The price of long-term care coverage keeps moving in one direction, and it isn't down.
A 55-year-old couple shopping for a policy today can expect to pay thousands more per year than their counterparts did a decade ago, according to industry pricing data and insurance agent surveys.
The increases hit hardest in policies that cover in-home care and nursing facilities, two of the most common claims.
Several forces are driving the sticker shock.
Insurers badly misjudged how long policyholders would live and how often they would file claims, and many carriers exited the market entirely after racking up losses.
The companies still writing policies have pushed premiums up to cushion against future payouts, and low interest rates earlier this decade made it harder to earn returns on the money backing those policies.
For shoppers, the numbers can feel brutal.
Industry surveys routinely show a healthy 60-year-old couple paying well over $3,000 a year combined for a mid-tier policy with inflation protection, and some quotes run several times higher depending on coverage limits.
Women often pay more than men because they tend to live longer and file more claims.
A history of health issues can push a quote higher or knock an applicant out of the running entirely.
That doesn't mean the coverage is a bad deal for everyone.
A private room in a nursing home can run north of $100,000 a year in many states, and even part-time in-home care adds up fast.
Medicare generally doesn't cover long stretches of custodial care, and Medicaid only kicks in after most assets are spent down.
For families with savings to protect, a policy can mean the difference between leaving an inheritance and draining a retirement account.
Choosing a lower daily benefit, shortening the payout period to three years instead of five, or buying a policy with a longer waiting period before benefits start can all trim premiums.
Some buyers pair a smaller policy with a dedicated savings account earmarked for care.
Couples can also look at shared-care riders, which let one spouse tap the other's unused benefits.
Newer hybrid products mix life insurance with a long-term care benefit, letting policyholders get some money back if they never need care.
These usually require a larger upfront payment, but they've grown popular with buyers who hate the idea of paying premiums for years and getting nothing.
Anyone considering coverage should get quotes from at least three carriers and read the fine print on inflation protection, which is often the first feature agents suggest dropping to lower the price — and the one that matters most decades later.
State insurance departments publish rate histories and complaint data that can reveal how a carrier treats existing customers.
The bottom line: long-term care insurance isn't cheap, and it's getting less cheap by the year.
But skipping coverage entirely is also a gamble, and it's one that often lands on family members instead of an insurer.
Final Thoughts
Buyers who shop carefully, understand what they're giving up, and start the conversation before health problems close the door will have the most options.