When to Buy Long-Term Care Insurance: The Trade-offs

There is no single right time to buy long-term care insurance. The timing turns on four things a person can actually measure: how health underwriting odds shift with age, what a policy costs across the entire holding period rather than in any one year, how many years of exposure to class-wide rate increases the purchase creates, and what else those dollars would be doing. Age is one input among several, not the answer.

Most long-term care planning guidance on when to buy long-term care insurance settles on a range — usually the mid-50s to mid-60s — and treats the question as closed. That range is where most purchases happen, which is not the same as it being right for any household. What follows are the factors on both sides, with sources, and no recommended age.

What long-term care insurance covers, and why timing matters at all

Long-term care means help with everyday activities — bathing, dressing, eating, transferring, toileting — and supervision required by cognitive impairment. It is largely custodial care, not medical treatment, which is why private health insurance and Medicare largely do not cover long-term care: Medicare pays for limited skilled nursing care after a qualifying hospital stay and some home health care, not extended custodial help in a nursing home, in assisted living, or at home.

Long-term care policies pay a daily or monthly benefit once a covered person cannot perform a set number of activities of daily living or has a documented cognitive impairment. Insurers price these policies at the age you apply and hold that issue age for the life of the contract, so the age at which you buy a policy is built permanently into the premium. That is the mechanical reason timing carries weight.

The premium arithmetic runs both ways

Annual premiums are lower at younger issue ages. That figure is true and it is the one nearly every article quotes. The American Association for Long-Term Care Insurance, an industry trade association, publishes an annual price index of average premiums for applicants in good health. In its 2026 index, a couple both age 55 buying $165,000 each in initial benefits with 3% annual compound growth averaged $5,050 per year combined. A couple both age 65 buying the same design averaged $7,030 — roughly 39% more per year.

The comparison rarely continues past that sentence. Run the same numbers across a holding period and the picture changes. A couple buying at 55 and holding to age 85 pays for 30 years: about $151,500 in nominal dollars. The same design bought at 65 and held to 85 runs 20 years: about $140,600. Extend both to age 90 and the totals are near even, $176,750 and $175,750.

The younger buyer does not pay less. They pay slightly more in total dollars and get something real for it — ten additional years in which the coverage is in force. Lower long-term care insurance premiums at a younger age do not by themselves mean a lower lifetime cost. Two caveats cut in opposite directions: these averages assume premiums never change, which history does not support, and they ignore the time value of money, which favors the later buyer.

Health underwriting tightens with age

This is the factual core of the case for buying younger, and it belongs here as a fact rather than a prod. Long-term care insurers underwrite for health, and applications are declined more often as applicants get older. Data from a 2021 Milliman survey, reported by the American Association for Long-Term Care Insurance trade association, showed 38.2% of applicants ages 65 to 69 declined and 47% of applicants ages 70 to 75 declined or deferred. Earlier association data put the decline rate at 30% for ages 60 to 69 and 44% for ages 70 to 79. Most traditional long-term care insurers stop accepting applications after age 75.

Two things follow. The ability to qualify for long-term care insurance is not something a person controls or can schedule; a diagnosis at 58 can foreclose the option as effectively as waiting until 78. And those figures are averages blending healthy and unhealthy applicants — a healthy 68-year-old is not a 38% risk of decline. A decline is also not always final: hybrid designs, meaning a life insurance or annuity contract with a long-term care rider, generally underwrite less strictly.

Buying earlier means more years exposed to rate increases

This is the cost of buying young that almost no article on timing mentions.

Long-term care policies are guaranteed renewable, not guaranteed in price. An insurer cannot single out one policyholder because of a claim or a change in health, but it can raise premiums for an entire class of policies with regulatory approval. Every additional year a policy is in force is another year in which that can happen.

The history is substantial. A 2016 study by the Center for Insurance Policy and Research at the National Association of Insurance Commissioners traced increases on older blocks to three assumptions that proved wrong: claims ran higher than expected, interest earnings on reserves fell far below historical norms, and voluntary lapse rates proved among the lowest of any insurance product, meaning policyholders kept coverage insurers assumed many would drop. The same study documented the market contracting from 104 insurers actively selling in 2002 to fewer than 20 selling standalone coverage by 2010.

The increases continued. A 2024 industry survey summarized by the Society of Actuaries in 2025, covering 17 carriers representing more than 75% of U.S. long-term care premium, found an average requested rate increase of 56%, up from 47% in the comparable 2021 survey, with cumulative increases across some jurisdictions and blocks “frequently exceeding 400%.” Regulators approved an average of 28% of what was requested, and the survey identified Florida among the states where large increases are hardest to obtain — a meaningful detail here, though not a guarantee about any future filing.

Older blocks absorbed the steepest increases, and newer long-term care insurance policies are priced on more conservative assumptions, so the pattern may prove less severe going forward. But a person who buys at 55 rather than 65 signs up for ten more years of exposure to whatever it turns out to be. That is a genuine cost of buying early, and it belongs beside the lower issue-age premium.

The chance of needing care before a typical purchase age

The Administration for Community Living reports that roughly 8% of people between ages 40 and 50 have a disability that could require long-term care services, rising to 69% among those age 90 and older. Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services in their remaining years, according to the same federal source; women average 3.7 years of care and men 2.2 years, about one-fifth will need care for more than five years, and roughly one-third will never need care at all.

Research prepared for the HHS Office of the Assistant Secretary for Planning and Evaluation in 2017 estimated that 70% of adults surviving to 65 develop severe long-term care needs, but only 48% ever receive paid care, 24% receive more than two years of paid care, and 6% have severe needs lasting over a decade. Women’s risk is higher than men’s, 75% versus 64%. Read together: the need for long-term care concentrates among those who live a long life. The odds of a long, expensive spell are much lower than the headline 70% suggests, and buying early only pays off in benefits if care arrives during those extra covered years.

What long-term care costs, and who pays for it

An ASPE research brief on Americans turning 65 estimated average expected lifetime long-term care costs of $138,100 per person, with about 2.0 years of need at the level analyzed; among those who use paid care, roughly $266,000. Distribution matters more than the average when sizing potential long-term care costs: about 63% face no out-of-pocket long-term care expenses at all, while about 17% will spend at least $100,000 out of pocket.

The same brief broke down who pays for long-term care nationally: 52.3% out of pocket, 34.3% Medicaid, 9.9% Medicare, 2.7% private insurance, and 0.6% other public sources. NAIC experience reporting for 2024 counted about 3.9 million lives covered by individual long-term care policies and 1.9 million by group coverage, with roughly $15.9 billion in individual and $2.7 billion in group claims paid that year.

The cost of long-term care varies widely by setting and region, and the national cost of care survey figures quoted most often come from private insurance companies rather than public agencies. Any median cost an insurance agent or financial advisor cites is worth tracing to its source and date.

Florida rules that bear on the decision

Florida’s long-term care statutes give buyers the same protections whether a policy is purchased at 52 or 68. The Florida Department of Financial Services consumer guide describes a 30-day free look period during which a policy can be returned for a full refund. Insurers must offer inflation protection, including a 5% compounded option, and must offer nonforfeiture benefits. Policies sold in the state are guaranteed renewable and can be canceled only for nonpayment or deliberate misrepresentation, premiums may change only class-wide, and insurers must send a notice of possible lapse and copy a designated secondary addressee if one is named.

Rate increases are reviewed by the Florida Office of Insurance Regulation under Rule 69O-157.301, which caps post-increase rates for actively marketing insurers at their own new business rate and sets maximum allowable rates for closed blocks using a market-share-weighted average of comparable products. Florida’s population is 21.8% age 65 and older as of Census Bureau 2025 estimates.

Types of coverage, and how they change the timing question

The type of long-term care protection you choose changes how much the timing question matters.

Traditional standalone long-term care insurance. Pays only for covered long-term care services. Lowest premium per dollar of benefit, strictest underwriting, fully exposed to future class-wide rate increases.
Hybrid or linked-benefit policies. A life insurance or annuity contract with a long-term care rider. Premiums are typically guaranteed or paid over a fixed period, removing most rate increase exposure. Underwriting is generally less strict; cost per dollar of benefit is higher.
Long-term care riders on existing life insurance, which accelerate the death benefit to pay for care.
Short-term care policies, with benefit periods under a year and looser health qualification, sometimes available where traditional coverage is not.
Employer group coverage, where offered, which may use simplified underwriting during an enrollment window — making timing a question about a date, not an age.

If premium guarantees matter more than cost efficiency, a hybrid policy shifts the question considerably, because rate increase exposure largely drops out.

The case for waiting, stated plainly

Total nominal premiums over a full holding period may be higher for the earlier buyer, not lower.
Each additional year in force is another year of exposure to class-wide rate increases, and the historical record on them is significant.
The probability of needing care in one’s 50s is low, so the additional years cover a low-risk period.
Premium dollars committed for decades are unavailable for other purposes, and whatever those dollars might otherwise have earned is forgone.
Health, family circumstances, and finances at 60 or 65 are known; at 50 they are forecasts, and to purchase a policy later is also to buy one priced on more current assumptions.

The case for buying earlier, stated plainly

Declination rates rise materially with age, and disqualifying health events are not schedulable.
Issue age is locked for the life of the contract, so the base cost of long-term care insurance never rises because you got older.
The additional years of long-term care coverage are real, and the risk of a long-term care event during them, while low, is not zero.
A younger applicant is more likely to qualify for preferred health classes and spousal or partner discounts.
Applying earlier leaves time to reapply or restructure if a first application is declined or rated, and spreading premiums over more years lowers the annual and monthly cost of the same insurance protection.

Questions that move the timing more than age does

What resources could you call on to pay for long-term care services for two years? For five?
Is there a health history — yours or your family’s — that underwriting will treat as material?
How much premium volatility can your financial plan absorb if a class-wide increase arrives in your seventies?
Would a design with guaranteed premiums change your answer entirely?

Frequently asked questions

What is the best age to buy long-term care insurance?

There is no optimal age that applies to everyone, and the research does not support naming one. The commonly cited window of the mid-50s through the mid-60s reflects where purchases cluster — trade association data has put about 55% of traditional buyers between 55 and 65, 27% younger than 55, and 18% at 66 or older — not a finding that this age range produces the best outcome. What actually moves the answer is underwriting odds, total premium across the holding period, tolerance for rate increase exposure, and the household’s own finances.

Why do people decide not to buy long-term care insurance?

Common reasons include cost relative to other priorities, the history of premium increases on older blocks, a preference to pay for care from savings, expectation of unpaid family care, being declined for health reasons, and the fact that a policy may never pay a claim. That private insurance funds about 2.7% of national long-term care spending reflects how few households hold it.

Is it ever too late to buy long-term care insurance?

Traditional long-term care insurers generally stop accepting applications after age 75, and declination rates in the 70 to 75 band ran 47% in the 2021 survey data. A hybrid policy, a long-term care rider on life insurance, or a short-term care policy may remain available at ages or health conditions where traditional coverage is not, at different cost and benefit levels.

How does health affect the ability to qualify for long-term care insurance?

Underwriting reviews medical records, prescription history, and often cognitive screening and an interview. Conditions suggesting a near-term need for help with activities of daily living, or indicating cognitive decline, are the most common grounds for declination. Insurers assess health at application, so being in good health when you apply is what determines qualification.

What are the costs of long-term care insurance by age?

Premiums rise with issue age. In the 2026 price index published by the American Association for Long-Term Care Insurance, a trade association, a single male age 55 buying $165,000 in level benefits averaged $950 per year; with 3% annual growth, $2,200; with 5% growth, $3,710. A single female age 55 averaged $1,500, $3,750, and $6,400 for those designs, a gap reflecting women’s longer average duration of care. A couple both age 55 with 3% growth averaged $5,050 combined; a couple both age 65, $7,030. At age 60, the association reported an average of $4,450 for a single woman with $165,000 in initial benefits. Actual quotes, and the monthly cost they translate into, vary by health class, benefit period, elimination period, and insurer.

What are the pros and cons of buying long-term care insurance at different ages?

Buying at a younger age locks a lower annual premium and a health class while qualification is easier, but extends the years premiums are paid and the years exposed to class-wide increases. Buying later shortens both and is decided with better information, but faces higher annual insurance costs and materially higher declination rates. Neither dominates on the evidence.

How do people pay for long-term care?

Federal analysis of how people turning 65 pay for long-term care services attributes 52.3% of long-term care costs to out-of-pocket payment, 34.3% to Medicaid, 9.9% to Medicare, 2.7% to private insurance, and 0.6% to other public sources. Medicare, the government program most people assume covers this, is limited to skilled care following a qualifying hospital stay and some home health care, not extended custodial care in a nursing home, in assisted living, or at home.

How do I compare long-term care insurance policies?

Compare the daily or monthly benefit, the benefit period or total pool, the elimination period, the inflation protection option, the benefit triggers, whether home care and assisted living are covered at the same rate as nursing care, whether premiums are guaranteed, and the insurer’s rate increase history on similar blocks. Approved filings are public through the state’s insurance department, and the National Association of Insurance Commissioners publishes a shopper’s guide.

Disclosures

This article is general information about long-term care insurance and is not financial, tax, or legal advice, and it is not a recommendation to purchase or decline any insurance product. Figures cited are averages from the sources named and do not predict any individual’s premium, eligibility, or care costs. Premium examples come from a published industry price index and assume applicants in select health; actual rates depend on underwriting, benefit design, and insurer. Policy provisions and limitations are governed solely by the contract as issued, and availability varies by state. Lifeworth Insurance Agency is a trade name of Lifeworth Financial Group LLC, National Producer Number 21228343, licensed in Florida.

More on this: the long-term care insurance overview.