Sometimes, but not automatically. Long-term care insurance premiums are deductible only when the policy is tax-qualified, only up to an age-based dollar cap set each tax year by the IRS, and, for most people, only as part of itemized medical expenses that exceed 7.5% of adjusted gross income. Self-employed taxpayers follow different rules.
The federal rules sit in the Internal Revenue Code, and the dollar figures change every tax year. Long-term care insurance premiums may reduce what you owe, but only inside firm limits on the amount you are allowed to count. Below is how the deduction works, what the 2026 IRS limits are, which expenses are deductible, how tax deductibility differs from the tax treatment of LTC insurance benefits, and what Florida residents should know about state-level tax breaks before tax season.
Which LTC policies are tax-qualified under IRS rules
None of the federal tax benefits apply unless the contract meets the definition of a qualified long-term care insurance contract in Internal Revenue Code section 7702B(b). That definition came out of the Health Insurance Portability and Accountability Act of 1996, which is why the tax-qualified framework is often called the HIPAA standard.
Under section 7702B(b), a qualified contract generally must:
- Provide coverage only for qualified long-term care services;
- Be guaranteed renewable;
- Carry no cash surrender value and no ability to borrow against or pledge the contract, apart from limited premium refunds;
- Apply any refunded premiums or dividends only to reduce future premiums or increase future benefits; and
- Meet specified consumer protection standards.
The contract also cannot pay expenses reimbursable under Medicare, except as a secondary payor. Long-term care insurance policies issued before January 1, 1997 that met applicable state law requirements are generally treated as qualified under the HIPAA transition rules.
Activities of daily living and the chronically ill test
Section 7702B(c)(2) defines a chronically ill individual, and this is the benefit trigger a tax-qualified policy has to use. A licensed health care practitioner must certify, within the previous 12 months, that the person either:
- Is unable to perform at least two activities of daily living without substantial assistance from another individual for a period of at least 90 days; or
- Requires substantial supervision to protect against threats to health and safety because of severe cognitive impairment.
The six activities of daily living named in the statute are eating, toileting, transferring, bathing, dressing, and continence, and a qualifying contract must take at least five into account. Qualified long-term care services are the necessary diagnostic, preventive, therapeutic, rehabilitative, and maintenance and personal care services a chronically ill person requires under a plan of care prescribed by a licensed health care practitioner, covering facility care and home care alike.
If a policy does not meet the section 7702B(b) definition, the premium is not a deductible medical expense at all, whatever its size, and none of the tax advantages below apply. Confirm with the tax professional handling the return that you hold a tax-qualified long-term care insurance policy before assuming a deduction exists.
How the medical expense deduction treats long-term care insurance premiums
Two provisions do the work. Section 213(d)(1)(C) treats qualified long-term care services as medical care. Section 213(d)(1)(D) treats amounts paid for a qualified long-term care insurance contract as amounts paid for medical care. An eligible premium under a qualified insurance contract is therefore a medical expense in the same category as a doctor bill or a health insurance premium, and it joins your total qualified medical expenses for the year.
Section 213(d)(10) then caps how much of the premium counts. Only the “eligible long-term care premium” is deductible, limited by the insured person’s attained age before the close of the tax year. The statute set base figures of $200, $375, $750, $2,000, and $2,500 across five age bands, adjusted annually using the medical care cost component of the Consumer Price Index. That indexing is why an article citing an older table can be off by hundreds of dollars.
2026 tax deduction limits for long-term care insurance premiums by age
For tax years beginning in 2026, the IRS set the section 213(d)(10) caps on qualified long-term care insurance premiums in Revenue Procedure 2025-32. The amount is per covered person, based on attained age before the close of the tax year, and it applies to each spouse separately on a joint return.
| Attained age before the close of the tax year | 2026 eligible premium limit | 2025 eligible premium limit |
|---|---|---|
| 40 or less | $500 | $480 |
| More than 40 but not more than 50 | $930 | $900 |
| More than 50 but not more than 60 | $1,860 | $1,800 |
| More than 60 but not more than 70 | $4,960 | $4,810 |
| More than 70 | $6,200 | $6,020 |
The 2025 column comes from IRS Publication 502 for the 2025 tax year, reflecting Revenue Procedure 2024-40. The 2026 limits apply to returns filed in early 2027. Limits for tax year 2027 have not been published as of this writing, so any 2027 figure in circulation is an estimate rather than an IRS number.
Two points trip people up. The cap is on the premium you may count, not on the tax savings you receive: counting $4,960 of premium toward medical expenses is not the same as cutting your tax by $4,960. And a married couple filing jointly applies the caps individually, so a 68-year-old and a 72-year-old could count up to $4,960 and $6,200 respectively in tax year 2026, a combined $11,160, if both long-term care insurance policies are tax-qualified and both premiums were that high.
The 7.5% of adjusted gross income floor, and why you must itemize deductions
Section 213(a) allows a deduction only for total medical expenses above 7.5% of adjusted gross income. This threshold is permanent and applies regardless of age. Everything below the floor is disregarded, which is why many tax returns show no medical expense deduction at all.
You also have to itemize deductions on Schedule A. If total itemized deductions do not exceed your standard deduction, the medical expense deduction produces nothing. For tax year 2026 the standard deduction is $32,200 for married couples filing jointly, $16,100 for single filers and married filing separately, and $24,150 for heads of household. Taxpayers 65 or older, or blind, add $1,650 per qualifying condition, increased to $2,050 for someone unmarried and not a surviving spouse. Those amounts are also in Revenue Procedure 2025-32.
An illustration for tax year 2026: a joint filer with $90,000 of adjusted gross income has a floor of $6,750. If the couple counts $11,160 of eligible long-term care premiums under the age caps plus $3,000 of other unreimbursed medical expenses, that is $14,160 of qualified medical expenses and $7,410 above the floor. That $7,410 goes on Schedule A, and it reduces taxable income only to the extent their total itemized deductions exceed the standard deduction they would otherwise claim.
One change takes effect for tax years beginning in 2026: the overall limitation on itemized deductions returns in modified form, limiting the tax benefit of itemized deductions for taxpayers in the 37% bracket. A high-income household should ask a tax advisor how it applies.
Several mechanical rules also reduce what you can count. Premiums an employer paid pre-tax are not deductible, since they were never in your income; Publication 502 notes employer-sponsored premiums count only if they appear on your Form W-2. Expenses paid with a tax-free health savings account distribution cannot also be deducted. And under section 213(d)(11), amounts paid for long-term care services provided by your spouse or a relative generally do not count unless that person is a licensed professional.
Self-employed owners can deduct premiums without itemizing
Section 162(l) gives self-employed individuals a different path. The self-employed health insurance deduction covers premiums on a policy providing medical care for the taxpayer, spouse, dependents, and children under age 27, and it expressly includes premiums for a qualified long-term care insurance contract, subject to the same section 213(d)(10) age-based limits.
The distinction here: this deduction is an adjustment to income rather than a Schedule A item. You do not have to itemize, and the 7.5% of adjusted gross income floor does not apply. Within the age caps, a self-employed taxpayer can deduct premiums straight against income, so eligible LTC premiums reduce adjusted gross income directly.
Two limits apply. The deduction cannot exceed earned income derived from the trade or business under which the plan is established, and it is not allowed for any calendar month in which you were eligible to participate in a subsidized health plan maintained by an employer of yours or your spouse. Treatment also differs for a sole proprietor, a partner, an S corporation shareholder-employee, and a C corporation, which is a question for a CPA reviewing the entity structure.
Paying long-term care insurance premiums from an HSA
An HSA is a savings vehicle rather than an insurance program, so it generally cannot pay insurance premiums. Long-term care insurance is a stated exception. IRS Publication 969 says HSA funds may not be used for insurance except for a short list, and long-term care insurance leads it. Archer MSAs follow a similar rule.
The same age-based ceiling applies. Premiums you can treat as qualified medical expenses from an HSA are limited by the section 213(d)(10) table above. Distributions above the limit for that person’s age are not qualified medical expenses, and the excess is generally includible in income and may carry an additional tax. You also cannot deduct a premium you paid with a tax-free HSA distribution, which would count the same dollar twice.
Separately, section 125(f)(2) excludes any product advertised, marketed, or offered as long-term care insurance from being a qualified benefit under a cafeteria plan, so a section 125 plan or health FSA is not a route to pre-tax LTC insurance premiums.
Are long-term care insurance benefits taxable?
This is a separate question from whether you could deduct the premiums, and the favorable tax treatment here is broader. Section 7702B(a) treats a qualified long-term care insurance contract as an accident and health insurance contract and treats amounts received under it as amounts received for personal injuries and sickness. In practice, benefits under a qualified contract that reimburse actual costs for qualified long-term care services are generally excluded from income, without a dollar cap.
Indemnity-style contracts, which pay a fixed daily or monthly amount regardless of what care cost, fall under section 7702B(d). Periodic payments are excludable up to the greater of the per diem limitation or the actual costs incurred for qualified long-term care services, reduced by other reimbursements. Amounts above that are includible in income.
For calendar year 2026 the per diem limitation under section 7702B(d)(4) is $430 per day, set in Revenue Procedure 2025-32. For calendar year 2025 it was $420 per day, under Revenue Procedure 2024-40. If two or more contracts pay per diem benefits on the same insured, payments are aggregated against a single limit.
Payers report benefits on Form 1099-LTC, and a recipient of per diem or other periodic payments completes Section C of Form 8853 to figure any taxable amount. Receiving a Form 1099-LTC does not by itself mean anything is taxable.
Which long-term care expenses are deductible on their own
Apart from premium deductibility, out-of-pocket long-term care expenses for qualified long term care services are medical expenses under section 213(d)(1)(C). Nursing home costs, assisted living costs attributable to medical care, and in-home care services can count when the person is certified as chronically ill and care follows a prescribed plan of care. These expenses face the same 7.5% floor and itemizing requirement, and insurance benefits received for those costs reduce what you can deduct.
Medicare costs follow the general medical expense rules instead. Medicare Part B and Part D premiums, and Part A premiums for those who pay them, are generally deductible medical expenses subject to the 7.5% floor, and are not subject to the age-based caps, which apply only to eligible long-term care insurance premiums.
State tax breaks and tax savings, and what applies in Florida
Some states offer tax incentives for long-term care coverage, usually a state income tax deduction or credit for long term care insurance premiums on top of the federal treatment. The specifics vary by state, change with legislation, and several widely circulated comparison charts have not been updated in years.
For Florida residents the point is simpler. Florida does not impose an individual income tax. With no state individual income tax return, there is no state taxable income to reduce, so the state-level deductions and credits available in some other states do not apply to Florida residents, who are working with the federal rules above and nothing further. Someone who moved to Florida from a state that offered a credit does not carry that benefit along.
Limits on the federal tax benefits for LTC premiums
- The age caps bind at younger ages. A 55-year-old paying $3,200 a year can count only $1,860 of it in tax year 2026.
- The 7.5% floor absorbs a lot. At $120,000 of adjusted gross income, the first $9,000 of medical expenses produces no deduction.
- Standard deduction levels reduce itemizing. Many households with real deductible expenses still do not exceed the standard deduction, so the medical expense deduction never surfaces.
- Premiums are not fixed for life. Long-term care insurance premiums on many older policies have been increased with regulatory approval, which is a policy design question rather than a tax question.
- A policy may go unused. On traditional reimbursement LTC policies, premiums paid are not returned if benefits are never triggered. Hybrid designs pairing care benefits with life insurance policies are taxed under their own rules, and their tax implications are more complicated.
None of this makes the tax treatment unimportant. It does mean the deduction is better understood as a feature of long-term care planning than as the reason for it, and that purchasing long-term care insurance chiefly for a deduction inverts the decision.
Frequently asked questions
Are long-term care premiums tax deductible in 2026?
Eligible long-term care insurance premiums are deductible in tax year 2026 up to $500, $930, $1,860, $4,960, or $6,200 depending on the insured’s attained age, per Revenue Procedure 2025-32. The policy must be a qualified long-term care insurance contract, and for most taxpayers the amount counts only as an itemized medical expense above 7.5% of adjusted gross income.
Who is eligible to deduct long-term care insurance premiums?
Taxpayers who itemize and whose medical expenses exceed the 7.5% floor, plus self-employed individuals qualifying under section 162(l). You may generally include eligible premiums paid for yourself, your spouse, and your dependents. Premiums paid pre-tax through an employer, or with a tax-free HSA distribution, cannot be deducted again.
What is considered a tax-qualified long-term care policy?
One meeting Internal Revenue Code section 7702B(b): coverage limited to qualified long-term care services, guaranteed renewable, no cash surrender value, benefits triggered by chronic illness as defined in section 7702B(c)(2), and compliance with the specified consumer protection standards. Contracts issued before 1997 that met state requirements are generally treated as qualified.
Can you use an HSA to pay for long-term care insurance premiums?
Yes, within limits. Long-term care insurance is one of the few types of insurance an HSA may pay for, and the amount treated as a qualified medical expense is capped by the same age-based table, $500 to $6,200 for tax year 2026. Amounts above the cap are generally taxable distributions.
Are long-term care insurance benefits taxable?
Benefits from a qualified contract that reimburse actual qualified long-term care services are generally excluded from income. Per diem payments are excludable up to the greater of actual qualified costs or the per diem limitation, which is $430 per day for calendar year 2026 and was $420 per day for 2025. Excess amounts are includible in income and reported on Form 8853.
Which states offer tax breaks or credits for long-term care insurance?
Several states provide a deduction or credit, with rules that differ by state and change over time. Because Florida has no individual income tax, Florida residents have no state return on which to claim one. Anyone filing in another state should confirm current rules with a tax professional there.
Do I have to meet a threshold before deducting LTC insurance premiums?
On Schedule A, yes. Only total medical expenses above 7.5% of adjusted gross income are deductible, and you must itemize. The section 162(l) self-employed health insurance deduction is the exception, since it is an adjustment to income.
What is the biggest drawback of long-term care insurance from a tax standpoint?
That the deduction is capped and conditional. The age-based limit can sit well below the premium actually paid, the 7.5% floor removes a further slice, and standard deduction levels keep many households from itemizing at all. Treating the tax deduction as the primary reason to buy coverage overstates what the rules deliver.
Should you buy long-term care insurance for the tax deduction?
The tax rules are one factor alongside coverage design, benefit triggers, premium structure, and household finances. The federal treatment described here applies to a policy you would want on its merits; it does not make an unsuitable policy suitable.
Disclosures
This article is general information about federal tax rules and is not tax advice, legal advice, or a recommendation regarding any insurance product. Figures are stated for the tax year indicated and are adjusted annually by the IRS; tax year 2027 amounts had not been published when this was written. Individual results depend on filing status, adjusted gross income, entity structure, and whether a contract is qualified under section 7702B(b). Consult a qualified tax professional about your own situation before relying on any deduction described here. Lifeworth Insurance Agency is a trade name of Lifeworth Financial Group LLC, National Producer Number 21228343, licensed in Florida.
Related reading
- Long-Term Care Annuity Rider: Pros and Cons, How It Works
- Long-Term Care Insurance Benefit Period: How It Works
- Is Long-Term Care Insurance Worth It? Both Sides, Plainly
- Are Hybrid Long-Term Care Premiums Tax Deductible?
- Indemnity vs Reimbursement Long-Term Care Policies
This article is part of how long-term care planning works at Lifeworth.