Best Long-Term Care Insurance Companies 2026: Ratings & Fee-Only Comparison

An honest review of the carriers still writing LTC policies — traditional and hybrid — based on financial strength, rate stability, and policy design. No commissions earned on any product we mention.

How to evaluate an LTC insurance carrier

Four factors matter for carrier selection:

1. AM Best financial strength rating. LTC policies run 20–40 years. A carrier that looks fine today could be impaired by then. AM Best grades on a 15-tier scale; focus on A (Excellent), A+ (Superior), and A++ (Superior). Below A: elevated risk, not worth the savings on premium.
2. Rate stability history. LTC insurance was catastrophically mispriced in the 1990s and 2000s. Carriers that exited (Genworth, John Hancock, MetLife, Prudential, Transamerica) did so after staggering rate increases or losses. Remaining carriers have mostly repriced conservatively, but rate increases are still possible. A carrier's track record matters.
3. Policy design quality. Benefit triggers, elimination period mechanics, inflation rider options, and benefit period flexibility vary significantly. Cheap premiums from a carrier with a restrictive trigger definition may pay out less than a pricier policy from a carrier with a more claimant-friendly design.
4. State availability and underwriting standards. Not every carrier writes policies in all 50 states. Underwriting criteria differ — especially relevant for applicants with pre-existing conditions.

Traditional LTC insurance carriers (2026)

Only a handful of carriers still write new standalone (traditional) LTC insurance policies. The market contracted dramatically from the 2000s peak of 100+ carriers to roughly 4–5 today.¹

Traditional carrier analysis: who fits which carrier

Mutual of Omaha is the default recommendation for most buyers seeking traditional standalone coverage. It offers the broadest combination of financial strength, competitive pricing, and underwriting flexibility (including the widest age acceptance window). If you're shopping traditional LTC, Mutual of Omaha is the baseline to beat.

Thrivent often comes in #1 or #2 on price — sometimes meaningfully cheaper than Mutual of Omaha for equivalent coverage — with a better AM Best rating. The catch: Thrivent requires applicants to sign a statement of faith affirming Christian denomination membership. If that fits, Thrivent deserves serious consideration. If it doesn't, Mutual of Omaha is the next stop.

NGL is worth looking at for buyers who need a lower premium and are comfortable with somewhat lower financial strength. The HonestLTC product (2026) replaced EssentialLTC as NGL's flagship offering. Excluded from California and New York — residents of those states need one of the other carriers.

New York Life has unmatched financial strength (A++) and strong name recognition, but premiums run 20–40% higher than comparable Mutual of Omaha policies in most markets. The value proposition is highest for buyers who prioritize financial strength above all else and for older applicants (mid-70s) where NY Life's underwriting flexibility sometimes exceeds competitors.

Hybrid LTC insurance carriers (2026)

Hybrid products combine a life insurance or annuity chassis with a long-term care benefit rider. They cost more upfront but guarantee return of premium if you don't use LTC benefits, eliminate the "use it or lose it" concern of traditional policies, and tend to have more lenient underwriting.²

Hybrid carrier analysis: what makes each one different

Nationwide CareMatters II stands out on benefit design: it pays cash indemnity (you receive the daily benefit regardless of actual care costs), not reimbursement. That means if your home care costs $150/day but your benefit is $250/day, you keep the difference. For couples who plan to fund in-home care by a family member or informal caregiver, this structure is meaningfully more flexible.

Pacific Life PremierCare is often the best value on a pure cost-per-dollar-of-LTC-benefit basis. Reaffirmed A+ (Superior) by AM Best in December 2025. Best fit: buyers doing a single-pay lump sum ($100K–$300K) who want guaranteed premiums and strong financial strength.

OneAmerica Asset-Care is the go-to recommendation for couples. The shared care rider — which allows spouses to draw from each other's benefit pool — is better designed here than at competitors. OneAmerica has been selling hybrid LTC since the early 1990s. The claims track record and institutional knowledge accumulated over 30+ years provide some confidence in benefit trigger administration. Best fit: couples age 55–68 with $500K–$2M in assets who want certainty over flexibility.

Lincoln MoneyGuard offers the most flexibility in premium payment structures (7-pay, 10-pay, single-pay) and benefit customization. The AM Best downgrade in 2022 created some uncertainty, but the February 2025 outlook revision to stable suggests the restructuring has been absorbed. Lincoln's S&P AA- rating (one notch stronger than AM Best's implied equivalent) provides some counterweight. Acceptable choice but warrants monitoring.

Carriers that exited the LTC market

Understanding who left — and why — is important context for evaluating the remaining carriers. The mass exit between 2000–2020 happened because carriers systematically underestimated two things: how long people would keep their policies (lapse rates were assumed to be 5–8%/year; actual lapse was under 1%/year) and how long policyholders would live after claiming (care durations were longer than modeled).³

What this means for existing policyholders. If you have a policy from one of the exited carriers, it is still valid and claims will be paid — these companies did not go bankrupt. But rate hike exposure remains real. See our LTC premium rate hike guide for options if you've received an increase notice.

What if your LTC insurance carrier fails?

State insurance guaranty associations provide a backstop if a licensed insurer becomes insolvent. For LTC insurance, most states protect up to $300,000 in policy benefits per person, though limits vary by state. This is meaningful protection but not a full safety net for large benefit policies.⁴

The practical risk mitigation: buy from A-rated or better carriers, and don't build a plan that entirely depends on policy benefits with zero self-fund reserve. The hybrid products have an additional layer of protection in that the underlying life insurance death benefit is also covered by guaranty funds (up to state limits).

How a fee-only advisor changes the carrier evaluation

Here's what a commissioned agent's "carrier comparison" typically looks like versus a fee-only advisor's:

If you're comparing carriers and products, the most efficient thing you can do is talk to a fee-only advisor who specializes in LTC planning. You'll get quotes from multiple carriers in parallel — usually in a single meeting — along with a model of what self-funding would require so you're making an apples-to-apples comparison.