The bill for long-term care coverage keeps getting bigger, and not by a little.
According to the American Association for Long-Term Care Insurance, a 60-year-old couple can now expect to pay roughly $3,800 to $5,000 a year for a policy with meaningful benefits.
A decade ago, that same couple might have paid half as much.
The reason is straightforward: care itself costs more.
Genworth's annual Cost of Care survey puts the national median for a private nursing home room above $116,000 a year, with assisted living near $64,000 and a home health aide around $75,000.
Insurers price policies against those numbers, and when aides, nurses, and facilities charge more, premiums follow.
For years, insurers assumed they could earn a decent return on the premiums they collected before paying claims.
When rates stayed near zero, that math broke.
Several major carriers, including Genworth and John Hancock, stopped selling new traditional policies or raised rates sharply.
Fewer sellers means less competition, and less competition rarely helps buyers.
There's also a gender gap that catches people off guard.
Women typically pay 20% to 40% more than men for the same coverage, simply because they tend to live longer and file more claims.
Couples who apply together often qualify for a shared-care discount, which lets one partner tap the other's benefit pool if needed.
If the sticker price feels steep, there are ways to bring it down.
Choosing a longer elimination period, meaning the days you pay out of pocket before benefits kick in, can shave hundreds off the annual premium.
A shared family policy splits one pool of benefits between two people and usually costs less than two separate policies.
Some buyers opt for a policy with a 3% inflation growth rider instead of 5%, trading future protection for a smaller bill today.
These combine life insurance or an annuity with a long-term care benefit.
You pay a lump sum up front, and if you never need care, your heirs get a death benefit.
The catch is that you need cash on hand, often $50,000 to $100,000, and the care benefit may run out faster than a traditional policy's would.
Premiums for identical coverage can vary by 50% or more between carriers, and an independent agent who represents multiple companies can show you the spread.
It's also worth asking whether your state offers a Partnership policy, which lets you keep more assets under Medicaid if you exhaust your coverage.
One thing experts agree on: waiting rarely helps.
Premiums rise with age, and a health scare can make you uninsurable overnight.
A 55-year-old in good health is a much easier sell to an underwriter than a 68-year-old with a new diagnosis. **Our take:** Long-term care insurance isn't cheap, and it isn't getting cheaper.
But for many households, the alternative, draining retirement savings to pay $100,000 a year for a nursing home, is far worse.
Final Thoughts
Run the numbers while you're still healthy, and treat the premium like any other bill you plan for.