Best Long-Term Care Insurance
of 2026
About 70% of Americans who reach age 65 will need some form of long-term care — and Medicare won’t pay for it, according to the U.S. Department of Health and Human Services. Long-term care costs an average of $121,000 per year for nursing home care, and most families don’t realize the exposure until a parent or spouse needs placement. This guide covers the best long-term care insurance companies of 2026 across both traditional and hybrid policy types — what each covers, how the two approaches differ, and how to choose before age and health make the decision for you.
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⚠️ Insurance Disclaimer
NME is not a licensed insurance agent, elder care specialist, or financial advisor. The information on this page is for educational and comparison purposes only and does not constitute insurance, financial, or legal advice. Long-term care insurance coverage, premiums, underwriting, and availability vary significantly by carrier, age, health history, state, and policy type. Hybrid LTC products combine life insurance or annuity structures with long-term care benefits and involve additional considerations. The long-term care insurance market has contracted significantly — several major carriers no longer write new LTC policies. Always consult a licensed long-term care insurance specialist and review full policy terms before purchasing. Consider Medicaid planning with an elder law attorney as part of a comprehensive long-term care strategy.
How NME ranks the best long-term care insurance companies: We evaluated LTC carriers across five independent criteria — coverage breadth (which care settings are covered and at what benefit levels across nursing facilities, assisted living, memory care, home health, and adult day services), policy type and structure (traditional standalone LTC vs. hybrid life/LTC or annuity/LTC, with different premium and benefit characteristics), financial strength (composite financial strength scores from independent rating agencies, especially critical for policies that may not pay claims for 20 to 30 years after purchase), claim flexibility (daily or monthly benefit structures, indemnity vs. reimbursement payment, care coordination services), and use-case fit (which asset levels, ages, health profiles, and coverage goals each carrier serves best). An important market context note: the LTC insurance market has contracted sharply over the past two decades — MetLife, Unum, Prudential, and several other major carriers no longer write new LTC policies. NME evaluates only carriers actively writing new policies in 2026.
⭐ NME Top Pick — Mutual of Omaha
Mutual of Omaha earns the top position for best long-term care insurance as the most consistent performer across all five evaluation criteria for traditional standalone LTC policies — offering the widest issue age range in the market (ages 30 to 79), competitive couple discounts of up to 15%, and two distinct policy structures that accommodate a wide range of benefit amounts and elimination periods. The MutualCare Custom Solution’s $50,000 to $500,000 benefit pool with elimination period options from zero to 365 days is the most flexible traditional LTC structure available from any single carrier in this review. Mutual of Omaha has paid LTC claims continuously since 1987 and maintains a below-average NAIC complaint ratio for its long-term care lines.
Compare the Best Long-Term Care Insurance Plans for 2026
Side-by-side look at policy type, maximum monthly benefit, maximum benefit period, inflation protection availability, and issue age range across all ten reviewed carriers.
| Company | Policy Type | Max Monthly Benefit | Max Benefit Period | Issue Age Range |
|---|---|---|---|---|
| Mutual of Omaha | Traditional Standalone LTC | ⭐Up to $10,000/month | Unlimited (pool of dollars) | ⭐Ages 30–79 (widest range) |
| New York Life | Traditional + Hybrid Life/LTC | Varies by policy | To age 100 (hybrid) | Ages 18–75 (varies) |
| Nationwide | ⭐Hybrid Life/LTC (CareMatters II) | Up to $15,000/month | Up to 7 years | Ages 30–75 |
| Northwestern Mutual | Traditional + Hybrid Life/LTC | Varies by policy | Lifetime option available | Ages 18–79 (varies) |
| Lincoln Financial | ⭐Hybrid Life/LTC (MoneyGuard) | Up to $12,000/month | Up to 6 years | Ages 40–75 |
| National Guardian Life (NGL) | Traditional Standalone LTC | Up to $9,000/month | Up to 5 years / Unlimited | Ages 18–79 |
| OneAmerica | ⭐Hybrid Annuity/LTC (Asset-Care) | Varies by premium placed | Lifetime option available | Ages 0–85 (Asset-Care) |
| Transamerica | Traditional + Hybrid options | Varies by policy | Varies by plan | Ages 18–79 (varies) |
| GoldenCare | ⭐Multi-Carrier Broker | Varies by carrier selected | Varies by carrier selected | Varies by carrier |
| Genworth | Traditional (limited new sales) | Varies by existing policy | Varies by existing policy | ⚠ Limited new sales in 2026 |
Policy Type indicates the primary LTC insurance structure. Traditional Standalone LTC policies pay premiums specifically for LTC coverage — “use it or lose it” if never needed, but provide the most LTC coverage per premium dollar. Hybrid Life/LTC policies combine whole life insurance with an LTC rider — guaranteed premiums, death benefit if LTC is never needed, but typically less LTC coverage per dollar than traditional. Hybrid Annuity/LTC (OneAmerica Asset-Care) repositions existing assets into an annuity structure with LTC benefits. Maximum monthly benefits reflect standard policy maximums — actual benefit amounts depend on individual policy selection. Genworth ⚠ note: Genworth has significantly curtailed new policy sales in most states as of 2026; existing policyholders should maintain coverage but new applicants should evaluate alternative carriers first.
Best Long-Term Care Insurance Reviews: 10 Carriers Evaluated
Mutual of Omaha is the most consistently top-ranked traditional standalone LTC carrier in the market, accepting applicants from ages 30 to 79 — the widest issue age range available — and offering two distinct policy structures: the MutualCare Secure Solution ($1,500 to $10,000/month) and the MutualCare Custom Solution, which provides a pool of benefit dollars from $50,000 to $500,000 with elimination period options from 0 to 365 days. Couple discounts of 15% apply when both partners enroll together, with an additional 15% health discount for qualifying applicants. The policy includes premium waiver during benefit receipt, access to a licensed care coordinator, and optional inflation protection, return of premium, and shared care riders. Mutual of Omaha’s below-average NAIC complaint ratio and continuous LTC claims payment history since 1987 make it the most reliable traditional LTC carrier actively writing new business in 2026.
Pros
- Ages 30–79 — widest issue age range in this review
- 15% couple discount; 15% health discount available
- Flexible pool-of-dollars benefit structure (MutualCare Custom)
- Premium waived during benefit receipt; care coordinator included
Cons
- Traditional LTC premiums can increase — not guaranteed level for life
- “Use it or lose it” if LTC is never needed (without return-of-premium rider)
New York Life offers both traditional standalone LTC policies and hybrid life/LTC products — the NYL MyFlex linked-benefit product allows policyholders to access a pool of LTC benefits that grows over time while maintaining a death benefit if LTC is never used, addressing the “use it or lose it” objection that deters many buyers from traditional policies. As a mutual company with 181 years of operating history and the deepest financial reserves in the life insurance industry, New York Life represents the strongest claims-paying certainty of any carrier in this review for policies that may not trigger benefits for decades after purchase. The company’s below-average NAIC complaint ratio for its life and health lines reflects consistent service quality. Available through New York Life’s captive agent network in all 50 states — not through independent brokers.
Pros
- Strongest financial position of any LTC carrier reviewed — 181 year history
- Hybrid NYL MyFlex product — death benefit if LTC never used
- Both traditional and hybrid options from one carrier
- Below-average NAIC complaint ratio
Cons
- Captive agent only — no independent broker comparison available
- Premiums tend to be higher than Mutual of Omaha for comparable traditional coverage
Nationwide’s CareMatters II is the most frequently cited best-in-class hybrid LTC product in the market — a standalone hybrid policy that is not attached to a life insurance death benefit but instead functions as a dedicated LTC vehicle with guaranteed premiums that never increase, a critical advantage over traditional LTC where premium increases have been a documented problem across the industry. Monthly LTC benefits reach up to $15,000, benefit periods extend up to seven years, and the policy pays a return of premium if the insured dies without using the LTC benefit — eliminating the “use it or lose it” concern entirely. Benefits are paid on an indemnity basis, meaning the full monthly benefit amount is paid regardless of actual care costs — no receipts required. CareMatters II is considered the gold standard hybrid LTC product by independent LTC specialists and is available through licensed insurance agents and independent advisors in most states.
Pros
- Guaranteed premiums — never increase (key advantage over traditional)
- Up to $15,000/month; up to 7-year benefit period
- Indemnity payment — full benefit paid regardless of actual care cost
- Return of premium if LTC is never used
Cons
- Higher upfront cost than traditional LTC for equivalent monthly benefits
- Not available in all states
Northwestern Mutual offers both traditional QuietCare LTC policies and hybrid life/LTC options through its captive financial advisor network, with the highest composite financial strength score of any insurance company and a premium-waiver benefit available to policyholders who qualify for care. The QuietCare product includes caregiver training benefits, hospice care coverage, care in Canada, and a companion discount in approved states — enhancements that reflect decades of policy refinement. For high-net-worth clients already in a Northwestern Mutual financial planning relationship, the LTC products integrate directly with wealth management, estate planning, and life insurance strategies through a single advisor relationship. As with its life insurance and disability products, Northwestern Mutual LTC is accessible only through captive advisors — independent broker comparison shopping is not possible.
Pros
- Highest composite financial strength of any carrier reviewed
- Caregiver training, hospice, and Canada care coverage included
- Integrated with Northwestern Mutual wealth and estate planning
Cons
- Captive advisor only — no independent comparison shopping
- Premiums among the highest in the market for traditional LTC coverage
Lincoln Financial’s MoneyGuard product is the second-most cited hybrid LTC product after Nationwide CareMatters II — a linked-benefit whole life policy that provides both a death benefit and an LTC benefit pool, with guaranteed premiums and return of premium if neither the death benefit nor LTC benefits are used. Monthly LTC benefits reach up to $12,000 with benefit periods up to six years. The MoneyGuard platform allows single premium (lump sum) funding, which appeals to buyers who want to reposition a taxable asset — a CD, savings account, or inherited IRA rollover — into a tax-advantaged structure that provides LTC coverage with a death benefit backstop. Lincoln’s independent broker distribution makes it genuinely comparable alongside Nationwide CareMatters II for buyers evaluating hybrid options side by side.
Pros
- Single premium option — reposition assets into LTC + death benefit
- Guaranteed premiums; return of premium if benefits unused
- Independent broker distribution — comparable alongside Nationwide
Cons
- Ages 40–75 — narrower issue window than Mutual of Omaha or NGL
- Up to 6-year benefit period — shorter than Nationwide’s 7-year maximum
National Guardian Life Insurance Company (NGL) is one of the few carriers still actively writing standalone traditional LTC policies in 2026 and is consistently named alongside Mutual of Omaha as a primary option for traditional coverage by independent LTC specialists. NGL’s EssentialLTC product offers monthly benefits up to $9,000, with benefit periods from two years to unlimited, an elimination period from 0 to 365 days, and issue ages from 18 to 79. The policy covers home care, assisted living, memory care, adult day services, and nursing facility care, with care coordination services included. NGL’s below-average NAIC complaint ratio and active product development in a market where competitors have exited position it as one of the most committed traditional LTC carriers available to new applicants in 2026.
Pros
- Actively writing new traditional LTC — committed to the market
- Ages 18–79; unlimited benefit period option available
- Below-average NAIC complaint ratio; care coordination included
Cons
- $9,000/month cap — below Mutual of Omaha’s $10,000 maximum
- Lower brand recognition than Mutual of Omaha among general consumers
OneAmerica’s Asset-Care product is the leading annuity-based LTC solution in the market — a structure where a single premium funds a whole life annuity that earns tax-deferred growth and doubles or triples into an LTC benefit pool if care is needed, while the full premium is returned as a death benefit if care is never used. Issue ages range from 0 to 85 — the widest issue age of any carrier in this review — and the structure accepts money from non-qualified savings, CDs, and fixed annuity transfers, making it the most tax-efficient vehicle for repositioning existing assets into LTC coverage. OneAmerica’s State Life subsidiary, which underwrites Asset-Care, runs below the market average for consumer complaints in individual life and annuities per 2026 NAIC data. The annuity structure provides a lifetime LTC benefit option without the “use it or lose it” concern of traditional policies.
Pros
- Ages 0–85 — widest issue age range of any carrier reviewed
- Asset repositioning — accepts CDs, savings, annuity transfers
- Lifetime LTC benefit option; full premium returned as death benefit
Cons
- Requires lump sum or large premium — not a monthly premium product
- Annuity structure is more complex than traditional or life/LTC hybrid
Transamerica offers long-term care coverage through its life insurance products with LTC acceleration riders — whole life, universal life, and indexed universal life policies that include LTC benefit triggers allowing the death benefit to be accelerated for qualified long-term care expenses. This structure means LTC coverage is integrated into a life insurance purchase rather than purchased separately, eliminating the standalone LTC underwriting process for buyers who are also seeking permanent life coverage. The approach provides coverage for nursing facility, assisted living, home care, and adult day services when 2 of 6 ADLs cannot be performed or cognitive impairment is present. Transamerica is most relevant for buyers in their 40s and 50s who are purchasing or reviewing permanent life insurance and want to embed LTC access in the same policy rather than managing two separate contracts.
Pros
- LTC rider embedded in life insurance — one policy, two protections
- Eliminates standalone LTC underwriting for life insurance buyers
- Broad coverage — nursing, assisted living, home care, adult day
Cons
- LTC benefit reduces death benefit — a trade-off between two coverage needs
- Less comprehensive LTC coverage than dedicated standalone or hybrid products
GoldenCare, founded in 1974, is one of the largest dedicated long-term care insurance brokers in the United States, placing policies from Mutual of Omaha, Nationwide, National Guardian Life, and other active LTC carriers through a network of licensed independent agents. GoldenCare is not an insurance carrier — it is a comparison and placement platform that allows buyers to receive side-by-side quotes across multiple carriers from a single conversation with a licensed LTC specialist. The brokerage also offers Medicare Advantage, prescription drug plans, and critical illness insurance, giving it a broader elder care and senior insurance context than most single-carrier agents. For buyers who want professional guidance in comparing traditional vs. hybrid LTC options across the available market without committing to a single carrier’s captive advisor, GoldenCare is the strongest multi-carrier starting point in this review.
Pros
- Multi-carrier access — Mutual of Omaha, Nationwide, NGL, and others
- Side-by-side traditional vs. hybrid comparison from one specialist
- 50+ years of LTC brokerage experience
Cons
- Not a carrier — policies are issued by underlying insurance companies
- Agent-dependent service quality varies by representative
Genworth Financial was once the largest LTC insurance provider in the United States but has significantly curtailed new policy sales in most states due to sustained pricing challenges from higher-than-projected claims costs across the industry. As of 2026, Genworth is generally not a viable option for new LTC insurance applicants and should not be the primary option buyers evaluate when shopping for new coverage. For the millions of existing Genworth LTC policyholders, maintaining current coverage is strongly recommended — lapsing an existing policy after years of premium payments forfeits substantial accrued benefits. Genworth’s existing policyholders may have experienced or may face future premium increase requests; state insurance regulators review and must approve these increases, and policyholders have options including reducing benefits to maintain the current premium rather than accepting higher rates.
Pros
- Existing policyholders: maintain coverage — don’t lapse
- State regulators must approve premium increases — not unilateral
- Long operational history — deep claims-handling experience
Cons
- Significantly curtailed new policy sales in most states as of 2026
- Not recommended as first-choice for new LTC insurance applicants
How to Choose the Best Long-Term Care Insurance
Six decisions that determine whether your LTC insurance actually works when care costs arrive.
Traditional vs. Hybrid — The Core Choice
Traditional standalone LTC policies provide the most LTC coverage per premium dollar — but premiums can increase over time, and benefits are forfeited if care is never needed. Hybrid life/LTC policies (Nationwide CareMatters II, Lincoln MoneyGuard) have guaranteed premiums that never increase and pay a death benefit if LTC is never used — but provide less LTC coverage per dollar than traditional for the same premium spend. The right choice depends on two questions: Can you absorb the risk of future premium increases? Do you want a guaranteed benefit regardless of whether care is needed? If yes to the first and no to the second, traditional may be the better value. If no to the first and yes to the second, hybrid is likely the right structure.
Buy Before 60 — Health Matters More Than Age
The LTC insurance market is health-underwritten, meaning your current health status at application determines whether you qualify, at what rate, and with what exclusions. Most carriers accept applicants up to age 79, but the practical reality is different: the older you are at application, the more likely you are to have a health condition that results in a surcharge, exclusion rider, or outright decline. Premiums also increase with age. The optimal window for LTC insurance purchase is typically ages 55 to 65 — old enough to have some sense of retirement financial needs, young enough that health underwriting produces favorable terms and premiums. Waiting until you’re 70 and approaching care age substantially increases the probability of being declined or priced out of coverage.
Benefit Amount and Benefit Period — Match to Your Market
The monthly benefit amount should approximate the cost of care in your area — not the national average. Nursing home costs vary from under $80,000 per year in lower-cost states to over $180,000 in high-cost coastal markets. Genworth’s annual Cost of Care Survey (updated annually at genworth.com/aging-and-you/finances/cost-of-care.html) provides state-by-state care cost data by service type, giving you a primary source for determining the monthly benefit amount you actually need. Benefit periods of two to three years cover the average care duration according to the Department of Health and Human Services; longer periods or unlimited pools address severe or chronic conditions that require care for five years or more. Combining a shorter benefit period with a lower elimination period (or vice versa) can balance premium cost against coverage duration.
Elimination Period — Your LTC Deductible
The elimination period is the number of days of paid care you must receive before benefits begin — functioning like a deductible measured in time rather than dollars. Standard options run from 0 to 365 days; the most common is 90 days, which substantially reduces premium relative to a 0- or 30-day elimination period. A 90-day elimination period means you pay approximately three months of care out of pocket before the policy activates — at $10,000 per month of care cost, that’s roughly $30,000. If you have sufficient liquid savings to cover three months of care costs, a 90-day elimination period is typically the best premium-to-protection trade-off. If savings are limited, a shorter elimination period is worth the additional premium.
Inflation Protection — Non-Negotiable for Younger Buyers
A $5,000/month benefit that you purchase today will cover a fraction of care costs in 20 years without inflation protection. At a 3% annual inflation rate, care costs roughly double every 24 years — meaning a benefit that covers care adequately at 65 may cover only half the cost at 89. Standard inflation protection options include 3% compound (the most common), 5% compound (stronger protection, significantly higher premium), and simple inflation (less protective than compound over long periods). For buyers in their 50s purchasing coverage that won’t be used until their 80s or 90s, 3% compound inflation protection is generally the minimum that preserves meaningful coverage purchasing power. Buyers in their 60s or early 70s purchasing coverage they may use within 10 to 15 years may reasonably consider 0% inflation with a higher initial benefit amount as a cost trade-off.
Home Care vs. Facility Care — The Setting You Actually Want
Most people express a strong preference for receiving care at home rather than in a nursing facility — and most LTC policies now cover home health aide services, adult day services, and assisted living alongside nursing facility care. The critical thing to verify before purchase is that the policy covers home care at the full monthly benefit amount rather than at a reduced rate (some older policies paid home care at 50% of the facility benefit). Also confirm the policy covers memory care units and assisted living facilities, not just licensed skilled nursing facilities — as most LTC claims involve assisted living and memory care rather than traditional nursing home placements. For homeowners, confirm whether modifications to the home to accommodate a disability (ramps, bathroom grab bars, stair lifts) are covered under the policy’s home modification benefit.
Also Worth Considering
Three additional LTC coverage options for specific situations outside the top 10.
Other Long-Term Care Coverage Options Worth Knowing
Five additional approaches and carriers that round out the full LTC planning landscape.
- Medicaid Long-Term Care — Medicaid is the primary payer for nursing home and long-term care in the United States for individuals who have spent down assets to qualifying levels; Medicaid planning through a licensed elder law attorney is a legitimate strategy for some households, but Medicaid coverage is facility-focused, limits care setting choices, and requires meeting strict income and asset tests that vary by state — not a strategy suited to all financial profiles.
- MassMutual Long-Term Care — MassMutual offers hybrid life/LTC products through its financial professional network, available to existing MassMutual policyholders and new applicants; a natural extension of MassMutual’s whole life and disability relationships for buyers who want to build a comprehensive income and care protection stack through one mutual company.
- Health Savings Account (HSA) for LTC — Qualified LTC insurance premiums are deductible from HSA funds up to IRS-set age-based annual limits; for buyers who carry a high-deductible health plan and fund an HSA, using accumulated HSA savings to pay LTC insurance premiums is a tax-efficient funding strategy; the IRS updates eligible LTC premium deduction limits annually at irs.gov.
- Medicare and LTC — What It Actually Covers — Medicare covers only short-term skilled nursing care (up to 100 days following a qualifying 3-day hospital stay, with copays applying after day 20) and does not cover custodial care — meaning assistance with activities of daily living, which is what most long-term care involves; understanding Medicare’s LTC limitations is the starting point for understanding why private LTC insurance or Medicaid planning is necessary.
- National Academy of Elder Law Attorneys (NAELA) — NAELA members are attorneys who specialize in legal planning for older adults and people with special needs, including LTC insurance structuring, Medicaid planning, asset protection strategies, and long-term care benefit coordination; consulting a NAELA member alongside an LTC insurance comparison is recommended for households with complex asset profiles or significant Medicaid planning needs.
Best Long-Term Care Insurance Awards — NME 2026
Three editorial awards recognizing standout long-term care insurance performance based on NME’s independent research.
Answers to the most common long-term care insurance questions from NME’s editorial team.
What does long-term care insurance cover?
Does Medicare pay for long-term care?
What’s the difference between traditional and hybrid long-term care insurance?
When is the best age to buy long-term care insurance?
What is an elimination period in long-term care insurance?
How does NME evaluate the best long-term care insurance companies?
Sources & Citations
- U.S. Department of Health and Human Services (HHS) — “About 70 percent of individuals over age 65 will require at least some type of long-term care services during their lifetime.” longtermcare.acl.gov
- HHS / Assistant Secretary for Planning and Evaluation (ASPE) — Long-term care cost estimates; average cost of nursing home care. aspe.hhs.gov
- Centers for Medicare & Medicaid Services (CMS) — Medicare coverage rules for skilled nursing facility care and exclusion of custodial care. medicare.gov
- Mutual of Omaha — MutualCare Secure Solution and MutualCare Custom Solution product documentation. mutualofomaha.com
- Nationwide — CareMatters II hybrid LTC product documentation. nationwide.com
- LTC News — Best Long-Term Care Insurance Companies 2026: Mutual of Omaha ranked #1 traditional, Nationwide ranked #1 hybrid. ltcnews.com
- National Association of Insurance Commissioners (NAIC) — Long-term care insurance complaint data and market conduct reports. content.naic.org
Find the Best Long-Term Care Insurance for Your Situation
Start with a traditional vs. hybrid decision. If guaranteed premiums and a death benefit backstop matter, compare Nationwide CareMatters II and Lincoln MoneyGuard. If maximum LTC coverage per dollar is the priority, start with Mutual of Omaha or National Guardian Life. Don’t wait until health makes the decision for you.
