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Top 10 Best Long Term Care Insurance Companies

Fact Checked by Jason Herring & Barry Brooksby
Licensed Agents & Life Insurance Experts.
Insurance and Estates, a strategic life insurance provider composed of life insurance professionals, is committed to integrity in our editorial standards and transparency in how we receive compensation from our insurance partners.
best long term care insurance

At I&E, we specialize in helping our clients find the best insurance company for their needs, whether that be cash value life insurance, long term care insurance, or a mixture of both.

In the following article we will take a deep dive into long term care insurance to help you locate a company, as well as demonstrate our expertise in this area in hopes of providing you with the information you need to make an informed decision.

If you are interested in any of the companies below, please give us a call or fill out our contact form for a complimentary strategy session with a life insurance professional.

The Growing Need for Long Term Care Insurance

Nowadays, with growing health care costs on just about everyone’s mind, many folks are choosing to take a look at their “risk” of one day needing to receive long term care, which may or may not be covered by existing insurance policies that they already have in place.

This is why…

We decided to create our Top 10 Best Long Term Care Insurance Companies article so that our readers would have a good place to begin their search.

In this list…

We have included Long Term Care (LTC) providers who offer pure long term care insurance, hybrid long term care insurance, including life insurance with long term care riders.

In addition, we provide a list of additional LTC insurers, as well as a LTC FAQ section, where we address commonly asked questions.


If you’re thinking that you might need to purchase a long term care insurance policy, or you’ve just recently applied for one, we would strongly encourage you to keep on reading and give us a call if you have any questions.

Table of Contents:

Top Long Term Care Insurance Providers Snapshot

LTCi CompaniesCompany Ratings (as of November 2017)Type of LTCi
AXAA.M. Best rating: A
S&P rating: A+
Fitch rating: A+
Moody's rating: A1
LTC Services rider
GenworthA.M. Best rating: B
S&P rating: B+
Fitch rating: BB
Moody's rating: B2
Pure LTCi
GuardianA.M. Best rating: A++
S&P rating: AA+
Fitch rating: AA+
Moody's rating: Aa2
LTC rider
Lincoln NationalA.M. Best rating: A+
S&P rating: AA-
Fitch rating: A+
Moody's rating: A1
Hybrid LTCi
A.M. Best rating: A++
S&P rating: AA+
Fitch rating: AA+
Moody's rating: Aa2
LTCi Rider
Pure LTCi
Minnesota Life
A.M. Best rating: A+
S&P rating: A+
Fitch rating: AA
Moody's rating: Aa3
Hybrid LTCi
Mutual of OmahaA.M. Best rating: A+
S&P rating: AA-
Fitch rating: NR
Moody's rating: A1
Pure LTCi
NationwideA.M. Best rating: A+
S&P rating: A+
Fitch rating: NR
Moody's rating: A1
LTC rider
OneAmericaA.M. Best rating: A+
S&P rating: AA-
Fitch rating: NR
Moody's rating: NR
Hybrid LTCi
Pacific LifeA.M. Best rating: A+
S&P rating: AA-
Fitch rating: A+
Moody's rating: A1
Hybrid LTCi

The Best Long Term Care Insurance

[What to Look For In LTC insurance]

The best long term care insurance company and policy will be the one that offers the most features and flexibility, while providing an affordable premium.

When deciding between the different companies and policies, it is important to know your options.

The following list of long term care companies will help equip you to make the best decision for you, based on your individual goals and objectives.

Stand Alone LTCi vs Hybrid LTCi

The following best long-term care companies offer either pure long term care insurance or hybrid asset based long-term care insurance.

There are long term care pros and cons of each.

For more on the different living benefit options available, please visit our article covering long-term care riders vs chronic illness riders, where we go more in depth of the advantages and disadvantages of life insurance with living benefits.

Long Term Care Insurance Pros & Cons

One pro of pure LTC insurance is you get more customization and flexibility. Hybrid policies are catching up, though.

Another traditional long-term care insurance pro is your LTC premiums may qualify for a tax deduction if you meet the IRS requirements. In addition, funds in an HSA may also be used to pay your LTC insurance premiums up to the IRS requirements.

A con to stand alone policies is the premiums are not fixed, and can be raised if the company decides to raise the premiums on an entire class or group.

Hybrid LTC Pros & Cons

A pro of asset based long-term care life insurance is your premiums are fixed, so you don’t have to worry about a premium increase destroying your budget in retirement.

A con of hybrid life insurance with long term care is your premium payment does not currently qualify for a tax deduction, most likely due to individual life insurance premiums not being tax deductible.

In addition, you cannot currently use funds in your HSA to pay your combination policy premiums.

These are just of few of the benefits and drawbacks. We put together our top 10 long-term care insurance pros and cons article that goes deeper into the benefits of LTCI, as well as the potential disadvantages.

Top 10 Best Long-Term Care Insurance Companies

  1. AXA
  2. Genworth
  3. Guardian
  4. Lincoln
  5. MassMutual
  6. Minnesota Life
  7. Mutual of Omaha
  8. Nationwide
  9. OneAmerica
  10. Pacific Life

Long Term Care Services Rider

AXA Equitable Life Insurance Company

AXA offers a hybrid long term care policy under the product name Long Term Care Services Rider. The product is available on single life UL and VUL policies for ages 20-75. The policy provides monthly cash indemnity, rather than reimbursement.

Monthly benefit percentages of 1%, 2% or 3% are available. You can choose a fixed death benefit option or an increasing death benefit option. An increasing death benefit may also increase the future maximum LTC benefit. Up to 200% IRS per diem limit available in the first year.

After a LTC benefit claim has been filed, the policy’s elimination period  is 90 days. Claims can be temporary, rather than permanent. Certification that the insured is unable to perform 2 of 6 activities of daily living is required.

For more, please visit our AXA Equitable review.

Privileged Choice Flex 3Genworth Life Insurance Company

February 2, 2019 update: Due to Genworth’s continued financial problems and with various sources around the web stating that the deal with China Oceanwide Holding Co. may not win regulatory approval, we do not recommend Genworth to our clients at this time.

Genworth offers a pure long-term care insurance policy. The Company sells its LTC policy under its Privileged Choice Flex 3 product line.

The different elimination periods available range from 30 days, 60, 90 or 180 days. You can choose calendar day elimination periods or service day elimination periods. Calendar day reflects a true 30 days, whereas service day only counts on days you receive LTC services.

Inflation protection is available. You can choose 2, 3, 4, or 5% compound interest growth or 5% simple interest growth. You can also elect the Future Purchase Option, which allows you to increase your LTC coverage every three years by 3%.

The Shared Benefit Rider provides a shared pool of money for covered long term care expenses that you and your spouse can both use.

Home Assistance Training provides a friend or family member with training to help care for you at home.

For more, please visit our Genworth long-term care insurance review.

Guardian’s Long Term Care RiderThe Guardian Life Insurance Company of America

Guardian’s Long Term Care Rider is a combination long term care whole life insurance policy.

The LTC rider allows you to accelerate a portion of the policy’s death benefit to help cover long-term care costs. It is an indemnity policy, so you will receive a cash benefit upfront, rather than reimbursement for expenses.

And since it is dividend paying whole life insurance, dividend payments can further grow the LTC benefit.

Monthly benefits amounts are the lesser of either 2% of the basic LTC pool or 200% of the daily IRS per diem limit ($360 for 2017).

The maximum benefit amount available equals the lesser of 90% of the total death benefit or the policy face amount less $25,000. The LTC benefit period lasts as long as you remain eligible.

For more, please visit our Guardian Life review.

Lincoln MoneyGuard II LTC

Lincoln National Life Insurance Company

Lincoln National offers its hyrbid long term care life insurance under the Lincoln MoneyGuard II product line in all states except NY. In NY, the Company offers MoneyGuard Reserve.

MoneyGuard is a limited pay universal life insurance policy with long-term care reimbursement rider. You can choose flexible premium years 1-10. The LTC rider is available for issue ages 40-79.

The Value Protection Rider provides return of premium upon surrender. So, you have three options with this hyrbid LTC+LIFE policy.

There is a lump sum death benefit if you die; there is a long term care benefit if you need help with LTC services; and there is a return of premium option if you decide to surrender the policy.

Your death benefit that you apply for determines how much LTC benefits you will be eligible to receive under the Long-Term Care Accelerated Benefits Rider – LABR. You can also add the Long Term Care Extension of Benefits Rider (LEBR), which continues benefits once the LABR has run out.

Total benefit period options from 2 years to 7 years.

Each benefits rider also provides either 3% or 5% compound interest growth optional inflation protection rider.

For more, please visit our Lincoln National review.

SignatureCare CareChoice One

Massachusetts Mutual Life Insurance Company

MassMutual SignatureCare provides a stand lone LTC option. SignatureCare allows you to choose from two base policy options: Facility Services Only Plan and Facility Services and Home and Community Based Services plan.

Around 75-80% of people prefer to remain at home, so the second LTC plan is generally the more desired one.

However, a cash indemnity benefit rider is available on the Facility Only Plan that pays you your daily benefit amount no matter your actual expenses.

Therefore, both the pros and cons of each long term care plan need to be weighed to determine which one is best for you.

You can choose lifetime premiums, 10 Pay or 20 Pay limited pay life insurance. Elimination periods of 0 days, 30, 60, 90 or 180 days are available.

An income protection rider is available which will grow your daily benefit amount by either 5% simple interest growth or 5% compound interest growth.

In addition to a stand alone LTC policy, MassMutual CareChoice One offers a single premium whole life insurance policy, combined with a long term care insurance rider.

The policy uses a pool of benefits, initially based on your death benefit, and then it switches over to extended long term care coverage.

Dividends earned as a policyowner can be used to buy paid up additions, which will increase the death benefit, further increasing the LTC benefit pool.

You can further grow the LTC benefit pool by choosing an inflation protection rider, which grows your LTC benefit at a 5% compound rate annually.

For more, please visit our MassMutual review.

SecureCare long term care life insurance

Minnesota Life Insurance Company

Minnesota Life provides a hybrid long term care life insurance policy under its SecureCare product line.

SecureCare is a cash indemnity LTC policy, so there is no need to apply for reimbursements.

The product is a single premium universal life insurance policy that provides death benefit protection, long-term care coverage and return of premium.

The income benefit period maximum is 3 years, with an additional extended long-term care benefits option that lasts up to 4 years.

An income protection rider is also available offering 3% simple, 5% simple or 5% compound interest growth.

For more, please visit our Minnesota Life review.

Mutual's Secure Solution and Custom Solution

Mutual of Omaha Insurance Company

Mutual of Omaha offers two stand alone long-term care insurance policies in its MutualCare Solutions line: Secure Solution and Custom Solution available for ages 30-79. Both LTC policies include a waiver of premium.

Secure Solution long-term care insurance provides tons of options, including a reimbursement benefit for actual LTC costs and a cash indemnity benefit which pays you a percentage of the policy’s home health care benefit each month, after the elimination period has passed. You can choose from 90, 180 or 365 calendar days.

An additional Inflation Protection Rider allows for 3%, 4% or 5% compound interest growth.

You can also choose 20 year inflation protection of 3% or 5% compound interest growth.

Further, if you run out of benefits and still need care, the Shared Care rider allows you to access the benefits under your spouse’s identical policy.

Custom Solution provides more flexibility than Secure Solution because of it many customization options.

The policy provides a pool of benefits, with 50,000 to $500,000 benefit options in $500 increments. Elimination periods range from  0, 30, 60, 90, 180 or 365 calendar days.

A customizable inflation Income Protection rider is available ranging from 1% to 5% compound interest growth in .25% increments. You can also customize your income protection rider period between a 10, 15, or 20 years or lifetime.

For more, please visit our Mutual of Omaha review.

YourLife CareMatters linked benefit long term care insurance

Nationwide Life Insurance Company

Nationwide’s linked benefit long-term care insurance is marketed under its YourLife CareMatters. The policy is hybrid universal life with a LTC indemnity benefit.

As an asset based policy, it provides cash indemnity for long-term care services and a lump sum life insurance death benefit. Issue ages available from 40-75.

The policy’s premiums are fixed and can be paid as single premium, 5-Pay or 10-Pay.

An inflation protection rider is available at 3% simple growth or 5% compound interest growth.

The policy also provides a guaranteed return of premium upon surrender for the premiums paid, plus any policy growth.

You can use the entire long-term care benefit and your beneficiaries will still receive a guaranteed 20% minimum death benefit.

Your benefit period can range from 2 years, up to a maximum of 7 years.

And benefits can be used to pay a member of your family or a friend to provide you with care under a plan provided and approved by a licensed health care practitioner.

For more, please visit our Nationwide Life Insurance with Long-Term Care rider review.

Asset-Care asset based long term care insurance


Asset-Care from OneAmerica provides payment schedules of single premium, 10 pay, 20 pay or to age 100.

The whole life insurance plus long-term care policy is available for ages 35-80 and provides a guaranteed minimum 4% interest rate, along with a guaranteed death benefit.

The elimination period is 30 days for in home care; all other care requires a 60 day elimination period.

An income protection benefit of 2%, 3%, or 4% is available.

Waiver of premium if your are receiving qualified care.

The policy is non-cancelable (i.e. fixed premiums).

Asset-Care benefits are not excluded if the chronically ill individual has LTC costs due to a mental or nervous disorder.

For more, please visit our OneAmerica review.

PremierCare Choice life insurance long term care rider

Pacific Life Insurance Company

Pacific Life offers life insurance with long term care through its PremierCare Choice line of LTC insurance products.

The policy is hybrid whole life insurance plus long term care insurance combined.

You can choose from the following premium schedules: single pay, 5 Pay, 10 Pay, 15 Pay or 20 Pay.

The policy provides income benefit periods of 2 to 8 years. The base policy includes an Accelerated Benefit Rider (ABR) with a benefit of 2 years.

An optional Extended Benefit Rider (EBR) can extend the benefit an additional 2-6 years.

The elimination period for in-home care is zero days. For care in a facility, the required elimination period is 90 days.

An inflation protection rider is available with 3% or 5% simple inflation growth or 5% compound inflation growth. A spousal discount when both you and your spouse elect long term care insurance coverage.

For more, please visit our Pacific Life review.

Long-Term Care Insurance Quotes

The average yearly cost for in home care and care in an assisted living facility can range between $3,000-$5,000 a month. Nursing home care can exceed $100,000 a year.

So, the question becomes, what would you be willing to pay today, for insurance that will cover LTC costs in the future?

Your long term care insurance rates are determined by several factors, including

  • 1. your total income benefit,
  • 2. benefit period,
  • 3. elimination period and
  • 4. additional riders and features all need to be designed with your budget and goals in mind.

For example, the following table represents long term care rates from 3 different LTC plans for a 60 year old male at a standard rate class, including a 4% income protection rider, with A rated LTC providers. The LTC insurance quotes range from $3,122.45 to $3,763.84 annually.

Long-term care insurance rates

If you are interested in seeing your own long-term care insurance quotes, please give us a call or enter your information in our quote request form below. We can run some illustrations for you after we know your own personal goals and objectives.

Additional LTC Insurance Companies

Some additional Top LTC Insurance Companies are listed below. We may be able to provide you long-term care insurance quotes from these providers, although some of the companies on the list below employ captive agents only.

  1. Northwestern Mutual
  2. New York Life
  3. Prudential
  4. State Farm
  5. Thrivent
  6. Transamerica

Long-Term Care Insurance FAQs

The following are long-term care frequently asked questions. If you have additional questions, such as what is long-term care insurance, please don’t hesitate to give us a call or leave a comment below.

What are the requirements for a successful long-term care benefit claim?

IRC 7702B(c)(2) defines a “chronically ill individual” and lays out the requirements that must be met to qualify. In order to qualify for long-term care benefits you must be diagnosed as a chronically ill individual for a period of at least 90 days.

Chronically Ill Individual – To be considered chronically ill for eligibility purposes, you must be certified by a Licensed Health Care Practitioner as either:

(1) being unable to perform 2 of 6 Activities of Daily Living (ADLs). (Most states and companies do not require that the condition be permanent in order to qualify for LTC benefits, but some do); or

(2) due to cognitive impairment you require substantial supervision to protect you from threats to your health and safety.

What are the different activities of daily living?

Activities of Daily Living (ADLs)

  1. Bathing – washing oneself and getting in or out of the tub or shower.
  2. Continence – the ability to maintain control of bowel and bladder function.
  3. Dressing – putting on and taking clothing, including braces, fasteners, or artificial limbs.
  4. Eating – putting food into your body from a receptacle or feeding tube or intravenously.
  5. Toileting – being able to get to and from the toilet and get on and off the toilet.
  6. Transferring – moving in and out of a bed, chair, or wheelchair.

What are some examples of cognitive impairments?

A few examples of cognitive impairments that may eventually require substantial supervision are Alzheimer’s Disease, Parkinson’s Disease and other such dementia.

Are long-term care benefits taxed?

Typically, reimbursements of actual expenses are not taxable as income, even if the reimbursement exceeds the per diem limit.

However, payments received in excess of the greater of per diem tax maximum limits or actual expenses paid are probably going to be taxable as income.

For 2022, the IRS per diem maximum is $390 a day, increasing to $420 a day in 2023.

And similarly to life insurance benefits not being taxed, accelerated death benefits under IRC Section 7702B are generally excluded from income taxation.

Do I need long-term care insurance?

According to the U.S. Department of Health and Human Services, at least 70% of people over age 65 will require long-term care services, and more than 40% will need nursing home care.

The costs associated with LTC services are staggering. Anyone who desires wealth preservation should consider LTCi.

What is the limit that can be deducted on traditional long-term care insurance premiums in 2021?

Under current tax law, hybrid long term care life insurance policy premiums are not tax deductible. However, traditional stand alone long-term care insurance premiums may qualify for a federal income tax deduction.

If you are older than 60 but not older than 70 the maximum you may be able to deduct is $4,520 per spouse, a potential deduction of $9,040 for the household if both husband and wife have a policy.

If you are 71 and older, up to $5,640 in LTC premiums may be able to be deducted per spouse, a potential deduction of $11,280 for the household if both husband and wife have a policy.

Maximum Deduction for Qualified LTC Insurance Premiums Under IRC Section 213(d)(10)

Attained Age Before Close of Year202020192018
40 or Less$430$420$420
More Than 40 But No More Than 50$810$790$780
More Than 50 But No More Than 60$1,630$1,580$1,560
More Than 60 But No More Than 70$4,350$4,220$4,160
More Than 70 $5,430$5,270$5,200

Can I use my HSA to pay for long term care insurance?

Under current tax law, you cannot use your HSA to pay your combination long term care life insurance policy premiums.

However, you should be able to use your HSA to pay for your long-term care insurance premiums, up to the deduction limits by age set by the IRS.

For 2020, if you are older than 50 but not more than 60, you can use up to $1,630 from your HSA.

And, if you are older than 60 but not more than 70, you can use up to $4,350 from your HSA.

Finally, if you are older than 70, you can use up to $5,430 from your HSA.

What does long-term care insurance cover?

Long-term care insurance covers different services, such as in home care, hospice, adult day care centers, care in a nursing home or assisted living facility.

It also provides respite care if a care giver needs some time off.

It can pay for a medical professional such as a nurse or a therapist.

And LTCi can also provide support for in home care, including caregiver training for a loved one (family member or friend).

Does medicare cover long-term care costs?

If you are over the age of 65 or under 65 with a disability, you may qualify for Federal Medicare benefits.

Medicare covers the cost of a hospital stay, skilled nursing facility stay, hospice or home health services.

Medicare will cover the full cost for the first 20 days and partial costs for days 21 to 100.

Long-Term Care Partnership Program

The Long-Term Care Partnership Program can help protect your assets. The program has certain requirements, including the requirement that a qualifying LTC insurance policy include a mandatory 5% compound interest rider for certain states, while other states simply want any compound interest cost of living adjustment.

Does long-term care insurance have exclusions?

Some pre-existing conditions may be excluded for a period of time, such as the initial six months after the policy is placed in force.

In addition, some policy exclusions you may encounter are conditions due to:

  • alcoholism and drug addiction;
  • attempted suicide or intentionally self-inflicted injuries;
  • war or an act of war, whether declared or undeclared;
  • participation in a riot, felony, or insurrection;
  • service in the armed forces; or
  • aviation activities if not a fare-paying passenger.

Next Steps


We’ll be the first to admit that we just went over a lot of information in this article,  Which is why we want to make it perfectly clear that we really don’t have any expectations for most folks to fully “absorb” everything that we just discussed.

All we’re hoping is…

That you’ll leave this article understanding two things.  First, when it comes time to purchase a Long Term Care Insurance Policy, there are a lot of different options out there and second, we can help.

You see…

Here at I&E, we know that purchasing insurance can be a “bit” overwhelming for someone, and we understand that for most folks, what they really want is to find someone who is willing and able to clearly explain what their options are in a “non-salesy”, stress free environment.

Which is…

Exactly how our agents like to to business here at I&E.

So, if you think that you might need to purchase Long Term Care Insurance coverage, (or you’ve recently applied for one and would like to get a second opinion) feel free to give us a call,

We would be more than happy to review your options, and if it looks like we might have a good fit for you, we’ll be happy to walk you through the entire application process.

So what are you waiting for? Give us a call today and experience the I&E difference!

13 comments… add one
  • Earnest Powell January 10, 2018, 4:50 pm

    What are the selection criteria for these top ten LTCi providers?

    Thank you.

    • Insurance&Estates January 15, 2018, 9:37 am


      Our selection criteria is based on policy flexibility, price, options and company ratings.


  • Bill Liskowitz April 29, 2018, 1:58 pm

    This post does not add any added value or knowledge, nor does the information within give me any confidence that you actually know anything about long term care insurance policies. This is internet click bait at its worst. Good luck to your lead generation. Pure garbage. Throw together a meaningless list of company names.

    • Insurance&Estates April 29, 2018, 2:50 pm

      Hi Bill,

      Thanks for the feedback. Although we do not agree with your comment, we support your right to make it.



  • best investment online October 9, 2018, 4:08 pm

    That is a good tip especially to those new to the blogosphere.
    Simple but very precise info… Thank you for sharing this one.
    A must read article!

  • Joe October 16, 2019, 10:19 pm

    Looking for LTC insurance for my wife and I ages 64 and 65

    • Insurance&Estates October 17, 2019, 8:02 pm

      Hello Joe,

      Thanks for your interest and for reading. Your information has been forwarded to Jason Herring, our National Sales Director and long term care insurance expert.


      Steve Gibbs for I&E

  • Neil November 24, 2019, 11:25 am

    Happy to see that you have warning on Genworth Financial. They are reducing the benefits, trying to eliminate home health care and raising the rates. Stay away from them!

    • Insurance&Estates December 2, 2019, 10:22 pm

      Neil, thanks for commenting…important issue.


      Steve Gibbs for I&E

  • Derrick March 6, 2021, 7:04 am

    Curious what the BBB ratings for these companies are three years old? And why is the Bottom 1-10 list is not included with the first 1-10; as the top 20 rather than two sets of ten? Logically regardless of captive or independent status, there should be a visible list of the qualifications describing the rating system pro and cons of each company? Based on Black and White facts, on a neutral bias. The current way the page is set up, is not compelling in anyway. Communication is a talent, that few people get paid well for; that is because it is a difficult.

    • Insurance&Estates March 11, 2021, 7:21 am

      Hello Derrick, thanks for reading. I believe we’ve articulated the basis of our criteria and also qualified it by pointing out that it is in part based upon our practical experience in the industry. If your favorite company isn’t on the list, it just means they didn’t make our list. As in most things, there is a subjective element to all rating systems, even the almighty BBB, which is really a pay for play club at the end of the day in my humble “opinion”. If your communication skills are off the charts, I invite you to start your own blog:)

      Best, Steve Gibbs, for I&E

  • Steven Dugal March 7, 2021, 6:22 pm

    Interesting you do not show the highest rated insurance company, Northwestern Mutual.

    • Insurance&Estates March 11, 2021, 7:26 am

      Hello Steven, we get that question often, mostly from NW Mutual agents. They are a solid company to be sure, yet don’t make this list because it is featuring outstanding long term care insurance companies. Also, they lose points from our perspective because they are captive, thereby limiting consumers choices. Thanks for reading.

      Best, Steve Gibbs, for I&E

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