October 14, 2025

As interest in LTC insurance declines, families exposed to care costs

Image showing two overturned cups labeled "Covered Costs" and one labeled "Oops!". Decline-in-LTC-insurance-intent-leaves-families-exposed-to-care-costs.

The intent to purchase long-term-care insurance (LTCI) appears to be declining among some Americans. According to Nationwide’s 2025 Long Term Care Survey, 40% of Americans age 29+ said they do not plan to buy coverage, which is up from 32% during the previous year.

This reluctance by many Americans to buy LTCI is happening at a time when Americans are living longer than ever, the survey pointed out. The U.S. Census Bureau projects the number of centenarians to quadruple by 2054, and the likelihood of needing LTC, and needing it for many years, is rising sharply. In addition, many Americans are not ready. While 41% of Americans doubt they will live long enough to use LTCI, almost 70% of Americans turning 65 today will need LTC.

And this reluctance is also occurring at a time when LTCI awareness and usage remain low among Americans. According to a separate report released by Nationwide and The American College of Financial Services, while 32% believe LTCI would be one of the most helpful resources for preparing to live to 100, only 1 in 10 actually report owning a policy.

“Too many Americans are entering the most vulnerable stage of life with a false sense of security,” said Holly Snyder, president of Nationwide’s life insurance business. “We underestimate how long we’ll live, how likely we are to need long-term care, how much that care will cost, and how we’ll pay for it, leaving a growing number of Americans – and their families – unprepared for the financial and emotional toll that often comes with aging.”

Reasons for decrease in LTCI interest

There are many reasons for this increase in the growing number of Americans age 29+ who do not plan to buy LTCI. As explained by Snyder, this likely stems from widespread consumer misunderstanding about what long-term care (LTC) is and how it’s covered. “This misconception consistently appears in our annual research and is echoed across the broader industry,” she added.

For example, Snyder said, 58% of respondents said they plan to rely on Medicare—which doesn’t cover LTC—and 59% expect to rely on Medicaid, which is only available to individuals with limited assets (typically less than $2,000).

In spite of these perceptions, Snyder pointed out that “we’re seeing growth in LTC sales across the industry, including traditional policies, riders, and linked-benefit products. Nationwide’s own LTC sales have also risen significantly in recent years.”

Life combination products to the rescue?

As pointed out by many studies, the cost and availability of standalone LTCI care sometimes deter people in all demographics from buying the product. According to LIMRA, more than 1 in 4 (27%) consumers said that a standalone LTCI policy is too expensive.

But LIMRA data suggests that life combination products that provide LTC could be a more attractive option for many consumers. Over one quarter (26%) of American consumers would be extremely or very likely to consider purchasing life combination products — a 7-percentage point increase from 2019, according to LIMRA data.

In addition, LIMRA data shows that 36% of consumers would consider a life combination product because they’re concerned that LTC expenses may deplete or exceed their savings. Thirty-five percent of consumers also believe that a life combination product would be a more economical use of their assets, and 33% said that their benefits will still be paid even if they don’t incur long-term expenses.

LIMRA data also suggests that interest in life combination products is high among Millennials. For example, the 2024 Insurance Barometer Study from LIMRA and Life Happens shows that almost 4 in 10 Millennials are very likely to consider buying a life combination product, compared to 27% of Gen X and 17% of Baby Boomers.

Implications of fewer LTCI purchases

So, what are some of the implications of younger Americans’ reluctance to buy LTCI? “This trend reveals a critical gap in retirement planning,” Snyder said. “Without a long-term care strategy, individuals face the risk of substantial physical, emotional, and financial strain if an LTC event occurs. It underscores the need for our industry to better educate consumers and promote proactive planning.”

Helping to reverse the trend

And what can agents and advisors do to help reverse this trend? Agents and advisors play a key role in initiating LTC planning conversations and helping clients understand their options, Snyder said. “We want to continue to help agents and advisors start LTC planning conversations to better educate and prepare their clients. Our research shows that consumers are open to discussing LTC and look to their financial professionals for guidance. Long-Term Care Awareness Month in November presents a timely opportunity to engage clients, and Nationwide offers tools and resources to support these important discussions.”

To learn more about the 2025 Nationwide Retirement Institute Long-term Care survey, visit nationwide.com/SimplifyLTC. The Nationwide research was conducted online in the United States by The Harris Poll on behalf of Nationwide among 1,324 Americans ages 29+ with household income of $75K+. The survey was conducted March 17 – Apr. 7, 2025.