Long term care insurance exists for one simple reason. It helps pay for care when daily tasks like bathing, dressing, or eating are no longer easy to manage alone. This kind of coverage can help with nursing homes, assisted living facilities, adult day care, and in-home health services.
When people ask what the best and worst long term care insurance companies are, they usually want a clear answer. They want to know which providers have treated policyholders fairly over time and which ones have caused problems through rising premiums, policy changes, or slow claims handling.
I am going to walk through that answer directly. Early on, I will explain what separates well rated providers from poorly rated ones. Then I will break down ten real, established companies. Some have stronger reputations today. Others have struggled in ways buyers should understand before committing to a policy that may last decades.
10 Poorly Rated And Highly Rated Long Term Care Insurance Companies Explained
Long term care coverage is not like auto or homeowners insurance. Claims often start many years after the policy is purchased. Because of that delay, mistakes made by insurers decades ago still affect policyholders today.
Poorly rated companies usually share a few patterns. These often include repeated premium increases, exiting the market after selling large numbers of policies, and complicated benefit structures that confuse customers during claims. On the other hand, better regarded providers tend to show steadier pricing history, clearer policy language, and more predictable claims processes.
Before reviewing individual companies, the table below gives a snapshot comparison of ten well known long term care insurers, including both stronger and weaker performers based on customer feedback, financial stability history, and regulatory records.
| Company Name | Market Status | Key Strength Or Issue | Common Policyholder Experience |
| Genworth Financial | Legacy policies only | Large premium increases | Long claim waits reported |
| John Hancock | Active seller | Strong underwriting | Higher entry costs |
| Mutual of Omaha | Active seller | Simple policy options | Limited customization |
| MetLife | Closed to new sales | Stable legacy plans | No new enrollment |
| Transamerica | Closed to new sales | Predictable benefits | Older policy designs |
| New York Life | Active seller | Strong financial backing | Strict underwriting |
| Northwestern Mutual | Active seller | Solid claims support | Agent dependent experience |
| MassMutual | Active seller | Conservative pricing | Slower approvals |
| Lincoln Financial | Closed to new sales | Structured benefits | Less flexibility |
| CNA Insurance | Legacy only | Past pricing errors | Policy revisions |
Now let us go company by company. Each section explains how these insurers earned their reputation and what buyers should realistically expect.
Genworth Financial
Genworth is one of the most widely recognized names in long term care insurance, but it is also one of the most criticized. At one time, the company dominated the market and sold millions of policies across the United States.
The problem began with pricing assumptions made decades ago. Genworth underestimated how long people would live and how many policyholders would eventually need care. As claims increased, the company sought approval from state insurance departments for repeated premium hikes.
Many policyholders saw their monthly costs double or even triple over time. Some were forced to reduce benefits or drop coverage entirely because payments became unaffordable.
Common concerns raised by customers include:
- Frequent premium increases approved at the state level
- Complicated benefit reduction options
- Lengthy claims review timelines
Genworth no longer sells new long term care policies. Existing customers remain covered, but the company is often cited as an example of how aggressive early pricing can harm policyholders later.
John Hancock
John Hancock is often viewed more favorably, especially among current sellers of long term care coverage. The company adjusted its approach after watching competitors struggle. Instead of offering overly generous benefits at low initial prices, it focused on stricter underwriting and more conservative assumptions.
As a result, John Hancock policies often cost more upfront. Buyers with health issues may also find it harder to qualify. However, those who are approved tend to face fewer surprises later.
Positive aspects commonly mentioned include:
- Clear benefit triggers for claims
- Strong integration with care coordination services
- Fewer reported premium shocks compared to legacy insurers
The tradeoff is affordability. Many middle income buyers find the cost challenging, but those who can maintain coverage often appreciate the predictability.
Mutual of Omaha
Mutual of Omaha is known for simplicity. Its long term care offerings focus on straightforward benefit structures without excessive riders or complex formulas. This appeals to buyers who want to understand their coverage without relying heavily on advisors.
The company has also benefited from observing earlier market exits. It avoided selling extremely long benefit periods that proved costly for others.
Policyholder feedback often highlights:
- Easy to understand policy language
- Responsive customer service during claims
- Fewer customization options than competitors
Mutual of Omaha may not suit buyers looking for advanced inflation structures or hybrid designs, but it remains a steady choice for those prioritizing clarity.
MetLife
MetLife once played a major role in the long term care market but stopped selling new policies years ago. Existing policyholders continue to receive coverage, and many report relatively stable experiences compared to other closed blocks.
MetLife’s advantage lies in its conservative benefit definitions. Claims triggers were not overly broad, which helped limit unexpected losses.
That said, since the company is closed to new enrollment:
- No updates or modern features are available
- Customer support teams focus on maintenance, not expansion
- Policyholders must manage within older policy frameworks
For existing customers, MetLife policies are often viewed as dependable, even if dated.
Transamerica
Transamerica also exited the long term care insurance market after recognizing long term profitability challenges. Its policies were structured conservatively, which helped avoid some of the extreme premium volatility seen elsewhere.
Policyholders often report:
- Predictable benefit payouts
- Clear elimination periods
- Limited flexibility once policies are active
Because Transamerica does not offer new policies, it mainly serves as a reference point for how conservative planning can reduce long term disruption.
New York Life
New York Life stands out due to its mutual company structure. It is owned by policyholders rather than shareholders, which influences long term decision making. The company approaches long term care coverage with a focus on sustainability rather than aggressive expansion.
Many of its offerings are hybrid life insurance policies with long term care riders. These allow unused benefits to pass to beneficiaries if care is never needed.
Strengths often cited include:
- Exceptional financial strength ratings
- Stable pricing history
- Clear contractual guarantees
However, underwriting is strict, and policies are not cheap. Buyers must be prepared for higher premiums in exchange for long term reliability.
Northwestern Mutual
Northwestern Mutual follows a similar philosophy to New York Life. It emphasizes financial security and long term obligations. Its long term care policies are typically sold through advisors, which means experience can vary depending on agent quality.
Customers often report:
- Strong claims advocacy once care begins
- Personalized policy structuring
- Slower approval processes during underwriting
This provider appeals to those who value guidance and long term planning support rather than quick enrollment.
MassMutual
MassMutual has remained cautious in the long term care space. Its pricing models are conservative, and it tends to limit exposure to high risk benefit designs.
From a policyholder perspective:
- Premium increases have been less severe than industry averages
- Claims approvals may take longer due to detailed review
- Coverage language is precise and structured
MassMutual is often chosen by buyers who prefer stability over flexibility.
Lincoln Financial
Lincoln Financial previously sold long term care policies but has since closed new sales. Its existing policies are structured around defined benefit pools rather than open ended coverage.
Policyholders generally note:
- Predictable maximum payouts
- Limited ability to adjust benefits later
- Straightforward claim documentation requirements
While not ideal for new buyers, Lincoln Financial policies demonstrate the value of capped exposure models.
CNA Insurance
CNA Insurance represents one of the more cautionary stories in the market. Like Genworth, it misjudged early pricing and claims behavior. The company faced pressure to revise policy terms and seek premium approvals.
Common complaints include:
- Confusing policy updates
- Communication gaps during premium changes
- Frustration over revised benefit structures
CNA no longer sells new long term care insurance, and its legacy policies require careful management by existing customers.
Learn how consumer complaints and service issues stack up on FinTech Revo .Com.
Conclusion
Long term care insurance decisions cannot be rushed. The best and worst companies are often separated by decisions made decades ago, not recent marketing promises. Providers that priced cautiously, limited benefit exposure, and focused on financial strength have generally treated policyholders more consistently over time.
On the other hand, insurers that chased market share with low initial premiums created long term stress for customers through rising costs and policy changes. Understanding that history helps explain why some names inspire confidence while others raise concern.
When evaluating long term care coverage, the goal is not perfection. It is predictability. A company that costs more upfront but remains stable may offer more peace of mind than one that appears affordable at first but changes dramatically later.
By looking closely at real company behavior rather than slogans, buyers can make decisions grounded in experience, not assumptions.
Frequently Asked Questions
Can long term care insurance be canceled by the company after I buy it
Once a long term care policy is issued, the insurer cannot cancel it as long as you continue paying premiums. These policies are guaranteed renewable, which means the company must keep your coverage active. However, they are allowed to raise premiums for an entire group of policyholders if approved by state insurance regulators. This is why understanding a company’s pricing history matters before buying.
What happens if I can no longer afford my premiums later in life
Most long term care policies include nonforfeiture options. These may allow you to reduce benefits, shorten the benefit period, or convert the policy into paid up coverage with a smaller pool of funds. The exact options depend on the policy terms, which is why reviewing downgrade choices in advance can help avoid losing coverage entirely.
Is it better to buy coverage at a younger age or wait until retirement
Buying earlier usually means lower premiums and better approval chances since health underwriting is less restrictive. Waiting until retirement can increase costs and raise the risk of denial due to medical conditions. That said, purchasing too early also means paying premiums for a longer period, so timing should align with financial stability rather than age alone.
How do claims actually get approved when care is needed
Claims typically require certification from a licensed healthcare professional stating that assistance is needed with specific daily activities or that cognitive impairment is present. Once approved, most policies reimburse expenses or pay a daily benefit based on care received. Delays often occur when documentation is incomplete, not because the claim is denied outright.
Does long term care insurance replace Medicare or Medicaid
This type of coverage does not replace Medicare or Medicaid. Medicare only covers short term skilled care under limited conditions, while Medicaid requires spending down assets to qualify. Long term care insurance helps fill the gap by covering extended care while allowing policyholders to preserve savings and maintain more control over care choices.
