Long-term care insurance is priced like life insurance and behaves like health insurance. You lock in an annual premium based on your age and health at application, then pay it for decades. Unlike life insurance, the premium is not contractually locked.
Everything below was verified against the source documents on September 6, 2026. Premium figures come from the AALTCI Price Index, whose 2026 edition was last updated July 28, 2026 with pricing calculated in July 2026. That edition publishes a narrower set of figures than the 2025 edition did, so a handful of cells below are still the 2025 numbers and are labeled. Care cost figures come from the CareScout Cost of Care Survey fielded July through November 2025. Tax figures are the 2026 IRS limits.
What a Policy Actually Costs Per Year
The table below is the standard industry benchmark: a traditional (not hybrid) policy with a $165,000 initial pool of benefits, buyer in “select” health, rates quoted in Illinois. Prices vary meaningfully by state and by carrier.
| Buyer, $165,000 initial benefit pool | No inflation growth | 3% compound growth | 5% compound growth |
|---|---|---|---|
| Single man, age 55 | $950 | $2,200 | $3,710 |
| Single woman, age 55 | $1,500 | $3,750 | $6,400 |
| Couple, both 55 (combined) | $2,080 | $5,050 | $8,575 |
| Single man, age 60 | $1,200 (25) | $2,610 (25) | $3,800 (25) |
| Single woman, age 60 | $1,900 (25) | $4,450 | $6,700 (25) |
| Couple, both 60 (combined) | $2,600 (25) | $5,800 (25) | $8,700 (25) |
| Single man, age 65 | $1,750 (25) | $3,280 (25) | $4,255 (25) |
| Single woman, age 65 | $2,700 (25) | $5,290 (25) | $7,225 (25) |
| Couple, both 65 (combined) | $3,750 (25) | $7,030 | $9,675 (25) |
Source: AALTCI Price Index. Unmarked cells come from the 2026 edition (pricing calculated July 2026, Illinois). Cells marked (25) are the most recent published figure for that design and come from the 2025 edition (calculated January 2025), because the 2026 edition does not republish full age-60 and age-65 tables.
One caveat on the source itself. The 2026 page’s summary paragraph puts the average for a couple both 55 at 3% growth at $5,010, while its own table further down the same page prints $5,050 for that identical cell. We use the table figure and flag the discrepancy rather than picking one silently.
Carrier choice matters as much as design. For an Illinois couple both age 60 buying a $165,000 pool with 3% compound growth, AALTCI’s July 20, 2026 quotes from five leading carriers came in at $4,591, $5,661, $6,440, $6,712, and $7,173 a year. The most expensive carrier costs 56.24% more than the cheapest for virtually identical coverage. AALTCI reports the 2026 spread reaching up to 80% for a couple both age 65 and up to 29% for a single woman age 60.
What Moves the Premium
Age at purchase. Buying at 65 instead of 55 roughly doubles the no-inflation premium for a man ($950 to $1,750) and increases it about 80% for a woman ($1,500 to $2,700), using the 2025 index cells, which are the most recent published at age 65. The age-55 figures are unchanged in the 2026 edition. You also pay for more years if you buy early, so “buy young” is not automatically cheaper in total. It mostly buys underwriting certainty, because health problems that develop in your late 50s can make you uninsurable.
Sex. Carriers went to sex-distinct pricing after the claims data came in. A 55-year-old woman pays about 58% more than a man for the same no-inflation policy and about 70% more with a 3% rider.
Couple versus single. Couples get a discount. On the 2025 index, the most recent edition to publish these cells, two singles age 60 buying 3% coverage separately would pay $2,610 plus $4,550, or $7,160, against a combined couples rate of $5,800, roughly 19% less.
Benefit amount and benefit period. The $165,000 pool in the table is a daily or monthly maximum multiplied by a benefit period. Doubling the pool roughly doubles the premium. Most policies sold today cap the benefit period at two to five years rather than offering lifetime benefits.
Inflation rider. This is the single largest lever. Adding 3% compound growth more than doubles the premium at age 55 ($950 to $2,200 for a man in the 2026 index) and added about 87% at age 65 on the 2025 index. It is not optional padding: AALTCI’s illustration shows a $165,000 pool bought at 55 growing to about $400,500 by age 85 at 3%, and to $679,100 at 5%. The NAIC Shopper’s Guide notes most automatic riders compound at about 3% a year.
Elimination period. The NAIC Shopper’s Guide describes elimination periods of 20, 30, 60, 90, or 100 days. You pay for your own care during that window. A longer elimination period lowers the premium. Watch how the days are counted: under a “service days” method, only days you actually pay for professional care count, so part-time care stretches the waiting period out.
Rate Increases Are the Real Risk
This is the part of the product that trips people up. Long-term care policies are guaranteed renewable, which means the carrier cannot cancel you but can raise rates on an entire class of policyholders.
The 2024 Milliman carrier survey (17 insurers, more than 75% of industry premium, published April 2025) found the average requested increase was 56%, up from 47% in the 2021 survey, and the average approved increase was 28%. Seventy-three percent of submitted increases were fully or partially approved. Cumulative requested increases on older blocks frequently exceed 400%.
The NAIC’s 2024 experience data shows why. Across stand-alone individual policies, carriers earned $12.3 billion in premium in 2024 and incurred $15.9 billion in claims, a direct loss ratio of 129%. Several of the largest blocks ran far worse: 152% at Genworth Life, 149% at MetLife, 254% at Continental Casualty.
Washington’s insurance commissioner states the regulatory reality plainly: if there is a good reason for an increase and it complies with state law, the state cannot deny it. When a hike lands, your options are to pay it, cut the daily benefit, shorten the benefit period, lengthen the elimination period, reduce the inflation rider, or take the contingent nonforfeiture option (stop paying and keep a paid-up benefit roughly equal to premiums paid). Roughly 11.9% of affected policyholders chose a reduced benefit option in the 2024 survey.
The Tax Break, Briefly
Premiums on a tax-qualified contract are medical expenses, but only up to an age-banded cap. For tax years beginning in 2026, Revenue Procedure 2025-32 sets those limits at $500 (attained age 40 or less), $930 (41 to 50), $1,860 (51 to 60), $4,960 (61 to 70), and $6,200 (over 70), per person.
On the benefit side, per diem contracts that pay a flat daily amount are tax-free up to $430 a day for calendar year 2026, or actual costs incurred if higher. Contracts that reimburse actual expenses are not capped by that figure. Full mechanics, including the self-employed route that skips the 7.5% AGI floor, are in our guide to whether long-term care insurance is tax deductible.
Partnership Policies and the Medicaid Asset Disregard
Most states run a Long-Term Care Partnership Program. Buy a qualifying policy and you get a dollar-for-dollar Medicaid asset disregard: for every dollar the policy pays out, you can keep a dollar of assets and still qualify for Medicaid.
Washington’s insurance commissioner gives the canonical example. If the partnership policy pays $200,000 in benefits, Medicaid lets you keep $200,000 in assets, assuming you meet all other requirements.
Partnership policies must be federally tax-qualified and must carry inflation protection for buyers age 75 or younger (compound protection under age 61, some level of protection from 61 to 75). Most participating states honor each other’s policies under a national reciprocity agreement, though the asset protection itself does not travel without that agreement. It does not change the Medicaid look-back period or exempt you from income rules. It only shelters assets, which changes the math on a Medicaid spend-down and on estate recovery.
What the Alternatives Cost
The reason people buy this coverage is that Medicare does not fund custodial care. See does Medicare cover long-term care for where its 100-day skilled nursing limit actually applies.
Paying out of pocket, per the 2025 CareScout Cost of Care Survey: a nursing home private room runs a median $355 a day, or $129,575 a year. Assisted living is $6,200 a month, or $74,400 a year. A non-medical home caregiver is $35 an hour, which at 44 hours a week is $80,080 a year. Adult day care is the cheap option at a median $95 a day.
The other routes are hybrid products, which fund long-term care through a life insurance or annuity chassis and do not carry standalone rate-increase risk, and state programs. AALTCI’s July 2026 comparison shows the size of that trade: a traditional policy with a $180,000 benefit pool runs a 55-year-old man about $1,050 a year, while a linked-benefit policy carrying the same $180,000 pool plus a $120,000 minimum death benefit runs $3,540. See hybrid long-term care insurance and, if you work in Washington, the WA Cares Fund payroll benefit.
Bottom Line
The sticker price ranges from under $1,000 a year for a bare-bones policy bought at 55 to nearly $10,000 for a fully inflation-protected couple’s policy at 65. The sticker price is also the least reliable number in this article, because the same product line has absorbed average approved increases of 28% and cumulative increases in the hundreds of percent. Price the policy on what you can still afford after a 50% hike, not on today’s quote, and read is long-term care insurance worth it before you sign. If you are already facing a bill, start with how to pay for a nursing home.