Americans shopping for long-term care coverage this year are running into a number that keeps moving in the wrong direction.
A recent industry survey found that a 60-year-old couple can expect to pay roughly $3,500 to $4,000 a year for a policy with modest benefits.
A decade ago, that same couple might have paid half as much.
The reason is simple, even if the math is ugly.
Insurers badly underpriced these policies in the 1990s and 2000s.
People lived longer than expected, care got more expensive, and low interest rates ate into the investment returns insurers counted on.
Companies like Genworth, John Hancock, and MetLife either raised premiums sharply or stopped selling new policies entirely.
What you pay now depends on a handful of choices.
Age is the biggest factor — buying at 55 costs far less than buying at 70.
A policy that pays $150 a day for three years is much cheaper than one paying $300 a day for five years.
Couples get a discount in most states, and a shared-care rider lets one spouse use the other's unused benefits.
There's also a decision many people get wrong: whether to add inflation protection.
Without it, a policy that pays $150 a day today might cover only a fraction of a nursing home bill 25 years from now.
With 3% compound inflation growth, that same benefit doubles in about 24 years — but the premium can jump 30% to 50% or more.
The sticker shock has pushed many families toward alternatives.
Some buy hybrid policies that combine life insurance with a long-term care benefit, paying a single lump sum instead of monthly premiums.
Others skip insurance altogether and plan to self-fund, which works if you have significant savings and a home to sell.
Medicaid covers nursing home care, but generally only after you've spent down most of your assets.
If you're considering a policy, a few practical moves can help.
Get quotes from at least three carriers, since prices for identical coverage can vary by thousands of dollars a year.
Ask about premium stability — some insurers have raised rates 50% or more on existing customers.
Check whether your state has a partnership program that lets you protect extra assets if you eventually need Medicaid.
And read the fine print on what triggers benefits, since most policies require you to need help with at least two daily activities like bathing or dressing.
One more thing worth knowing: some employers and professional associations offer group long-term care plans with simpler underwriting.
The coverage is often thinner than an individual policy, but for people with health issues that would trigger a denial elsewhere, it can be the only realistic door in.
The uncomfortable reality is that most Americans will need some form of long-term care, and nobody knows for how long.
Paying premiums for years and never using the policy feels like wasted money — until it isn't.
For families with modest savings, a policy bought in your late 50s is often cheaper than a single year of private nursing care.
Our take: this isn't a product to buy on a whim or skip out of avoidance.
Run the numbers with a fee-only advisor, compare at least three quotes, and decide based on what your savings could realistically absorb.
Final Thoughts
Doing nothing is also a choice — just usually the most expensive one.