Who Still Sells Long-Term Care Insurance in 2026? The Carriers Left Standing

In 2000, more than 100 insurers were writing new standalone long-term care insurance in the United States. Today, fewer than a dozen still do. The retreat was not gradual noise — more than three-quarters of standalone carriers had stopped writing by 2012, and the number of Americans holding standalone LTC coverage has itself fallen, from 7.4 million in 2012 to 6.3 million by year-end 2021. Then, in October 2025, something almost no one expected happened: a carrier came back. Genworth, which had suspended new sales in 2019, re-entered the market through a newly built subsidiary.

This is a map of the surviving supply side — who still writes new standalone policies among the eight biggest legacy names, who quit, and who returned — and, more to the point for anyone reading this who already owns a policy, what a shrunken market does and does not mean for the coverage you hold. It is not a buying guide, and it is not advice to keep or drop anything. It is the supply context that sits underneath a drop-versus-keep decision.

The census: four of the eight biggest legacy names have left new standalone sales

“Standalone” matters here. It refers to a policy whose only job is to pay for long-term care — the traditional product that dominated the market for two decades. It is distinct from a hybrid life-or-annuity policy with a long-term care rider, which is a different instrument with different underwriting, pricing, and trade-offs. Several carriers that stopped selling standalone LTC still sell hybrids; that is a pivot, not a continuation. The table below tracks the eight largest legacy names the Desk follows in its Carrier File.

Carrier	New standalone status	Since	What they offer individuals now
Mutual of Omaha	Still writing	—	Active standalone individual LTC; also LTC riders on IUL products
New York Life	Still writing	—	NYL My Care and Secure Care (standalone); Asset Flex (hybrid)
Northwestern Mutual	Still writing	—	QuietCare (standalone); Long-Term Advantage (hybrid)
Genworth	Re-entered	Oct 2025	Care Assurance via CareScout Insurance Company (new subsidiary)
John Hancock	Exited standalone	Dec 2016	LifeCare (indexed universal life + LTC benefits)
MassMutual	Exited standalone	Jan 2021	CareChoice One / Select (whole life + LTC riders)
Transamerica	Exited standalone	Mar 2021	LTC rider on IUL / universal life (from Nov 2023)
Brighthouse	Never wrote standalone	—	SmartCare (hybrid life + LTC)

Two clarifications the table compresses. First, Brighthouse never sold a standalone LTC product at all — it built its LTC presence entirely on the SmartCare hybrid — so it belongs in a “never entered” category rather than an “exited” one, even though the practical result for a shopper is the same: no standalone policy to buy. Second, this eight-name set is not the whole market. A few carriers outside it — National Guardian Life, Lincoln Financial, and Nationwide among them — still write standalone or asset-based coverage. So the honest count is not “only four companies left in America.” It is that half of the biggest, most familiar legacy names have stopped, and the entire surviving field — big names and small — now numbers fewer than a dozen where once it numbered more than a hundred.

Why the field collapsed

The exits were not a coincidence of corporate strategy. They were the same actuarial miss playing out across the industry. Policies written in the 1980s, 1990s, and 2000s were priced on assumptions that turned out to be wrong in the same direction at every carrier: policyholders lived longer, let their policies lapse far less often than expected, and claimed more care than the models projected. The American Academy of Actuaries has described the result plainly — a product written “in a short-term world” whose costs land decades later. Faced with blocks of business that needed repeated repricing to stay solvent, most carriers chose the exit over the fight, closed their books to new sales, and left the standalone market to a shrinking handful.

That history is why the surviving standalone policies are priced far more conservatively than the ones sold twenty years ago, and why carrier after carrier has pivoted to hybrids — products where the long-term care benefit is bolted onto life insurance whose pricing is easier to hold stable. It is also the engine behind the rate-increase letters that in-force policyholders keep receiving, which we track carrier by carrier in the Carrier File and analyze in our Genworth rate-filing coverage.

The one that came back: Genworth’s CareScout re-entry

Genworth is the anomaly. It suspended new individual LTC applications in March 2019 after years of some of the industry’s steepest rate increases. In October 2025 it re-entered new sales with a product called Care Assurance, available in 40 states with four more pending approval as of February 2026. Three details matter for a reader trying to make sense of it.

First, the new policy is not written by the old company. Care Assurance is issued by CareScout Insurance Company, a newly capitalized Genworth subsidiary — not by Genworth Life Insurance Company, which holds the legacy closed block. If you own an older Genworth policy, the fact that Genworth is selling again does not change your contract, your terms, or the separate rate filings that apply to your book. A new company selling a new product is exactly that.

Second, that newness cuts both ways for a prospective buyer. CareScout Insurance Company is a fresh entity without the long standalone track record an established insurer carries, and public reporting indicates its financial backing leans heavily on a reinsurance arrangement with a reinsurer rated A+ (Superior) by AM Best. That reinsurance support is a genuine strength, but the rating that belongs to the reinsurer is not the same as an independent long-run track record for the issuing company — a distinction worth understanding rather than glossing.

Third, the product is deliberately built to avoid its predecessor’s fate: more conservative pricing and benefit design, aimed at premiums that hold rather than climb. Whether that promise survives contact with the same longevity and lapse pressures that broke the last generation of pricing is the open question, and not one any carrier can answer at launch.

What a collapsed supply side means if you already own a policy

Here is where the market map actually touches a decision. The most common reason an in-force LTC policy is described as “irreplaceable” is that so few carriers still sell. That is real, but it is the weaker half of the reason. The stronger half is underwriting. A new policy — from any surviving carrier — requires fresh medical underwriting at your current age. Many people who bought coverage in their fifties would, a decade or two later, either be declined outright for health reasons or offered a new policy at a dramatically higher price for weaker benefits. For a large share of existing policyholders, replacement is not a live option regardless of how many carriers are technically still writing. That, more than the raw carrier count, is what makes a legacy policy hard to reproduce.

The same is true of the terms locked into older contracts. A generous inflation rider, a long or unlimited benefit period, a low elimination period bought years ago at a young-issue price — these are features the conservatively-priced 2026 products often do not match at any price. When people say an old policy is “worth more than it looks,” this is usually what they mean.

None of that, however, is a reason to keep a policy on autopilot — and this is the part the scarcity story tends to bury. Irreplaceability raises the cost of walking away; it does not make walking away wrong. A premium you genuinely cannot sustain is still unsustainable no matter how rare the coverage. A policy whose benefit design no longer fits your plan is still a poor fit. And scarcity says nothing about the alternatives — self-funding the risk, a hybrid product, or Medicaid planning — that may serve a specific situation better. The right way to read a shrunken market is as one input into a genuinely individual calculation, not as a thumb on the scale toward “keep.”

Work through the drop-versus-keep decision framework →

If the immediate pressure is a rate-increase letter rather than the abstract question of supply, start with the mechanics: the five options inside a rate-hike letter are the same for every carrier, and contingent nonforfeiture is the most overlooked of them. And if your carrier is one of the four that stopped writing, our analysis of what a carrier exit means for your in-force policy covers the servicing and guaranty-fund mechanics that a “stopped selling” headline leaves out — chiefly that exiting new sales does not cancel, weaken, or terminate the coverage you already hold.

What this is not

This is not a ranking of the best long-term care insurers, and it is deliberately not one. That which carrier still sells says nothing about which policy is right for any individual — the surviving carriers differ in pricing, underwriting, and product design, and the “best” among them is entirely situation-specific. It is also not a claim that a shrinking market makes new coverage a bad idea; for a healthy buyer who can qualify, a conservatively-priced 2026 policy may be a perfectly sound purchase. The point of the census is narrower and more useful: to show, accurately, how much the supply side has contracted, so that an existing policyholder weighing what to do next is working from the real shape of the market rather than a memory of the one that existed when they bought in.