What does long-term care insurance cover?

Long-term care insurance may cover in-home care, assisted living, memory care, adult day care, and nursing home care when a person needs help with activities of daily living or has a qualifying cognitive impairment.

How much does long-term care insurance cost?

The cost of long-term care insurance depends on age, health, benefit amount, benefit period, inflation protection, elimination period, state of residence, and the insurance carrier selected.

What is the best age to buy long-term care insurance?

Many people compare long-term care insurance in their 40s, 50s, or early 60s, before health changes reduce eligibility or increase premiums.

Does Medicare cover long-term care?

Medicare generally does not pay for extended custodial long-term care. It may cover limited skilled care under specific conditions, but it is not designed to fund ongoing help with daily living activities.

What health conditions affect long-term care insurance eligibility?

Insurance carriers review medical records, prescription history, cognitive history, mobility, chronic conditions, surgeries, and overall stability. Conditions such as diabetes, heart disease, neurological disorders, memory concerns, or recent major health events may affect eligibility.

NAIC Long-Term Care Insurance Guide | Long-Term Care Insurance Authority

A Shopper's Guide to Long-Term Care Insurance

About the Guide

A Shopper’s Guide to Long-Term Care Insurance is a comprehensive resource developed by the National Association of Insurance Commissioners (NAIC). The guide is designed to help you make informed financial choices regarding long-term care services and the private insurance options available to help pay for them. Because choosing long-term care insurance is a significant and long-term financial commitment, state laws often require companies or agents to provide this booklet to help guide your decision.

What You Will Learn

This guide walks you through the foundational aspects of planning for your future care needs, including:

Understanding Long-Term Care: Learn how long-term care differs from traditional medical care by focusing on helping you maintain daily living activities.
Evaluating the Costs: Review national average costs for nursing home care, assisted living facilities, and home health aides.
Payment Options: Discover how personal resources, Medicaid, and private insurance work—and understand why you shouldn't count on Medicare or Medigap to cover these long-term costs.
Navigating Insurance Policies: Get details on individual policies, employer group plans, and innovative options like hybrid life/annuity contracts or State Partnership Policies.
Understanding Policy Features: Master key insurance terms such as benefit triggers, elimination periods (waiting windows), and inflation protection.

Tools Included in the PDF

To help you actively shop and compare rates safely, the guide includes practical tools you can print out and fill out directly:

A Comprehensive Glossary: Plain-English definitions for complex insurance terminology.
A Personal Suitability Assessment: A checklist to evaluate your health, age, income, and assets against standard affordability rules of thumb.
Comparison Worksheets: Built-in tables to log and compare quotes, policy maximums, and benefit structures across different insurance companies.
State Directory: A complete, state-by-state list of Insurance Departments, Agencies on Aging, and State Health Insurance Assistance Programs (SHIP) to verify licenses or seek free local counseling.

A Quick Affordability Tip from the Guide: As a general rule of thumb, experts suggest that a long-term care policy may not be affordable if the premiums consume more than 7% of your total household income. Always consider whether you can comfortably maintain premium payments if they increase in the future.