Not every long-term care insurance company is right for every buyer. The best carrier for a healthy 55-year-old couple with $600,000 in savings is a different answer than the best option for a 67-year-old widower on a fixed income. This guide breaks down the top companies by what they actually do best — and who they’re genuinely built for.
Before you look at a single premium quote or company rating, these are the facts that shape every decision in long-term care insurance — and that most buyers wish they’d understood earlier.
- 1 What is the single most important factor when choosing a long-term care insurance company? Financial strength comes first — you’re buying a promise the insurer may not have to keep for 20 or 30 years. Look for an AM Best rating of A or better. The top traditional carriers (Mutual of Omaha at A+, New York Life at A++) and hybrid leaders (Lincoln Financial at A+, Nationwide at A+) have demonstrated the financial staying power to make this a reasonable bet. Beyond financial strength, a carrier’s claims-paying history and complaint ratio matter — a company with a beautiful policy design that drags out claims or disputes benefit triggers is worse than a simpler policy from a carrier known for smooth processing.
- 2 Traditional or hybrid — which type of policy is actually better? Neither is universally better — they solve different problems. Traditional standalone policies deliver the most long-term care coverage per premium dollar, making them the right choice if maximizing benefit protection is the priority. The tradeoff: premiums can increase with state regulatory approval, and if you never need care, the premiums are spent. Hybrid policies (life insurance combined with LTC benefits) offer guaranteed premiums and a death benefit if care is never needed — eliminating the “use it or lose it” concern. The tradeoff: for the same annual cost, hybrid policies generally provide less daily LTC benefit than a traditional policy. Neither is objectively superior — choose based on whether you’re more worried about paying for care you need or paying for coverage you never use.
- 3 What is the difference between a reimbursement policy and a cash indemnity policy? This distinction matters more than most buyers realize, and the industry doesn’t explain it well. A reimbursement policy (Lincoln MoneyGuard, Securian SecureCare) pays benefits by reimbursing actual documented care costs — you submit receipts or invoices from licensed providers and get paid back. A cash indemnity policy (Nationwide CareMatters II, OneAmerica Asset Care) pays your full monthly benefit in cash once a claim is approved — no receipts, no documentation of specific expenses, no requirement to use licensed providers. Cash indemnity gives you the flexibility to pay family members who provide care, use funds for whatever helps most, and avoid paperwork during an already stressful time. Most independent specialists consider cash indemnity the superior structure when it’s available at a comparable price.
- 4 Which company is best for couples? For couples who both want hybrid coverage, Nationwide CareMatters Together and OneAmerica Asset Care offer joint policies with shared benefit pools. A shared care pool lets either partner draw from the combined benefit — so if one spouse needs significantly more care than anticipated, they can access unused benefits from the other partner’s portion rather than exhausting their own pool and paying out of pocket. For traditional policies, Mutual of Omaha’s shared-care rider accomplishes the same thing. Couples also typically receive a premium discount of 25–35% compared to two separately purchased individual policies, but both partners must qualify through underwriting.
- 5 I’m in my late 60s — is it too late to buy long-term care insurance? It’s not too late, but the market changes significantly at this age. At 65–70, denial rates reach 35–47%, traditional policy premiums escalate steeply, and fewer carriers write new traditional policies for older applicants. However, several hybrid carriers maintain more lenient underwriting at this age, particularly for annuity-based hybrid products. A $100,000 lump-sum premium into a hybrid annuity/LTC product can generate $200,000–$400,000 in LTC benefits depending on the carrier and benefit period — and the money doesn’t disappear if care is never needed. This is one scenario where working with an independent broker who represents multiple carriers becomes especially important, because the viable options narrow considerably.
- 6 Which company offers truly unlimited lifetime benefits — does such a thing even exist? Yes — OneAmerica Asset Care is currently the only major hybrid policy on the market that offers a lifetime/unlimited benefit period option. Every other hybrid product (Nationwide CareMatters II, Lincoln MoneyGuard, Securian SecureCare) caps benefits at a defined period — typically two to seven years. Traditional standalone policies from several carriers also offer lifetime benefits, though at a significantly higher premium than policies with fixed benefit periods. Whether the lifetime option is worth the additional cost is genuinely debatable — research consistently shows that 90% of nursing home stays last under three years — but for people with family histories of extended dementia care needs, unlimited coverage provides meaningful peace of mind.
- 7 The Federal Long-Term Care Insurance Program — is it still an option for federal employees? No — the Federal Long-Term Care Insurance Program (FLTCIP), administered by John Hancock, has been suspended to new enrollments since December 19, 2022, and as of 2026 the suspension remains in effect with no confirmed reopening date. Federal employees and retirees who are shopping for coverage must now purchase through private carriers, which means going through independent underwriting and paying individual market rates rather than group rates. Federal employees who had FLTCIP coverage before the suspension keep their existing policies.
Traditional policies pay dedicated long-term care benefits and nothing else. They deliver more care coverage per premium dollar than hybrid products — and the three carriers below represent the strongest options still actively writing new business.
Mutual of Omaha has been the consistent top pick for traditional long-term care insurance for years — and it holds that position based on substance rather than marketing. It is one of the very few major carriers still actively writing new standalone traditional policies, which matters because the field has shrunk significantly. Their AM Best rating of A+ (Superior) was reaffirmed in April 2026, reflecting the financial strength needed for a policy you may hold for three decades. What sets them apart from a policyholder’s perspective is their claims-paying reputation: they’ve paid millions in long-term care claims and continue to invest in making the claims process less painful for families who are already under stress. Their policy design includes inflation protection riders, shared-care options for couples, and a waiver of premium feature — meaning you stop paying premiums once you’re receiving benefits, which is common in the industry but implemented cleanly here. Coverage spans home care, assisted living, memory care, and nursing facility settings with no requirement for prior hospitalization.
New York Life holds an A++ (Superior) rating from AM Best — the highest possible rating, shared by very few carriers in any sector of insurance. If financial fortress stability is the priority above all else, New York Life is the answer. Their My Care traditional policy covers all care settings and offers a tiered benefit structure that can be customized for different care scenarios. The important caveats: New York Life’s premiums are among the highest in the traditional market, and coverage is sold exclusively through their captive agent network — you cannot get a New York Life quote alongside other carriers from a single independent broker in the same sitting. For buyers who are primarily concerned with the carrier’s ability to pay claims 30 years from now and who are less price-sensitive, New York Life earns its consideration. Buyers who want to comparison-shop across carriers simultaneously will find the captive distribution model frustrating.
Transamerica offers traditional long-term care policies through independent brokers — meaning you can compare their pricing alongside Mutual of Omaha and other carriers in a single quote process, which is a real practical advantage. Their policies include built-in care coordination services, helping families navigate the care system when benefits are triggered, and optional inflation riders up to 5% compound. Their AM Best rating is A (Excellent), a solid position though below the A+ and A++ held by Mutual of Omaha and New York Life. Transamerica has faced premium increases on older policy blocks — a pattern common across the traditional LTC market for policies issued in the 1990s and 2000s — but their newer policy designs reflect updated claims experience and more conservative pricing assumptions. Worth including in any traditional policy comparison if you’re working through an independent broker.
Hybrid policies combine life insurance or an annuity with long-term care benefits — eliminating the “use it or lose it” concern with guaranteed premiums and a death benefit if care is never needed. These are the market leaders.
Nationwide CareMatters II consistently ranks as the top hybrid pick among independent LTC specialists, and the core reason is its cash indemnity benefit structure. Once a claim is approved, Nationwide pays your full monthly benefit in cash — no receipts to submit, no invoices to track, no restrictions on which specific provider the money goes to. This matters enormously when you’re receiving care: the family isn’t chasing paperwork while managing a health crisis, and the cash can go toward family caregivers, home modifications, or whatever combination of care actually works. CareMatters II also guarantees both the premiums and the death benefit — even if you use your entire LTC benefit, the death benefit remains intact for your beneficiary. The couples version (CareMatters Together) allows joint policies with pooled benefits. Nationwide holds an A+ AM Best rating. The main limitation: benefit periods are capped (typically up to six years), not unlimited — for lifetime benefit protection, compare OneAmerica.
Lincoln Financial’s MoneyGuard line has been a hybrid LTC pioneer with one of the broadest policy designs on the market. The standout feature is its zero-day elimination period option — meaning benefits can begin from the very first day of a qualifying care need rather than after 60 or 90 days of paying out of pocket. For people who are concerned about the financial exposure during that waiting period, this is a meaningful differentiator. MoneyGuard uses a reimbursement benefit structure rather than cash indemnity — you submit documentation of care costs and receive reimbursement — which requires more paperwork than Nationwide’s cash model but is otherwise comparable in coverage terms. Policy design is highly customizable: multiple benefit period lengths, single or multi-year premium payment options, and 3–5% compound inflation riders. Lincoln carries an A+ AM Best rating. Worth comparing directly against Nationwide CareMatters II using actual illustrations to see which delivers better value for your specific age and premium budget.
OneAmerica’s Asset Care is unique in the hybrid market for one reason that can’t be understated: it is currently the only hybrid long-term care policy offering a genuine unlimited/lifetime benefit period. Every other major hybrid product caps benefits at a fixed number of years. If family history suggests extended dementia care needs, or if the worry about outlasting a benefit period is a real concern, OneAmerica is the answer. Asset Care also has the longest track record of any hybrid product in this category, having been in market since the 1980s — which means actual claims data exists for this product in a way it doesn’t for newer hybrid designs. The policy is available on both a life insurance chassis and an annuity chassis, giving funding flexibility that most competitors don’t offer. The shared care rider for couples is exceptionally well-designed, creating one pool of benefits that either spouse can draw from with no artificial per-person limits.
Securian’s SecureCare consistently appears in top-tier hybrid comparisons for good reason — it offers cash indemnity benefits (like Nationwide, no receipts required once a claim is approved) with what independent reviewers describe as one of the cleaner, more straightforward policy structures in the hybrid market. The benefit mechanics are easy to understand, which translates to fewer surprises when claims happen. For buyers who want cash indemnity flexibility but want to compare a second option against Nationwide CareMatters II side by side, Securian is the natural comparison. At a $100,000 single premium for a married 60-year-old female, Securian delivers monthly LTC benefits in the same range as Nationwide — making them genuine competitors on value. The limitation: benefit periods are finite (typically two to six years), not unlimited. Securian’s financial strength is rated A+ by AM Best, placing it among the top tier of hybrid carriers.
MassMutual holds an A++ AM Best rating — the same maximum rating as New York Life — and is structured as a mutual company, meaning it is owned by its policyholders rather than outside shareholders. Their CareChoice products layer long-term care benefits onto a participating whole life chassis, which means policyholders may receive dividends over time (dividends are not guaranteed but have a strong historical track record at MassMutual). CareChoice is the right fit for buyers who already value whole life insurance’s permanent death benefit, cash value accumulation, and dividend potential, and want LTC protection integrated into that structure rather than as a separate product. For buyers whose primary motivation is maximizing LTC benefit per dollar, a traditional policy or a purpose-built hybrid may serve better. MassMutual’s products are sold through their own advisors, so independent broker comparison requires extra steps.
This table summarizes how the leading carriers compare on the factors most buyers care about. Request actual illustrations from each carrier for your specific age and health profile before making any decision — rates vary significantly.
| Carrier | Type | AM Best | Benefit Payout | Lifetime Benefits? | Couples Option | Best For |
|---|---|---|---|---|---|---|
| Mutual of Omaha | Traditional | A+ Superior | Reimbursement | Yes (optional) | Shared-care rider | Traditional buyers — best value & claims record |
| New York Life | Traditional | A++ Superior | Reimbursement | Yes (optional) | Yes | Maximum financial strength — price-insensitive buyers |
| Transamerica | Traditional | A Excellent | Reimbursement | Yes (optional) | Yes | Comparison shopping via independent broker |
| Nationwide CareMatters II | Hybrid Life/LTC | A+ Superior | Cash Indemnity | No — capped | CareMatters Together | Best hybrid overall — cash flexibility, guaranteed premiums |
| Lincoln MoneyGuard | Hybrid Life/LTC | A+ Superior | Reimbursement | No — capped | Yes | 0-day elimination period; most design flexibility |
| OneAmerica Asset Care | Hybrid Life or Annuity | A+ Superior | Cash Indemnity | ✅ Yes — only hybrid | Excellent shared pool | Unlimited benefits; couples with pooled needs |
| Securian SecureCare | Hybrid Life/LTC | A+ Superior | Cash Indemnity | No — capped | Yes | Cash indemnity alternative to Nationwide — compare both |
| MassMutual CareChoice | Hybrid Whole Life/LTC | A++ Superior | Reimbursement | Yes (optional) | Yes | Whole life fans who want LTC bundled in |
AM Best ratings current as of mid-2026. Policy features and availability change — confirm details directly with each carrier or through a licensed independent broker. “Lifetime benefits” for traditional policies refers to an optional unlimited benefit period rider; standard benefit periods are typically 2–5 years. All hybrid policies except OneAmerica Asset Care use capped benefit periods.
The “best” company is always relative to what you’re trying to solve. Here’s how the options map to the situations people actually find themselves in.
Not everything in the LTC insurance market is buyer-friendly. These are the specific patterns, pitfalls, and red flags that affect real purchasing decisions.
The Federal Long-Term Care Insurance Program (FLTCIP) has been suspended to new enrollments since December 2022. As of mid-2026, the program remains closed with no confirmed reopening date. Federal employees and their families who are waiting for FLTCIP to reopen before buying coverage are taking on meaningful health and age risk — every year of waiting adds to premiums and denial risk when they eventually turn to the private market. Treat the private market as the only available option and plan accordingly.
Some of the strongest carriers — New York Life and MassMutual — sell exclusively through their own captive agents. That means you cannot get a New York Life quote and a Mutual of Omaha quote in the same comparative analysis from the same person. If you’re serious about comparison shopping, work with an independent broker who holds contracts with multiple carriers, then separately get a quote from New York Life or MassMutual directly if their financial strength specifically appeals to you. Comparing illustrations from three or four carriers before choosing is standard practice among LTC specialists — and the 29% spread between carriers for the same buyer profile makes this genuinely worthwhile.
Reimbursement policies all use the same general structure, but the documentation requirements — what receipts you need to submit, how quickly claims are processed, whether the insurer requires coordination with a care manager — vary meaningfully between carriers. A policy that reimburses well on paper but has a history of claims processing delays or documentation disputes is not equivalent to one with a clean track record. Check the NAIC complaint index for the specific carrier (available at naic.org) and ask your broker specifically about the claims experience for the carrier and policy you’re considering.
- Use an independent broker who represents at least four carriers — single-carrier agents cannot give you a comparison, and the best fit for your health profile and budget may not be obvious without side-by-side illustrations
- Apply before your next birthday if you’re near an age threshold — age brackets for premium calculation mean that a policy issued before your birthday is often significantly cheaper than one issued two months later
- Ask for the carrier’s rate-increase history on similar policies — responsible brokers can show you which carriers have raised rates on existing policyholders and by how much; this information exists and you’re entitled to it
- Don’t buy the maximum benefit period if the premium is uncomfortably high — a policy you keep through retirement is worth far more than a comprehensive policy you drop at 72 because the premiums became unmanageable; fit the coverage to the budget
- Apply while healthy — a single new diagnosis between now and when you apply can raise your premium class, add a surcharge, or disqualify you entirely; this is the argument for acting sooner rather than later, not for buying from the first agent you talk to
This page is for general informational purposes only and does not constitute insurance, financial, or legal advice. Long-term care insurance is regulated at the state level — policy availability, features, and premium rates vary by state and individual health profile. AM Best ratings listed reflect publicly available 2026 data and are subject to change. Policy details including benefit periods, elimination periods, inflation riders, and payout structures change frequently as carriers update their products — verify all features directly with the carrier or a licensed insurance professional before making any purchasing decision. Premium examples and ranges referenced throughout this page are based on published 2025–2026 industry benchmark data and are not personalized quotes. The Federal Long-Term Care Insurance Program (FLTCIP) suspension status is current as of mid-2026; confirm current status at ltcfeds.gov. This content is not affiliated with, sponsored by, or endorsed by any insurance carrier listed. Always work with a licensed, independent insurance professional who can provide personalized illustrations based on your specific age, health, and coverage goals.