Aetna, a subsidiary of CVS Health, was one of the earlier participants in the long-term care insurance market and offered traditional LTC insurance products for many years before closing its block to new sales. In addition to its legacy LTCi business, Aetna became well known for its Recovery Care and Recovery Care Choice products, which are designed as short-term care or recovery care insurance solutions that help cover expenses for nursing home care, assisted living, home health care, rehabilitation, and hospital confinement.

Aetna’s Recovery Care Choice product was created to provide more flexible and affordable coverage for consumers who may not qualify for or want traditional long-term care insurance. The product offers cash-style indemnity benefits that can be used for facility care, assisted living, home care, observation hospital stays, and recovery services. Benefits are paid directly to the policyholder unless assigned to a provider, giving insureds flexibility in how care dollars are spent. Available features include nursing facility benefits, home care options, hospital indemnity coverage, bed reservation benefits, and guaranteed renewable coverage.

As of 2025, Aetna Life Insurance Company maintains an A (Excellent) Financial Strength Rating from AM Best with a stable outlook.

Bankers Life and Casualty, a subsidiary of CNO Financial Group, has been serving the senior insurance market for decades and has offered long-term care insurance products since the 1980s. The company focuses primarily on traditional long-term care insurance, short-term care coverage, and retirement-focused health insurance solutions for middle-income Americans.

Financial strength ratings for Lincoln Financial Group remain strong, including:

• AM Best: A (Excellent)
• CNO's financial strength and stability is rated as investment grade by all four leading ratings agencies-A.M. Best, Moody's, Fitch, and S&P.

According to the company’s most recent long-term care reporting, Bankers Life paid LTC insurance claims to more than 194,000 policyholders, totaling approximately $194 million in long-term care insurance benefits paid in 2025. The NAIC long-term care experience data also reflects Bankers Life as an established legacy LTC insurer with a significant in-force block of policyholders and ongoing claims exposure.

Bankers Life remains one of the more recognized career-agent long-term care insurance carriers in the United States, distributing coverage through a nationwide captive-agent network focused heavily on retirement-age consumers.

Brighthouse Financial is a major U.S. life insurance and annuity carrier that participates in the long-term care insurance market primarily through hybrid life insurance products with long-term care benefits, including Brighthouse SmartCare®. The company was established as an independent entity in 2017 following its separation from MetLife, although its insurance operations trace back decades through MetLife and Travelers-related companies.

Brighthouse Financial maintains strong financial strength ratings, including:

• A.M. Best: A (Excellent)
• S&P: A
• Moody’s: A3
• Fitch: A-

In the long-term care market, Brighthouse focuses on asset-based/hybrid long-term care solutions rather than traditional standalone LTC insurance. Its SmartCare product combines universal life insurance with long-term care benefits, allowing policyholders to access benefits for qualified long-term care expenses while preserving a death benefit for beneficiaries if care is never needed.

CareScout is the modern long-term care planning and services brand associated with Genworth Financial and its legacy long-term care insurance business. Through Genworth’s affiliated insurers, CareScout supports one of the largest in-force LTCi blocks in the industry, with decades of claims administration experience and care coordination resources.

Genworth’s long-term care insurance operations trace their roots back to 1974, giving the organization more than 50 years of LTC claims experience. According to CareScout and Genworth reporting, the company has paid more than 389,000 long-term care claims and over $32 billion in LTC benefits through December 31, 2024.

Financial strength ratings for Genworth’s principal LTC insurance subsidiaries currently include:

• Genworth Life Insurance Company (GLIC): AM Best “C++”
• Genworth Life and Annuity Insurance Company (GLAIC): AM Best “B-”
• Genworth Life Insurance Company of New York (GLICNY): AM Best “C++”

The NAIC long-term care experience reporting groups CareScout business under Genworth-affiliated insurance companies, primarily Genworth Life Insurance Company and related entities, rather than as a standalone “CareScout” insurer. Those affiliated insurers continue to manage a substantial nationwide block of LTC policyholders and claims.

In addition to insurance administration, CareScout has expanded into care navigation, provider quality networks, cost-of-care research, and long-term care planning tools designed to help consumers and families prepare for future care needs.

Forethought Life Insurance Company, part of Global Atlantic Financial Group, entered the long-term care insurance market primarily through linked-benefit and annuity-based long-term care products rather than large-scale traditional stand-alone LTCi policies. The company traces its roots to 1985 and today focuses heavily on asset-based long-term care planning solutions such as ForeCare.

The company maintains strong financial strength ratings, including:

• A (Excellent) — AM Best
• A2 — Moody's
• A — S&P Global Ratings
• A — Fitch

John Hancock, a subsidiary of Manulife Financial, has been a major participant in the long-term care insurance market since the late 1980s and is widely recognized as one of the largest legacy LTCi carriers in the United States. Today, the company primarily markets hybrid life insurance products with long-term care benefits, including LifeCare and other asset-based solutions. John Hancock emphasizes aging-in-place benefits, care coordination services, and wellness integration through its Vitality program.

John Hancock maintains strong financial strength ratings, including:

• A+ (Superior) from A.M. Best
• AA- from S&P Global
• A1 from Moody’s
• AA from Fitch Ratings

According to John Hancock marketing and carrier materials, the company has more than 40 years of long-term care insurance experience.

The most recent NAIC Long-Term Care Insurance Experience Report identifies John Hancock as one of the nation’s largest LTC insurers by in-force business and cumulative claims experience. The report reflects billions of dollars in long-term care claims paid to policyholders and beneficiaries over the life of its LTC block.

For consumers evaluating long-term care insurance carriers, John Hancock remains notable for its financial strength, extensive historical LTC claims experience, and continued presence in the hybrid LTC planning marketplace.

Lincoln Financial Group
is a major U.S. financial services company and a recognized leader in hybrid long-term care insurance solutions through its MoneyGuard® product line. Lincoln pioneered the hybrid life insurance and long-term care market in 1987–1988 with the introduction of its original MoneyGuard design, helping establish the modern asset-based LTCi marketplace.

Lincoln’s long-term care solutions are issued primarily through subsidiaries, including Lincoln Benefit Life Company and The Lincoln National Life Insurance Company. The company focuses heavily on linked-benefit and cash-value LTC planning products rather than traditional stand-alone LTC insurance.

Financial strength ratings for Lincoln Financial Group remain strong, including:

• AM Best: A (Excellent)
• S&P: A+
• Moody’s: A2 / A1
• Fitch: A+

According to the NAIC 2024 Long-Term Care Insurance Experience Report, Lincoln Benefit Life Company reported approximately 51,569 long-term care policyholders/lives in force and incurred LTC claims of approximately $201.3 million in 2024.

Lincoln Financial continues to be viewed as one of the leading carriers in the hybrid LTCi market, particularly for consumers seeking guaranteed-premium, asset-based long-term care protection with death-benefit features and flexible benefit options.

ManhattanLife is a privately held insurance company founded in 1850 that focuses primarily on life insurance, supplemental health products, annuities, and limited-benefit extended care coverage. Unlike many traditional long-term care insurance carriers, ManhattanLife’s long-term care offerings are generally structured as short-term care or indemnity-style products, such as the OmniFlex plan, rather than comprehensive traditional LTCi policies.

Within the long-term care market, ManhattanLife is best known for serving consumers who may not qualify for traditional LTC insurance due to health concerns. Their OmniFlex product provides limited nursing home, assisted living, and home health care benefits with optional inflation coverage.

Financial Strength Ratings:

• Demotech Financial Stability Rating (FSR): A (Exceptional)
• AM Best: recent third-party reviews cite approximately B++ (Good) financial strength for Manhattan Life Insurance Company.

ManhattanLife entered the extended care market primarily through limited-benefit and short-term care products rather than traditional standalone LTC insurance. The OmniFlex short-term care product has been marketed in recent years as an alternative for individuals unable to qualify for traditional LTCi.

Mutual of Omaha is one of the most recognized and financially stable carriers in the long-term care insurance industry. The company entered the long-term care insurance market in 1987 and continues to offer both traditional and hybrid long-term care planning solutions nationwide. Mutual of Omaha is known for flexible policy design, strong home care benefits, and competitive couples discounts.

The company maintains strong financial strength ratings, including:

• A+ (Superior) — AM Best
• A1 — Moody's
• A+ — S&P Global Ratings

According to the most recent publicly available reporting from the National Association of Insurance Commissioners Long-Term Care Insurance Experience Report, Mutual of Omaha currently serves approximately 150,000 long-term care insurance policyholders and has paid well over $1 billion in long-term care insurance claims to policyholders and their families.

Mutual of Omaha remains one of the few major insurers still actively offering new traditional long-term care insurance policies in the United States, making the company an important carrier in today’s LTC insurance marketplace.

Nationwide is best known in the long-term care market for its hybrid life insurance and long-term care products, particularly the CareMatters® line. Rather than focusing on traditional stand-alone LTC insurance, Nationwide has concentrated on linked-benefit solutions that combine life insurance, long-term care benefits, and death benefit protection. Nationwide entered the modern LTC-linked benefits market in 2017 with the launch of CareMatters.

Nationwide’s key financial strength ratings include:

• A+ (Superior) — AM Best
• A1 — Moody's
• A+ — S&P Global Ratings

The 2024 NAIC Long-Term Care Insurance Experience Report primarily tracks stand-alone LTC insurance business. Nationwide was not listed among the top stand-alone LTC insurers by lives in force or claims paid, which reflects its strategic focus on hybrid/linked-benefit products rather than legacy traditional LTCi blocks.

New York Life is one of the largest and oldest mutual life insurance companies in the United States and remains an active participant in the long-term care insurance market through both traditional and hybrid LTC solutions. The company currently markets long-term care coverage designed to help policyholders pay for home health care, assisted living, nursing home care, and care coordination services.

New York Life entered the long-term care insurance market in the late 1980s and continues today to offer LTC planning solutions for affluent and upper-middle-income consumers seeking asset protection and retirement security. The company is especially known for its financial stability and strong claims-paying reputation.

New York Life holds some of the highest financial strength ratings available in the insurance industry, including:

• A++ from AM Best
• AAA from Fitch
• Aaa from Moody’s
• AA+ from Standard & Poor’s

According to the 2024 NAIC Long-Term Care Insurance Experience Report, New York Life reported approximately 164,710 long-term care insurance lives in force and approximately $223.9 million in incurred LTC claims.

NGL Insurance Company is a mutual insurance company headquartered in Madison, Wisconsin, founded in 1909. NGL has become an emerging player in the hybrid and linked-benefit long-term care insurance market, focusing heavily on asset-based long-term care solutions designed for middle- and upper-income retirees seeking leverage and simplified underwriting. The company markets long-term care protection through products such as EssentialLTC and other cash-value linked-benefit policies.

NGL entered the long-term care insurance marketplace in the mid-2010s, expanding beyond its traditional life and annuity business into hybrid LTC planning solutions. The company has grown rapidly in the linked-benefit LTCi segment due to competitive pricing, flexible benefit structures, and strong partnership distribution with independent agencies and financial advisors.

From a financial strength standpoint, NGL currently holds:

• A (Excellent) — AM Best
• NGL is not currently rated by Moody’s, Fitch, or Standard & Poor’s.

According to recent company reporting, NGL serves approximately 1.2 million policyholders nationwide across all product lines.

The most recent available data from the NAIC Long-Term Care Insurance Experience Report indicates that NGL has paid hundreds of millions of dollars in long-term care insurance claims to policyholders and beneficiaries through its LTC product portfolio. The NAIC report reflects NGL’s continuing growth as a newer participant in the LTC insurance industry compared with legacy carriers that entered the market in the 1980s and 1990s.

OneAmerica Financial entered the long-term care insurance market in 1989 and has become one of the leading providers of hybrid or asset-based long-term care solutions, primarily through its Asset Care® and Annuity Care® product lines. The company is especially well known in the LTCi industry for offering one of the few hybrid policies with optional unlimited lifetime long-term care benefits. OneAmerica reports more than 35 years of experience in the long-term care market.

Financially, OneAmerica remains highly rated. Its insurance companies, including The State Life Insurance Company
and American United Life Insurance Company currently holds:

• A+ (Superior) — AM Best
• AA- — S&P Global Ratings

According to the NAIC Long-Term Care Insurance Experience Reports for 2024, the long-term care insurance industry paid billions in claims nationwide, with hybrid and asset-based LTC products continuing to grow rapidly. The NAIC report also confirms that OneAmerica participates in the extended-benefit and acceleration-benefit LTC marketplace rather than the traditional stand-alone LTC market segment.

OneAmerica does not publicly disclose an exact current number of long-term care policyholders, unlike some traditional LTC insurers. However, the company remains one of the most recognized hybrid LTC insurance carriers in the United States, especially for affluent consumers seeking guaranteed premiums, death benefits, and lifetime LTC benefit options.

Thrivent Financial is a fraternal financial services organization that has offered traditional long-term care insurance since the late 1980s, making it one of the more established carriers still actively participating in the LTCi marketplace. Thrivent is known for offering both traditional standalone long-term care insurance and hybrid life insurance products with long-term care benefits, primarily serving Christians and their families.

Thrivent's key financial strength ratings include:

• A++ (Superior) — AM Best
• AA2 — Moody's

Thrivent entered the long-term care insurance market in approximately 1987 and remains one of the few insurers continuing to sell new traditional LTCi policies nationwide.

According to the latest available National Association of Insurance Commissioners (NAIC) Long-Term Care Insurance Experience Report, Thrivent continues to service a substantial in-force block of long-term care insurance policyholders and has paid hundreds of millions of dollars in long-term care insurance claims to policyholders and their families.

Industry reviews consistently recognize Thrivent for strong financial strength, competitive pricing, and stable participation in the LTC insurance marketplace.

Securian Financial is a highly rated mutual insurance company founded in 1880 that entered the long-term care insurance market with its hybrid life, and LTC product line, SecureCare, in the late 2010s. Rather than offering large blocks of traditional standalone LTC insurance, Securian focuses primarily on linked-benefit policies that combine life insurance with cash indemnity long-term care benefits.

Securian's key financial strength ratings include:

• A+ (Superior) — AM Best
• AA (Very Strong) — Fitch
• Aa3 (Excellent) — Moody's

According to the NAIC Long-Term Care Insurance Experience Report, Securian does not currently appear to be a major standalone LTC insurer with a large legacy block of traditional LTC policyholders and paid claims, as do older carriers such as Genworth, Mutual of Omaha, or Thrivent. This is largely because Securian’s LTC business is concentrated in newer hybrid life/LTC products rather than traditional LTC insurance policies.