term care coverage with a life insurance policy or an annuity. These policies offer a death benefit to beneficiaries if long-term care services are not utilized, or provide long-term care benefits if needed. A key difference from traditional policies is that hybrid policies often come with guaranteed premiums, providing predictable costs. Hybrid policies may also offer non-forfeiture benefits, ensuring a portion of the premium paid is returned or available even if the policy is surrendered. The integration with life insurance or an annuity means the policy value can grow, and long-term care benefits are accessed from this combined pool of funds.

Common policy riders enhance the value of both traditional and hybrid long-term care policies. Inflation protection riders help the daily or monthly benefit amount grow to keep pace with rising care costs. This can be simple inflation (fixed percentage increase) or compound inflation (increase based on the previous year’s adjusted benefit).

Shared care benefits allow couples to pool their long-term care benefits, providing flexibility if one partner requires more extensive care. A return of premium rider ensures that if the policy is canceled or the insured passes away without using all benefits, a portion of premiums paid are returned. The waiver of premium rider, if triggered by receiving long-term care benefits, exempts the policyholder from paying further premiums while receiving care.

Navigating the Application and Underwriting Process

The application and underwriting process assesses an applicant’s health and determines eligibility for coverage. The initial application requires personal details, including name, address, contact information, and relevant financial information.

The initial application focuses on medical history. Applicants provide information about past and present health conditions, medications, and previous medical treatments. This helps the insurer understand the applicant’s health status and potential risks.

Medical underwriting is a thorough health assessment conducted by the insurance company. This process involves reviewing medical records from healthcare providers. Insurers may also conduct phone interviews to clarify health information or ask additional questions about medical history and lifestyle. In some instances, an in-person assessment may be required, which could include a cognitive evaluation or a functional assessment of daily living activities.

The underwriting team evaluates collected medical and personal data to determine the risk associated with insuring the applicant. This assessment influences premium rates and policy terms. Underwriters consider factors such as age, current health, family health history, and pre-existing conditions.

Following the underwriting review, an underwriting decision is rendered. Outcomes include approval, approval with modifications, or decline. Approval means the applicant is accepted for coverage at standard rates. Approval with modifications might involve a higher premium, a reduced benefit amount, or specific exclusions based on identified health risks. A decline indicates the insurer cannot offer coverage due to the risk presented.

Upon approval, policy issuance begins. The insurance company generates the final policy documents, detailing terms, conditions, benefits, and premium schedules. Once the policy is issued and the initial premium is paid, coverage becomes active, providing financial protection for long-term care needs.