North Carolina Long-Term Care Insurance
Compare 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?
- Types of Long-Term Care Insurance in North Carolina
- North Carolina Long-Term Care Partnership (State-Endorsed Program)
- Long-Term Care Insurance Companies in North Carolina
- North Carolina Long-Term Care Insurance Rates
- North Carolina Long-Term Care Insurance Quotes
- FAQs About North Carolina Long-Term Care Insurance
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.
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
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
In 2025, the average for 3 years of long-term care expenses in North Carolina is $306,930, or about $102,310 per year. By 2045, that figure is projected to rise to $610,725, or $203,575 per year.3
These national statistics become more meaningful when compared with actual costs in your area. North Carolina’s long-term care expenses vary significantly by region, making it important to understand what you might face locally.
North Carolina Long-Term Care Costs
Long-Term Care Rates in North Carolina – 2025 | |||
| Region | Nursing Home (private room) | Assisted Living (private room) | Home Care (44 hours) |
| North Carolina Average | $102,310 | $72,241 | $60,986 |
| Asheville | $120,273 | $75,396 | $69,442 |
| Burlington | $112,595 | $53,452 | $61,548 |
| Charlotte-Concord-Gastonia | $101,438 | $60,844 | $74,231 |
| Durham-Chapel Hill | $102,368 | $54,993 | $59,755 |
| Fayetteville | $105,966 | $41,134 | $56,514 |
| Goldsboro | $112,979 | $53,132 | $37,112 |
| Greensboro-High Point | $115,079 | $87,967 | $57,096 |
| Greenville | $116,566 | $72,692 | $50,661 |
| Hickory-Lenoir-Morganton | $123,382 | $63,184 | $62,503 |
| Jacksonville | $98,235 | $55,195 | $59,511 |
| Raleigh-Cary | $114,691 | $89,078 | $72,591 |
| Rocky Mount | $108,954 | $54,033 | $47,617 |
| Wilmington | $107,278 | $92,487 | $64,343 |
| Winston-Salem | $107,762 | $77,281 | $54,161 |
Source: Rates from the 2025 Nationwide Financial cost of care survey conducted by HVS, site accessed 11/10/2025
About Medicare and Long-Term Care
Medicare 
provides very limited long-term care coverage, primarily up to 100 days of skilled nursing care following a 3-day hospital stay. It does not cover custodial care (help with daily activities), which represents over 90% of long-term care needs. This limited coverage is why many North Carolina residents consider long-term care insurance. Get complete details about how Medicare handles long-term care coverage.
When To Buy Long-Term Care Insurance
When is 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 50s or early 60s because long-term care insurance premiums cost less at that age and you’re likely in better health. While you would pay premiums for more years, the total lifetime cost may still be lower.
- Buying earlier, like in your 40s, 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 60s might make sense if you’re healthy and have sufficient savings. But premiums are much higher, and health issues may arise that make coverage harder to qualify for. And discounts may no longer be available. If you become ill before purchasing coverage, you would be responsible for all long-term care costs.
One of our licensed North Carolina long-term care professionals can review your health situation and provide personalized quote comparisons.
Find Out If You Qualify >Types 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 2-4% 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 2-3 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: 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
The North Carolina Long-Term Care Partnership Program is a collaboration between the State of North Carolina and private insurance companies designed to help residents protect their savings while planning for future long-term care needs.
Partnership-certified policies follow state-approved standards and offer an important benefit: if your long-term care needs last longer than your policy benefits, you may keep more of your assets if you later apply for Medicaid.
Learn how the program works and see which companies offer partnership-certified plans on our North Carolina Long-Term Care Partnership Guide.
LTC 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:
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- 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.
How Much Does LTC Insurance Cost in North Carolina?
North Carolina long-term care insurance costs range from $1,500 to $5,000+ annually, depending on your age, health, and coverage choices. Most people pay between $2,000 – $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
Long-term care insurance in North Carolina covers expenses for extended care services, like nursing homes, assisted living, or in-home care, helping individuals maintain independence and financial security.
North Carolina residents typically qualify for long-term care insurance if they are in good health and meet insurer criteria, often requiring an application process to assess medical history and needs. Hybrid LTC insurance plans may be easier to qualify for than traditional plans.
Costs for long-term care insurance in North Carolina vary based on age, health, and coverage options, typically ranging from $1,500 to $5,000 annually, with customizable plans to fit budgets.
Long-term care insurance in North Carolina covers services like nursing home care, assisted living, in-home care, adult daycare, and respite care, tailored to policyholders’ specific needs and preferences.
Purchasing long-term care insurance in North Carolina is best in your 50s or early 60s, as premiums are lower and health qualifications are easier to meet before age-related issues arise.
The North Carolina Long Term Care Partnership is a cooperative program between the State of North Carolina and private insurance companies designed to help residents protect their assets if they later apply for Medicaid. Partnership-qualified policies must include inflation protection and other state-approved consumer safeguards.
To explore eligibility, benefits, and approved insurers, visit our North Carolina Long-Term Care Partnership Guide.
No. Only long-term care insurance policies that meet specific North Carolina Partnership Program requirements, such as state-approved inflation protection, are eligible. Our licensed advisors can confirm whether a policy qualifies under the North Ca Long-Term Care Partnership guidelines.
Last updated: November 10, 2025
Written by: Craig Matesky, President, ACACIA Insurance
Reviewed by: Mike Berger, National Sales Manager
Sources:
1. “How Much Care Will You Need?” LongTermCare.gov, U.S. Department of Health and Human Services, site accessed 11/10/2025
2. “How Much Care Will You Need?” LongTermCare.gov
3. Nationwide Financial 2025 cost of care survey conducted by HVS, site accessed 11/10/2025
4. “Who Will Provide Your Care?” LongTermCare.gov
5. Family Caregiver Alliance Caregiver.org, site accessed 11/10/2025
Note: Coverages and features vary between insurers, differ by state, and may not be available in all locations.