North Carolina Long-Term Care Insurance
Compare North Carolina Plans, Costs & Coverage Options
For more than 30 years, ACACIA Insurance has helped North Carolina residents plan for their long-term care needs. As fully independent advisors, we compare long-term care insurance plans and highly rated companies to provide personalized, unbiased recommendations.
We review benefits, features, and pricing to help you choose the long-term care insurance coverage that fits your goals and your budget.
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TABLE OF CONTENTS
- Do I Need Long-Term Care Insurance in North Carolina?
- North Carolina Long-Term Care Costs
- Medicare and Long-Term Care in North Carolina
- When To Buy Long-Term Care Insurance in North Carolina
- Types of Long-Term Care Insurance in North Carolina
- North Carolina Long-Term Care Partnership
- Long-Term Care Insurance Companies in North Carolina
- Cost of Long-Term Care Insurance in North Carolina
- FAQs About Long-Term Care Insurance in North Carolina
Estimated reading time: 8 minutes
Do I Need Long-Term Care Insurance in North Carolina?
Many North Carolina residents are surprised by how likely long-term care becomes later in life and by how quickly costs can add up. Care needs often arise suddenly, and expenses vary widely across the state. This makes advance planning especially important. The facts below provide a clearer picture of long-term care risks and costs in North Carolina and can help you determine whether long-term care insurance is a good fit for your situation.
The Likelihood of Needing Care
North Carolina residents face the same long-term care risks as the rest of the country. Nearly 70% of people turning 65 today will need some form of long-term care in the future, with an average duration of about three years.1
How Long Care Lasts
For North Carolina families, this means planning ahead is essential. While one-third of people may never need long-term care, 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
Care Costs in North Carolina
In 2026, the average for 3 years of long-term care in North Carolina is $334,176, or about $111,392 per year. By 2046, that figure is projected to rise to $664,938, or $221,646 per year.3
North Carolina Long-Term Care Costs
Long-term care costs vary across North Carolina. A private nursing home room averages $106,154 a year in Durham-Chapel Hill and $130,170 in Hickory-Lenoir-Morganton. The table below shows 2026 averages for the six largest metro areas. All 15 regions are listed in the section that follows.
Long-Term Care Costs in North Carolina 2026 | |||
| Region | Nursing Home (private room) annual / monthly | Assisted Living (private room) annual / monthly | Home Health Aide (44 hrs/week) annual / monthly |
|---|---|---|---|
| North Carolina Average | $111,392 $9,283 a month | $77,788 $6,482 a month | $68,344 $5,695 a month |
| Charlotte-Concord-Gastonia | $108,600 $9,050 a month | $79,692 $6,641 a month | $76,021 $6,335 a month |
| Raleigh-Cary | $121,348 $10,112 a month | $100,087 $8,341 a month | $78,324 $6,527 a month |
| Greensboro-High Point | $121,286 $10,107 a month | $83,339 $6,945 a month | $63,053 $5,254 a month |
| Winston-Salem | $113,863 $9,489 a month | $83,040 $6,920 a month | $63,329 $5,277 a month |
| Durham-Chapel Hill | $106,154 $8,846 a month | $75,638 $6,303 a month | $72,039 $6,003 a month |
| Wilmington | $108,448 $9,037 a month | $87,749 $7,312 a month | $71,659 $5,972 a month |
| Source: Nationwide Financial 2026 Cost of Care Survey (HVS), accessed September 25, 2026. Monthly figures are the annual cost divided by twelve. | |||
| Region | Nursing Home (private room) annual / monthly | Assisted Living (private room) annual / monthly | Home Health Aide (44 hrs/week) annual / monthly |
|---|---|---|---|
| Asheville | $122,578 $10,215 a month | $81,443 $6,787 a month | $79,153 $6,596 a month |
| Burlington | $118,298 $9,858 a month | $75,701 $6,308 a month | $64,716 $5,393 a month |
| Charlotte-Concord-Gastonia | $108,600 $9,050 a month | $79,692 $6,641 a month | $76,021 $6,335 a month |
| Durham-Chapel Hill | $106,154 $8,846 a month | $75,638 $6,303 a month | $72,039 $6,003 a month |
| Fayetteville | $111,921 $9,327 a month | $57,779 $4,815 a month | $62,254 $5,188 a month |
| Goldsboro | $128,730 $10,728 a month | $54,196 $4,516 a month | $50,075 $4,173 a month |
| Greensboro-High Point | $121,286 $10,107 a month | $83,339 $6,945 a month | $63,053 $5,254 a month |
| Greenville | $108,839 $9,070 a month | $66,680 $5,557 a month | $60,883 $5,074 a month |
| Hickory-Lenoir-Morganton | $130,170 $10,848 a month | $64,507 $5,376 a month | $68,656 $5,721 a month |
| Jacksonville | $107,704 $8,975 a month | $60,008 $5,001 a month | $66,057 $5,505 a month |
| Northeastern Counties | $122,617 $10,218 a month | $74,649 $6,221 a month | $71,143 $5,929 a month |
| Raleigh-Cary | $121,348 $10,112 a month | $100,087 $8,341 a month | $78,324 $6,527 a month |
| Rocky Mount | $120,830 $10,069 a month | $69,335 $5,778 a month | $59,625 $4,969 a month |
| Wilmington | $108,448 $9,037 a month | $87,749 $7,312 a month | $71,659 $5,972 a month |
| Winston-Salem | $113,863 $9,489 a month | $83,040 $6,920 a month | $63,329 $5,277 a month |
Medicare and Long-Term Care in North Carolina
Medicare 
is not long-term care coverage. It pays for skilled nursing only after a qualifying 3-day hospital stay. Coverage continues just while that care remains medically necessary. Custodial help with bathing, dressing, eating and moving around is not covered when it is the only help you need. The benefit is also shorter than most people expect. Days 1 through 20 cost nothing. Days 21 through 100 carry a $217 daily coinsurance in 2026. From day 101, the entire bill is yours.
When Medicare stops, NC Medicaid pays only after your savings are nearly spent. A single applicant may hold no more than $2,000 in countable assets. A husband or wife remaining at home may keep up to $162,660. Transfers made in the five years before applying can delay eligibility. Once approved, most of your monthly income goes toward the bill. You keep a $70 personal needs allowance.
Approval does not guarantee care at home. In-home services run through the Community Alternatives Program for Disabled Adults, known as CAP/DA. The program has a fixed number of slots, and applicants may be placed on a statewide waitlist. A private policy pays for home care without waiting for a state slot.
Learn more about Medicare and custodial care ➜
When To Buy Long-Term Care Insurance in North Carolina
What is the right age to buy long-term care insurance? No single age fits everyone. Health, budget and goals all shape the answer. These patterns hold for most North Carolina buyers:
- Mid 50s to early 60s. The most common window. Rates are still moderate, and health discounts remain within reach.
- Your 40s. Lower premiums and an easier approval, in exchange for more years of payments.
- Late 60s and beyond. Still workable for many. Pricing climbs, declines happen more often and discounts usually disappear.
Nursing home costs in North Carolina rise about 3.5% a year. Assisted living goes up faster, near 5%. Home care moves slower, closer to 2%. The gap between them keeps widening until you file a claim. That makes the setting you expect to use a guide to how much inflation protection is worth buying.
Already past 65? Do not assume it is too late. Carriers underwrite to different standards, and products vary just as widely. Plenty of applicants at that age still qualify. A licensed specialist can review your situation and put real numbers next to it.
Find Out If You QualifyTypes of Long-Term Care Insurance in North Carolina
North Carolina residents can choose from several long-term care insurance options, each designed to help cover care at home, in assisted living, or in a nursing facility. Understanding how traditional long-term care insurance, hybrid life/LTC policies, LTC annuities, and short-term care plans differ can help you decide which type fits your budget, health, and long-term planning goals.
Traditional Long-Term Care Insurance
What It Is: A standalone policy specifically designed to cover comprehensive long-term care expenses, including in-home care, assisted living facilities, and nursing homes. These policies are fully portable and provide coverage wherever you receive care.
Coverage Benefits: Provides the most extensive long-term care coverage per dollar spent with flexible daily or monthly benefit amounts for your selected benefit period. Ideal for North Carolina residents planning comprehensive care coverage.
Premium Structure: Recurring payments (monthly, quarterly, or annually). Premiums may experience rate adjustments over time based on insurance company claims experience.
Health Requirements: Requires full medical underwriting with stricter health qualifications than hybrid options. Your current health can significantly impact eligibility and premium costs for North Carolina applicants.
Tax Advantages for North Carolina Residents: Premiums for tax-qualified long-term care insurance policies may qualify as medical expenses for federal tax deductions (subject to income thresholds). North Carolina follows federal tax treatment, and benefits received are generally tax-free.
Life Insurance with Long-Term Care Rider (Hybrid Life + LTC)
What It Is: A permanent life insurance policy with an added LTC benefit rider that allows policyholders to access the death benefit early for qualified long-term care expenses, regardless of where care is received.
Coverage Benefits: Typically provides 2 to 4% of the death benefit monthly for long-term care with guaranteed cash value growth. Unused benefits pass to beneficiaries tax-free.
Premium Structure: Guaranteed level premiums that NEVER increase. Higher initial cost than traditional LTC insurance but protected from future rate increases. Can provide important stability for North Carolina residents on fixed incomes.
Health Requirements: Moderate medical underwriting with more flexible health guidelines than traditional LTC insurance, making qualification easier for many North Carolina applicants with health issues.
Tax Advantages for North Carolina Residents: Can utilize 1035 exchanges from appropriate existing policies without tax consequences and can be funded with qualified retirement accounts (IRAs, 401(k)s).
Annuity with Long-Term Care Rider (LTC Annuity)
What It Is: A fixed rate or indexed deferred annuity contract with an integrated long-term care benefit rider, ideal for those seeking asset protection with a simplified approval process. Coverage is portable and can be used anywhere care is needed.
Coverage Benefits: Typically multiplies your annuity value by 2 to 3 times for long-term care expenses. For example, a $100,000 annuity might provide $200,000-$300,000 in LTC coverage. If not exhausted for healthcare, the annuity value transfers to your estate at death.
Premium Structure: Can be purchased with a single premium payment with NO future premium payments or rate increases. Best for North Carolina residents with existing assets to reposition for long-term care planning.
Health Requirements: Simplified underwriting with the most lenient health qualifications, sometimes requiring only a phone interview rather than medical exams or records review. Ideal for North Carolina residents with health concerns.
Tax Advantages for North Carolina Residents: Supports tax-free 1035 exchanges from existing annuities, and LTC benefits are generally received tax-free under current North Carolina and federal tax regulations.
Short-Term Care Insurance
What It Is: A policy that provides coverage for care in a nursing home, assisted living, or at home for a shorter duration, typically up to 12 months. Coverage is portable and can be used wherever you need short-term care.
Coverage Benefits: Helps cover costs for short-term care needs, including recovery from surgery, illness, or injury. Most policies have a 0-day deductible with benefits paid as soon as you qualify. This bridges gaps before long-term care insurance or Medicare coverage begins for services like home health aides.
Premium Structure: Generally lower than long-term care insurance due to the shorter benefit period, making it an affordable option for many North Carolina families.
Health Requirements: Often features simplified underwriting with fewer health questions, making it easier to qualify. Very helpful for North Carolina residents who may not meet traditional long-term care insurance health or age requirements.
North Carolina Long-Term Care Partnership Program
A North Carolina Long-Term Care Partnership policy lets you keep savings that Medicaid would otherwise expect you to spend. The exchange is dollar for dollar. Every dollar the policy pays in benefits shelters a dollar of countable resources when the state reviews your eligibility. A policy that has paid out $300,000 would shelter $300,000, on top of the $2,000 a single applicant may already keep. The rest of the eligibility test still applies.
Not every plan qualifies. Coverage must take effect on or after March 7, 2011. North Carolina also sets a rule by your age at purchase. Under 61, the policy must carry compound inflation protection. From 61 through 75, some level of protection is required. At 76 and older it becomes optional. Ask whether a policy is Partnership qualified before you sign.
Estate recovery is the other half. North Carolina can seek repayment from the estate of someone who received Medicaid at 55 or older. A Partnership policy reduces that claim by the same amount it protected when you applied.
That is the practical appeal. Coverage pays first, and if the benefits run out, the protected savings remain.
Learn how Long-Term Care Partnership programs work nationwide ➜
Long-Term Care Insurance Companies in North Carolina
North Carolina residents have access to long-term care insurance from a wide range of trusted, financially strong carriers. We work with multiple top-rated LTC insurance providers to help you find a plan that fits your age, health, and budget, whether you’re looking for a traditional policy or a hybrid life + LTC option.
Below is a list of long-term care insurance companies available in North Carolina:
USAA member? Explore USAA long-term care coverage ➜
AARP member? Review AARP long-term care insurance ➜
- Bankers Life & Casualty
- Brighthouse Financial
- Global Atlantic
- LifeSecure
- Lincoln Financial (MoneyGuard)
- Mutual of Omaha
- National Guardian Life (NGL)
- Nationwide Life Insurance Company
- New York Life
- Northwestern Mutual
- OneAmerica
- Securian Financial
- State Farm
- Thrivent Financial
These companies offer a mix of traditional and asset-based (hybrid) long-term care insurance policies. Availability and pricing vary based on your age, health history, and the type of coverage you need.
Read reviews and ratings of long-term care insurance companies ➜
Cost of Long-Term Care Insurance in North Carolina
Traditional long-term care insurance costs in North Carolina range from $1,500 to $5,000+ annually, depending on your age, health, and coverage choices. Most people pay between $2,000 and $3,000 per year for comprehensive coverage. Several factors influence your premium:
- Age at purchase: Buying at 55 vs 65 can save thousands over time
- Current health status: Better health means lower rates
- Daily or monthly benefit amount: Typically $100 to $300 per day
- Total coverage limit: Usually $100,000 to $500,000+
- Elimination period: 30, 60, or 90-day waiting period before benefits start
- Inflation protection: Protects against rising care costs
North Carolina Long-Term Care Insurance Quotes
Our licensed North Carolina professionals offer objective guidance on a wide range of long-term care insurance products and strategies. You’ll receive personalized service including:
✔ Finding the right coverage that fits your budget and protection needs
✔ Getting matched with North Carolina’s top-rated carriers based on your specific situation
✔ Helping you secure coverage even with pre-existing health conditions
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FAQs About Long-Term Care Insurance in North Carolina
Most North Carolina buyers pay $2,000 to $3,000 a year for traditional coverage, which is about $167 to $250 a month. The full range runs $1,500 to $5,000 a year, or $125 to $417 a month. Where you land depends on your age at purchase, your health, the benefit amount, the waiting period and whether you add inflation protection.
A private nursing home room averages $9,283 a month statewide in 2026. Assisted living runs $6,482. A home health aide at 44 hours a week costs $5,695. Those figures come from the Nationwide Financial 2026 Cost of Care Survey. They work out to $111,392, $77,788 and $68,344 a year.
Comprehensive policies do. Traditional, hybrid life and LTC annuity coverage can all pay for care at home as well as in a facility. Benefits usually start once you need help with two of six daily activities, such as bathing or dressing, or need supervision because of cognitive impairment. A waiting period you choose at purchase applies first. Many policies require care from a licensed home care agency. North Carolina licenses those agencies through its Division of Health Service Regulation, which publishes a list of them.
Yes. Short-term care insurance is sold here as a separate product from long-term care coverage. Its benefits last less than a year. North Carolina law reserves the long-term care label for coverage of 12 months or more. Depending on the plan, it can pay for a nursing home, assisted living or care at home. Underwriting is simpler, often a short list of health questions. Some plans accept applicants up to age 89. Many pay from the first day, with no waiting period. It is not short-term health insurance, which covers medical bills.
Yes. The Asheville region covers Buncombe, Henderson and Madison counties, including Hendersonville. A private nursing home room there averages $122,578 a year. That is $11,186 above the state average, or $10,215 a month against $9,283. Home care costs more here than anywhere else in North Carolina, at $79,153 a year against $68,344 statewide. Assisted living runs $81,443 against $77,788.
The Greensboro-High Point region covers Guilford, Randolph and Rockingham counties, including Asheboro. A private nursing home room there averages $121,286 a year, or $10,107 a month. That is $9,894 above the state average. Assisted living runs $83,339 against $77,788 statewide. Home care is the exception, at $63,053, or $5,291 below the state figure.
Last updated: September 26, 2026
Written by: Craig Matesky, President, ACACIA Insurance
Reviewed by: Mike Berger, National Sales Manager
Sources: