Here's a number that should bother you: a 65-year-old couple retiring today has roughly a 70% chance that at least one of them will need some form of long-term care, according to research cited by the Department of Health and Human Services.
The average private nursing home room now runs over $120,000 a year.
Medicare, which most people assume covers this, generally does not pay for extended custodial care.
That gap is exactly why long-term care insurance exists.
It's also why the product has a reputation problem that's been building for two decades.
A healthy 60-year-old man buying a policy with $165,000 in initial benefits can expect to pay roughly $1,700 to $3,000 a year, depending on the insurer and options, according to industry price indexes.
A 60-year-old woman pays significantly more, often 30% to 50% higher, because women live longer and file more claims.
Wait until 70 and those premiums can double or triple.
Wait until you have a diagnosis, and you may not qualify at all.
Most policies sold before the mid-2000s were priced on assumptions that turned out wrong.
Interest rates fell, people lived longer than expected, and claims came in higher than projected.
Insurers responded by going back to state regulators for rate increases, and they got them.
Genworth, one of the largest players, has pushed through multiple rounds of hikes on older blocks of business.
Some policyholders have seen premiums double, then double again.
AARP has documented cases of increases exceeding 100%.
Insurers collect premiums for years, then raise them when the math turns against them.
Regulators approve increases to keep carriers solvent, because the alternative is a failed insurer that can't pay any claims.
Policyholders are stuck in the middle: pay more, cut benefits, or walk away and lose everything they've put in.
It means the older generation of policies was sold on promises the industry couldn't keep.
Newer policies are structured differently, with shorter benefit periods, shared-care riders for couples, and cash-benefit designs that pay a set monthly amount rather than reimbursing receipts.
Some come with built-in inflation protection, which sounds great until you see the premium.
For anyone weighing this today, the practical questions matter more than the marketing.
Can you afford the premium if it rises 50%?
Would you rather self-insure with savings and a smaller house, and rely on family?
Does your state's Medicaid program matter as a backstop, and do you understand its asset limits?
A fee-only financial planner who doesn't sell insurance can run those numbers without a commission attached.
The uncomfortable truth is that long-term care is a real risk, and the private market has done a mediocre job of making it affordable.
That's not a reason to ignore the problem.
It's a reason to plan for it while you still have options. **Our take:** Long-term care insurance isn't a slam dunk, and anyone selling it as one should be questioned hard.
But pretending the risk disappears if you don't buy a policy is a worse bet.
Final Thoughts
Run the numbers, assume the premium will rise, and decide with your eyes open.