Long-term care insurance premiums for a 65-year-old typically range from $2,000 to $4,500 per year for a standard policy, but the actual cost depends heavily on your health, the coverage you choose, and which company you buy from.
A 65-year-old in good health buying a policy that covers three years of care in a nursing home will pay less than someone with high blood pressure or diabetes buying five years of coverage. The same policy can cost 30 to 50 percent more at one insurance company than another, which is why getting quotes from multiple carriers matters. Your age at purchase is locked in for life, so waiting even a few years will raise your premium permanently.
Unlike health insurance, long-term care insurance has no standard pricing. Insurers set rates based on their own claims experience and assumptions about how long people will need care. This means two identical policies from different companies can have very different price tags, and the cheapest option is not always the one that will serve you best over decades.
Key Takeaways
- Monthly premiums for a 65-year-old range from roughly $165 to $375, depending on health status, coverage length, and daily benefit amount.
- A policy covering three years of care costs significantly less than one covering five years, but most people who need long-term care use it for two to three years.
- Health conditions like diabetes, heart disease, or cognitive decline can raise your premium by 25 to 100 percent or make you ineligible to buy at all.
- Rates are locked in at the age you purchase, so buying at 65 is cheaper than waiting until 70, but you pay premiums for years before you might use the benefit.
- Comparing quotes from at least three insurers is essential, because the same coverage can cost $1,000 to $2,000 more per year from one company to another.
What the daily benefit amount means for your premium
The daily benefit is how much the insurance company will pay per day toward your care. A $150 daily benefit means the insurer covers up to $150 of your nursing home or home care costs each day. A $200 daily benefit costs more but covers more of the actual bill. Most nursing homes in the United States cost between $100 and $300 per day, depending on the state and facility type, so a $150 to $200 daily benefit is common.
A 65-year-old buying a $150 daily benefit might pay $1,800 to $3,000 per year. The same person buying a $200 daily benefit could pay $2,400 to $4,200 per year. The difference is not proportional—jumping from $150 to $200 per day does not cost 33 percent more; it typically costs 20 to 30 percent more because the insurance company spreads its overhead across the larger benefit.
You also choose an elimination period, which is how many days you pay out of pocket before the insurance kicks in. A 30-day elimination period means you cover the first month of care yourself. A 90-day elimination period means you cover the first three months. Choosing 90 days instead of 30 days can lower your annual premium by 15 to 25 percent, because the insurer pays less overall.
How health status affects what you pay
Insurance companies underwrite long-term care policies the way they underwrite life insurance—they want to know your medical history. A 65-year-old with no chronic conditions and normal blood pressure will pay the standard rate. Someone with controlled high blood pressure or high cholesterol might pay 10 to 25 percent more. Someone with diabetes, heart disease, or a history of stroke could pay 50 to 100 percent more or be turned down entirely.
Cognitive decline, even mild, is a major red flag. If you have been diagnosed with mild cognitive impairment or early-stage dementia, most insurers will decline your application. Some will offer coverage at a much higher rate or with exclusions that limit what they will pay for. This matters because dementia is one of the most common reasons people need long-term care.
You will need to complete a health questionnaire and often a phone interview with a nurse. Some insurers require a medical exam, including blood work and sometimes a cognitive screening. The exam is usually free, but it takes time and can delay approval by several weeks.
The cost difference between three-year and five-year policies
Coverage length is one of the biggest cost drivers. A three-year policy covers up to three years of daily benefits. A five-year policy covers up to five years. A 65-year-old buying a $150 daily benefit with a three-year term might pay $1,800 to $2,400 per year. The same person buying a five-year term could pay $2,800 to $3,800 per year.
The longer the coverage period, the higher the premium, but the relationship is not linear. Going from three years to five years does not cost 67 percent more; it typically costs 40 to 60 percent more. Going from five years to lifetime coverage can double the premium or more, because the insurer is betting you might need care for decades.
Most people who use long-term care use it for two to three years. Very few use it for longer than five years. This is why many financial advisors suggest a three-year policy as a middle ground—it covers the most common scenario without the steep cost of five-year or lifetime coverage. But if you have a family history of long life or dementia, a longer term might make sense.
Why the same policy costs different amounts at different companies
Long-term care insurance is not a commodity. There is no standard policy that every company offers at the same price. Each insurer sets its own rates based on its own claims data, investment returns, and business strategy. One company might have had better-than-expected claims experience and lowered rates. Another might be trying to attract new customers and offered discounts. A third might be exiting the market and raising rates to discourage new sales.
A 65-year-old in good health might get quotes ranging from $2,000 to $4,500 per year for the same coverage from different insurers. The difference is not a mistake—it reflects real differences in how companies price risk and manage their business. This is why getting at least three quotes is not optional; it can save you hundreds or thousands of dollars per year.
Some companies also offer discounts you should ask about: discounts for couples buying together, discounts for paying annually instead of monthly, or discounts for buying before a certain age. A couple discount can reduce premiums by 10 to 15 percent. An annual payment discount might save 5 to 10 percent.
How your age at purchase locks in your rate
Long-term care insurance premiums are based on your age when you buy, not your age when you use the benefit. A 65-year-old buying a policy pays the 65-year-old rate for life. If you wait until 70 to buy, you pay the 70-year-old rate for life, which is typically 30 to 50 percent higher. If you wait until 75, the rate is higher still.
This creates a tension: buying early locks in a lower rate, but you pay premiums for years or decades before you might need care. A 65-year-old buying a $2,500 annual premium might pay $50,000 or more in premiums over 20 years before ever filing a claim. If you die before needing care, that money is gone—long-term care insurance has no death benefit.
Some people buy in their late 50s or early 60s to lock in the lowest possible rate. Others wait until their mid-60s or early 70s, betting that they will not live long enough to need care or that they can self-insure. There is no universally right answer, but waiting past 70 is generally considered risky because rates climb steeply and your health is more likely to make you uninsurable.
What happens if you stop paying premiums
If you stop paying premiums, your policy lapses and you lose coverage. Some policies have a nonforfeiture benefit, which means if you stop paying after a certain point, you keep some reduced coverage rather than losing everything. This might mean your daily benefit drops from $150 to $75, or your coverage period shrinks from five years to two years. Nonforfeiture benefits cost more upfront but protect you if you cannot afford premiums later.
Some policies offer a return of premium rider, which means if you die without using the benefit, your beneficiary gets back some or all of the premiums you paid. This rider can cost 10 to 20 percent more but appeals to people worried about "wasting" money on insurance they never use. It is mathematically a poor deal—you are paying extra for a benefit that only pays if you die—but it provides peace of mind for some buyers.
Frequently Asked Questions
Can I buy long-term care insurance at 65 if I have diabetes?
Yes, but your premium will be higher than someone without diabetes. Most insurers will offer coverage to people with well-controlled Type 2 diabetes, though you might pay 25 to 75 percent more than the standard rate. Type 1 diabetes or poorly controlled diabetes may make you ineligible. You will need to provide recent blood sugar readings and your doctor's assessment of your condition.
What if I buy a policy and never need it?
You will have paid premiums for years with no benefit received. This is the main reason some people choose not to buy long-term care insurance—they prefer to self-insure or rely on family care. If you buy a policy with a return of premium rider, your beneficiary will receive some money back, but you will have paid extra for that feature all along.
Do premiums ever go down?
No. Long-term care insurance premiums can stay the same or go up, but they do not go down. Some insurers have raised rates on existing policyholders when claims experience was worse than expected. This is legal and happens periodically. Your rate is locked at your age of purchase, but the company can raise rates for your entire age cohort.
Is long-term care insurance worth it at 65?
That depends on your health, family history, assets, and risk tolerance. If you have significant savings, you might self-insure. If you have little savings and a family history of dementia or long life, insurance might protect you. A financial advisor or elder law attorney can help you think through the trade-offs for your specific situation.
Can I buy long-term care insurance if I have already been diagnosed with dementia?
No. Once you have a diagnosis of dementia or mild cognitive impairment, you are uninsurable for long-term care coverage. This is why some people buy policies in their late 50s or early 60s, before any cognitive decline appears. If you suspect cognitive problems, getting tested and buying insurance before a diagnosis is made can be important.