Paying Long-Term Care Premiums from Your IRA

November 27, 2025

How to Use Your IRA to Pay for LTC Insurance

You can use your IRA to pay for long-term care insurance, and many people do this to reduce long-term costs and improve tax efficiency. This strategy converts retirement dollars into tax-free LTC benefits while managing how and when taxes are paid.

  • Learn whether you can use IRA or 401(k) dollars for long-term care coverage
  • See how this strategy helps IRA owners protect assets and family
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Ways to Use Your IRA for Long-Term Care

Using Qualified Retirement Funds for LTC Protection

There are several ways to use IRA or 401(k) dollars to fund long-term care insurance. Below are four proven strategies—each suited to different goals, IRA types, tax considerations, and health profiles. A short review can help determine which option fits your situation best.

Strategy 1 — IRA-Funded Multi-Benefit Policy

This option uses a single policy, from an A+ rated insurance company that blends an annuity, life insurance, and a long-term care rider. It allows IRA or 401(k) dollars to be distributed gradually to fund LTC benefits. The policy also provides a 25% value enhancement when qualified funds are transferred.

Key benefits:

  • Spreads taxes over 10 years (avoids one large lump-sum taxable event)
  • Uses annual IRA withdrawals or RMDs to fund premiums
  • Level, predictable premiums for long-term stability
  • Combines LTC benefits, life insurance, and annuity value in one policy

Best for: Those wanting a simple, all-in-one policy with premium stability and a 25% boost on transferred funds.

Strategy 2 — Qualified Annuity + Hybrid LTC Coverage

With this approach, IRA dollars are used to purchase a tax-qualified annuity. Annual annuity distributions are then directed toward a hybrid long-term care insurance policy (life insurance with LTC benefits). This provides flexibility to choose from many top-rated carriers, while using taxable IRA distributions to secure guaranteed LTC benefits, cash value growth, or death benefits depending on the chosen plan.

Key benefits:

  • Carrier flexibility for both the annuity and the hybrid LTC policy
  • Gradual, tax-efficient use of IRA dollars
  • Predictable LTC benefits and premium stability
  • Ability to mix carriers for better pricing or underwriting fit

Best for: Those wanting flexibility and guarantees while spreading taxes over time.

Strategy 3 — IRA-Funded Traditional LTC Insurance

This strategy uses IRA distributions to pay premiums for a traditional long-term care insurance policy. It allows you to keep most or all of your IRA invested while redirecting only the necessary distributions toward LTC premiums. Many retirees use this to meet RMD obligations while locking in high-efficiency LTC protection at a lower cost than hybrid products.

Key benefits:

  • Often the lowest-cost way to secure strong LTC protection
  • Wide choice of top-rated LTC carriers
  • Pure LTC coverage without tying up IRA principal
  • Flexible benefit design (reimbursement or cash)

Best for: Those wanting maximum long-term care coverage for the lowest premium.

Strategy 4 — Annual IRA Distributions for LTC Premiums

For clients who prefer to leave their IRA investment strategy intact, this approach simply applies annual IRA distributions toward long-term care insurance premiums. It’s straightforward, and provides flexibility to adjust how you fund premiums as tax brackets or retirement income needs change.

Key benefits:

  • Works with traditional, hybrid, or linked-benefit LTC policies
  • Uses taxable IRA withdrawals to fund high-leverage LTC protection
  • Provides flexibility in how you fund premiums each year
  • May satisfy RMD requirements

Best for: Those wanting maximum flexibility while keeping their IRA as-is.

 

The right IRA funded LTC strategy depends on your goals and tax situation. We can help you compare the options.

Important: IRA funding methods differ in how they affect taxes and benefits. A brief review will help you identify the most suitable approach.

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IRA FAQs for Long-Term Care Insurance

How will using my IRA to pay long-term care premiums affect my taxes?

IRA distributions used to pay LTC premiums count as taxable income and may increase your tax bracket. Some people qualify for medical expense deductions if they itemize and exceed 7.5% of AGI.

Spreading distributions over multiple years, such as a 10-pay strategy, can help manage tax impact while converting taxable dollars into tax-favored LTC benefits.
Learn more: Tax Deductions for LTC Insurance

Will using my IRA for LTC premiums help satisfy Required Minimum Distributions (RMDs)?

Yes. IRA withdrawals used to pay LTC insurance premiums count toward your annual RMD.

This can be an efficient way to use required distributions, especially if you don’t need the RMD income and want to leverage it for long-term care protection.

Can married couples use this IRA strategy for shared long-term care coverage?

Yes. Each spouse can use their individual IRA to fund LTC coverage. Some companies offer shared benefit or shared pool options that allow spouses to access each other’s unused benefits.

This can reduce premium costs compared to buying two separate unlimited policies.

Can I use 401(k) funds instead of IRA funds for this LTC premium strategy?

Yes, typically by rolling your 401(k) into a traditional IRA first. Direct rollovers are tax-free when done correctly.

Once in the IRA, you can use distributions to fund long-term care insurance premiums.

Note: If your 401(k) is with a current employer, in-service withdrawals may be restricted.

Will I pay penalties if I'm under 59½?

Usually, IRA withdrawals before age 59½ incur a 10% early-withdrawal penalty plus income tax.

However, some exceptions may eliminate the penalty, such as disability or substantially equal periodic payments (SEPP).

Consult your tax professional to confirm your situation.

What is hybrid long-term care insurance?

Hybrid long-term care insurance combines life insurance or an annuity with LTC benefits.

If you need care, the policy pays tax-free long-term care benefits. If not, your beneficiaries receive a tax-free death benefit.

This structure helps avoid the “use it or lose it” concern of traditional LTC policies.

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Last updated: November 27, 2025

Written byCraig Matesky, President, ACACIA Insurance
Reviewed byMike Berger, National Sales Manager

Sources: IRS Publications 590-B and 502, IRC Section 7702B, IRS Notice 97-31, IRS.Gov,  Accessed 05/28/2025
Disclaimer: This information is not tax or accounting advice. ACACIA Insurance Services, Inc. does not provide tax or accounting guidance. Please consult your own qualified tax or accounting professional.