California Long-Term Care Insurance
Is it right for you? Understanding the Pros and Cons
For over 30 years, ACACIA Insurance has specialized in long-term care planning. We are independent advisors, representing numerous highly rated insurance companies and plan types.
We work with your best interests in mind, assessing policy features and benefits to provide you with the top choices for your consideration.
TABLE OF CONTENTS
- California LTC – What You Need To Know
- Three Types of LTC Policies in California
- California Partnership for Long-Term Care
- Long-Term Care Insurance Companies in California
- California Long-Term Care Insurance Rates
- Compare California Long-Term Care Insurance Quotes
- FAQs about California Long-Term Care Insurance
Multiple Highly Rated Companies
Who Needs Long-Term Care
Who Needs Care
Almost 70% of people turning age 65 today will need some type of long-term care in the future. The average length of time people need care is 3 years.1
How Long It Lasts
One-third of people may never need long-term care, but 20% will need it for longer than 5 years. On average women need 3.7 years of care while men need 2.2 years.2
What It Costs
In 2025, the average cost for 3 years of long-term care in California is $408,306 ($136,102/year). That cost is projected to be $894,648 ($298,216/year) in 2045.3
Cost of Long-Term Care in California
California LTC Rates – 2025 (annual) | |||
| Nursing Home (private room) | Assisted Living (private room) | Home Care (44 hours/week) | |
| State Average | $136,102 | $80,292 | $83,696 |
| Region | Nursing Home | Assisted Living | Home Care |
| Bakersfield-Delano | $108,487 | $53,590 | $75,761 |
| Chico | $137,926 | $62,961 | $80,089 |
| El Centro | $136,603 | $60,887 | $70,754 |
| Fresno | $126,760 | $69,595 | $76,642 |
| Hanford-Corcoran | $145,626 | $59,775 | $75,031 |
| Los Angeles-Long Beach | $129,323 | $78,899 | $77,987 |
| Merced | $119,413 | $51,572 | $77,373 |
| Modesto | $149,030 | $51,541 | $59,792 |
| Napa | $171,483 | $98,175 | $71,426 |
| Oxnard-Thousand Oaks-Ventura | $135,327 | $75,461 | $91,921 |
| Redding | $147,483 | $63,500 | $80,345 |
| Riverside-San Bernardino-Ontario | $118,476 | $60,291 | $81,151 |
| Sacramento-Roseville | $134,023 | $80,856 | $76,860 |
| Salinas | $137,682 | $92,666 | $80,737 |
| San Diego-Carlsbad | $143,514 | $79,283 | $79,476 |
| San Francisco-Oakland | $148,372 | $96,299 | $96,815 |
| San Jose-Sunnyvale-Santa Clara | $162,579 | $94,347 | $86,334 |
| San Luis Obispo-Paso Robles | $128,620 | $80,177 | $69,860 |
| Santa Cruz-Watsonville | $126,812 | $95,561 | $90,554 |
| Santa Maria-Santa Barbara | $171,030 | $82,231 | $74,318 |
| Santa Rosa-San Rafael | $140,107 | $86,517 | $85,323 |
| Stockton-Lodi | $127,035 | $53,002 | $73,120 |
| Vallejo-Fairfield | $124,590 | $74,298 | $63,419 |
| Visalia-Porterville | $99,764 | $55,928 | $69,771 |
| Yuba City | $123,935 | $55,989 | $80,162 |
Nationwide Financial annual cost of care survey conducted by HVS, site accessed 2/12/2025
Does Medicare Cover Long-Term Care?
Medicare 
can cover up to 100 days in a skilled nursing facility. But, you must first be in the hospital for at least three days, and you might have to pay part of the cost after the first 20 days. It can also pay for some home health care, like a visiting nurse, if a doctor says you need it. So, Medicare helps with short-term skilled care, not long-term daily help.
Most long-term care services required are custodial care. It makes up more than 90% of all long-term care services. Examples of custodial care are when you need help with activities of daily living (walking, bathing, dressing, eating or using the toilet). This is what people need most when they have a physical impairment from a stroke. Or, due to cognitive impairment from dementia or Alzheimer’s disease. Don’t make the mistake of thinking Medicare covers most long-term care costs. It doesn’t.
Further, about 80% of care at home is from unpaid caregivers 
. And more than half of this care includes intensive help with personal care like bathing or dressing.4 And it’s not only seniors that need long-term care. Over 35 percent of people currently receiving care are between the ages of 18 and 64.5
When To Buy Long-Term Care Insurance
When’s the best age to get long-term care insurance? It depends on your situation, but here are some key factors to consider:
- Experts suggest buying in your fifties or early sixties. Because, long-term care insurance premiums cost less then and you’re usually healthier at that age. You’ll pay for more years, but the total cost might still be lower than waiting.
- Buying earlier, like in your forties, can work too. Premiums are likely to be even lower and you’d lock in coverage and your good health. But you’d pay for a longer period before needing it.
- Waiting until your late sixties might make sense. This can work if you’re healthy and have cash saved up. But premiums are much higher. Plus, there may be health problems by then and you could miss out on discounts or the ability to get coverage. And if you get sick before buying, you’d be on the hook for all long-term care costs.
Three Types of LTC Policies in California
Traditional Long-Term Care Insurance
- Design: Specifically designed to cover long-term care expenses, such as in-home care, assisted living, or nursing home care. Provides the most comprehensive long-term care benefits for your dollar.
- Benefits: The broadest set of options & benefits. Provides a daily or monthly benefit for a set period or the policyholder’s lifetime, depending on the policy terms.
- Premiums: Recurring premiums paid monthly, quarterly, or annually. Possibility of premium increases over time.
- Underwriting: Requires medical underwriting, where health status impacts eligibility and premium costs.
- Tax Advantages: Premiums may be tax-deductible, and benefits are generally tax-free.
- About Traditional Long-Term Care Insurance >
Life Insurance with Long-Term Care Rider
- Design: Combines permanent life insurance with a rider allowing access to benefits you can use for long-term healthcare. If care is not needed, your asset passes to your estate as a tax-free death benefit.
- Benefits: May build cash value and have a Return of Premium option
- Premiums: Premiums will NOT increase. Cost is higher than standard life insurance due to the added rider, but often more cost-effective than separate policies.
- Underwriting: Medical underwriting is usually less strict than traditional long-term care insurance.
- Tax Advantages: 1035 exchanges are possible and can be funded with qualified dollars (IRA, 401k, etc.)
- About Life Insurance with Long-Term Care >
Annuity with Long-Term Care Rider
- Design: A deferred annuity contract with a rider to cover long-term care expenses. Includes a fixed interest rate and possible indexing for asset growth
- Benefits: Long-term care benefits are usually double or triple the value of the annuity. If not exhausted paying for long-term healthcare, the annuity will transfer to your estate at time of death.
- Premiums: No premium increases. Can be purchased using a single premiums payment.
- Underwriting: Health underwriting is simpler than the other plans available.
- Tax Advantages: Tax-Free 1035 exchanges are possible from an existing annuity to a long-term care annuity.
- Long-Term Care Annuity Details >
California Partnership for Long-Term Care
California Partnership for Long-Term Care policies combine private long-term care insurance with asset protection under Medicaid (Medi-Cal) 
. This special feature helps protect your assets if you need long-term care.
The asset protection starts if your care needs go beyond what your Partnership policy covers. Here’s how it works: for every dollar your policy pays for care, one dollar of your assets are safe from Medicaid’s asset limit. These protected assets are also safe from Estate Recovery, matching what the policy paid.
Premiums for California Partnership for Long-Term Care 
policies are like regular long-term care insurance. Be sure to compare them to traditional policies. You might find non-Partnership policies offer better options for you. For example, hybrid long-term care plans aren’t available under the Partnership program. All plans are regulated by the California Department of Insurance 
.
NOTE: At the time of this writing, there are no insurance providers offering Long-Term Care Partnership products in California. Consequently, it is not possible to purchase a California Partnership for Long-Term Care policy 
at this moment. However, this situation does not impact those who are currently insured and hold Partnership qualified policies.
Traditional and Hybrid Long-Term Care Insurance plans are available.
California Partnership Reciprocity
California does NOT take part in the national reciprocity agreement. The majority of states have Partnership Reciprocity but California is one of the exceptions.
In states with Reciprocity, you can:
- Buy a qualifying Partnership for Long-Term Care policy in one state
- Maintain the special asset protection when you move to another state with reciprocity
- Your new state recognizes accumulated asset protection for Medicaid qualification if you’re already receiving benefits before moving
Key Takeaway: The California Partnership for Long-Term Care provides a valuable benefit by combining private long-term care insurance with asset protection under Medicaid, allowing policyholders to shield their assets from the Medicaid asset limit for long-term care expenses. New policies are currently unavailable for purchase in California, but existing policyholders retain their coverage.
Long-Term Care Insurance Companies in California
Which are the best long-term care insurance companies in California? It depends on your personal situation because it relates to age, health, type of coverage, and other factors. Choosing a high ranking company is important, but the plan must have the right set of benefits for your needs.
One of our licensed professionals can help you navigate which long-term care insurance company is best for your situation by:
- Comparing the pros and cons of these insurers for policy benefits, financial stability, and premium cost
- Exploring alternatives like hybrid policies or self-funding if LTC insurance isn’t the right fit
- Identifying the appropriate insurance carriers based on your medical history
-
-
- Bankers Life & Casualty
- Global Atlantic
- Lincoln Financial – MoneyGuard
- Mutual of Omaha
- National Guardian Life
(NGL) - Nationwide Life Insurance Company
-
- New York Life
- Northwestern Mutual
- OneAmerica
- Securian Financial
- Thrivent Financial
California Long-Term Care Insurance Rates
California long-term care insurance rates depend on several factors. These include your age, health history, plan design, and the type of plan you choose. The following features allow you to customize your coverage for your situation:
- Benefit Period: Determine the duration of benefits that fits with your needs and budget.
- Daily Benefit: Select a daily benefit amount based on your preferences and the cost of care in your area.
- Elimination Period: A deductible but measured in days, the elimination period lets you choose how soon your coverage begins.
- Inflation Protection: This option safeguards your coverage against the impact of inflation over time.
Here is how much long-term care insurance costs in California. These are average monthly costs by purchase age for $144,000 in level benefits, without annual inflation growth. Rates are for preferred health which has the lowest cost.
Average Cost of Long-Term Care Insurance in California | |||
| Age 55 | Age 60 | Age 65 | |
| Male | $77 | $93 | $139 |
| Female | $111 | $139 | $210 |
| Couple | $151 | $185 | $279 |
For the same applicants purchasing a policy with 3% annual inflation growth protection, the average monthly costs are:
| Age 55 | Age 60 | Age 65 | |
| Male | $139 | $158 | $205 |
| Female | $232 | $266 | $347 |
| Couple | $296 | $339 | $442 |
Long-Term Care Insurance California Quotes
Our professionals help you compare a wide range of California long-term care planning products and strategies. Expect personalized service on topics such as:
✔ Choosing from a variety of long-term care planning products
✔ Suggestions for the insurance company best suited to your situation
✔ Help with medical underwriting (qualifying) for insurance coverage
Ready to start a conversation?
Get started now >
California Long-Term Care Insurance FAQ’s
Yes, California is exploring a long-term care tax to fund a state program. A Long Term Care Insurance Task Force is reviewing options that include a payroll tax. This follows Washington State that implemented a long-term care tax in 2023 for those who don’t own private long-term care insurance
No law has been passed yet in California, but proposals suggest residents with private LTC insurance might be able to opt out of the payrol tax if they purchased insurance before a set date. Updates are expected in 2025. Learn more >
The three types of long-term care insurance in California are:
- Traditional Long-Term Care Insurance: Specifically designed to cover long-term care expenses, such as in-home care, assisted living, or nursing home care.
- Life Insurance with Long-Term Care Rider: Combines permanent life insurance with a rider allowing access to benefits you can use for long-term healthcare. If care is not needed, your asset passes to your estate as a tax-free death benefit.
- Annuity with Long-Term Care Rider: A deferred annuity contract with a rider to cover long-term care expenses. Includes a fixed interest rate and possible indexing for asset growth. If not exhausted paying for long-term healthcare, the annuity will transfer to your estate at time of death. See product details >
In California, like other states, your health status and age determines your eligibility for long-term care insurance. But even people with significant health conditions may still qualify.
Conditions like Alzheimer’s, Parkinson’s, or currently needing care could disqualify you. Long-term care annuities have simpler underwriting and may be a good option for those with certain health issues. Find out if you qualify >
California Partnership for Long-Term Care policies combine private long-term care insurance with asset protection under Medicaid (Medi-Cal). This special feature helps protect your assets if you need long-term care. Additional information can be found in the CA Partnership section above on this page.
What Our Clients Are Saying
Written by Craig Matesky, ACACIA Insurance President
Edited by Mike Berger, National Sales Manager
SOURCES:
, U.S. Department of Health and Human Services, site accessed 2/05/2025
conducted by HVS, site accessed 2/05/2025 
, site accessed 2/05/2025