Updated August 7, 2026. Quick answer: a long-term-care premium increase usually arrives with a menu, and the options are not equally priced. 🔴 The one nobody explains is that a large enough increase can entitle you to a paid-up policy rather than nothing — and the one that looks cheapest, cutting the inflation rider, can quietly cost you the most.
What the menu usually contains
| Option | What it actually does |
|---|---|
| Pay the increase | Keeps every benefit intact. The only option that changes nothing except your cash flow |
| Reduce the daily or monthly benefit | Cuts what the policy pays per day of care. Predictable, and it bites hardest in the highest-cost years |
| Shorten the benefit period | Cuts how long it pays. Trades away the tail — which is the part insurance exists to cover |
| Raise the elimination period | You self-fund longer before it starts. Usually the cheapest real saving if you have liquid reserves |
| 🔴 Reduce or drop the inflation rider | The largest lever and the most dangerous. It cuts today’s premium by cutting tomorrow’s benefit — and it can forfeit partnership status entirely |
| Contingent nonforfeiture | Stop paying and keep a reduced paid-up policy. Not always offered — and sometimes required |
The option that may be owed to you
Under the NAIC model regulation, once a cumulative increase crosses a threshold set by your issue age, the insurer must offer a contingent benefit upon lapse — the policy becomes paid-up with a shortened benefit period rather than lapsing to nothing.
🔴 The trigger falls sharply as issue age rises: it takes a very large cumulative increase to trigger it for someone who bought young, and a much smaller one for someone who bought late — as little as 10% at the oldest issue ages. The older you were when you bought, the more likely you already qualify. How contingent nonforfeiture works, including what the paid-up benefit is worth.
⚠️ One caveat that applies to everything on this page. These are NAIC model rules. A model binds only where a state has adopted it, and states adopt different versions in different years. We have not surveyed which states adopted what. Treat this as the shape of the protection and confirm the detail with your own state insurance department.
Before you touch the inflation rider
⚠️ This is the one irreversible mistake on the menu. If your policy is partnership-qualified, the inflation protection is not a feature — it is a condition of the Medicaid asset protection you bought it for. Reducing it can end that protection. Read this before choosing the inflation option.
How to work the menu
- Find your issue age and the cumulative increase to date — not just this year’s. The trigger is cumulative.
- Ask in writing whether contingent nonforfeiture is available to you. If it is, you are choosing between options, not facing a bill.
- Ask whether the policy is partnership-qualified before considering the inflation option.
- Compare the elimination-period option honestly against your actual liquid reserves — it is often the least damaging real cut.
If the answer is that the policy no longer fits at any price, the wider question is at whether you can self-insure, whether the cover is worth it, and paying for care without insurance.
Sources
Contingent benefit upon lapse, the issue-age trigger table, rate-stability loss ratios: NAIC Long-Term Care Insurance Model Regulation #641, Sections 20 and 28. Option menus: Washington OIC, Oregon DFR and Wisconsin OCI consumer guidance. All read 7 August 2026. General information, not insurance, legal or tax advice on your policy. Your contract and your state’s rules govern.