Long-term care insurance premiums are tax deductible when the policy is tax-qualified under federal law, but the deduction is capped by your age and, for most filers, buried under a 7.5% adjusted-gross-income floor before it produces any actual savings. For 2026, the age-based caps run from $500 if you’re 40 or younger to $6,200 if you’re over 70.1Internal Revenue Service. Rev. Proc. 2025-32 Self-employed filers get a much better version of the same deduction: they can take it above the line without itemizing.
What Makes a Policy Tax-Qualified
The deduction only exists for contracts that meet the requirements of Internal Revenue Code Section 7702B.2Office of the Law Revision Counsel. 26 USC 7702B – Treatment of Qualified Long-Term Care Insurance A qualifying policy has to be guaranteed renewable, so the insurer cannot cancel it while you keep paying. It cannot have a cash surrender value or let you borrow against it. And its only benefit must be coverage of long-term care services, not general health or life insurance.
Benefits can only start once a licensed health care practitioner certifies that you are chronically ill. That means you need substantial help with at least two activities of daily living (eating, bathing, dressing, toileting, transferring, or continence) for at least 90 days, or you need substantial supervision because of severe cognitive impairment.3Internal Revenue Service. Instructions for Form 1099-LTC The certification has to be renewed at least once a year.
If your contract predates January 1, 1997 and satisfied your state’s long-term care insurance rules when it was issued, the IRS treats it as qualified even if it doesn’t match the modern definition point for point.2Office of the Law Revision Counsel. 26 USC 7702B – Treatment of Qualified Long-Term Care Insurance
How Much You Can Deduct in 2026
Even with a qualified policy, you cannot deduct the full premium. The IRS caps the deductible amount based on your age at the end of the tax year, and the limits are adjusted annually for medical-care inflation under IRC Section 213(d)(10).4Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses For 2026, the caps are:1Internal Revenue Service. Rev. Proc. 2025-32
- Age 40 or younger: $500
- Age 41 to 50: $930
- Age 51 to 60: $1,860
- Age 61 to 70: $4,960
- Age 71 or older: $6,200
The caps are per person. If both spouses hold their own qualified policies, each gets their own limit.5Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses Anything you pay above your bracket produces no federal tax benefit. Two spouses both aged 65 could count up to $9,920 combined toward their medical expenses; two 45-year-olds are stuck at $1,860 between them. The deduction is designed to be worth the most later in life, which is also when premiums tend to be highest.
How Most Filers Actually Claim It
For anyone who isn’t self-employed, long-term care premiums go into the medical expense pile on Schedule A of Form 1040.5Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses Two thresholds sit between you and any actual savings.
First, the 7.5% AGI floor. Only the portion of your total unreimbursed medical expenses that exceeds 7.5% of your adjusted gross income counts.4Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses On $100,000 of AGI, the first $7,500 of medical spending does nothing for you. Only dollars above that line move the needle.
Second, the standard deduction. Itemizing only pays off when your total Schedule A deductions — medical, state and local taxes, mortgage interest, charitable gifts — beat the standard deduction. For 2026, the standard deduction is $16,100 for single filers and $32,200 for married couples filing jointly.6Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026 Those numbers are high enough that many filers with a modest LTC premium never see a dollar of federal benefit.
The people who actually come out ahead tend to be older filers with meaningful medical costs from several sources at once — prescription drugs, dental work, LTC premiums — stacking together above 7.5% of AGI, plus enough other deductible expenses to make itemizing worthwhile.
A Better Deal for the Self-Employed
If you’re self-employed, the rules bend in your favor. You can deduct qualified long-term care premiums as an above-the-line adjustment on Schedule 1 of Form 1040, without itemizing and without clearing the 7.5% floor.7Internal Revenue Service. Topic No. 502, Medical and Dental Expenses The deduction reduces your adjusted gross income directly, which can also help you qualify for other benefits that phase out at higher income levels.
The same age-based caps still apply, and the deduction cannot exceed your net self-employment income for the year.8Internal Revenue Service. Instructions for Form 7206 If your business earned $3,000 and your eligible premium is $4,960, the deduction is capped at $3,000. Any premium you couldn’t claim above the line can still be dropped into your Schedule A medical total, where the usual 7.5% floor applies.7Internal Revenue Service. Topic No. 502, Medical and Dental Expenses
There’s a disqualifier that catches people off guard. You lose the above-the-line deduction for any month in which you or your spouse were eligible to participate in an employer-subsidized health plan. The test is eligibility, not enrollment. If your spouse’s employer offered a plan either of you could have joined, that month is out even if neither of you signed up.8Internal Revenue Service. Instructions for Form 7206
The self-employed treatment extends to partners and to shareholders owning more than 2% of an S corporation, but the plan has to be established under the business. For partners, that usually means the partnership pays the premiums directly, or reimburses the partner and reports the amounts as guaranteed payments on the K-1. For S-corp shareholders, the company pays or reimburses and the amount shows up on the W-2 as wages. If the shareholder just pays out of pocket and the company never reimburses, the above-the-line route isn’t available.8Internal Revenue Service. Instructions for Form 7206
Paying Premiums From an HSA
Health Savings Accounts generally cannot pay insurance premiums, but long-term care insurance is one of the explicit exceptions. If you use HSA funds to pay qualified LTC premiums up to the same age-based caps, the distribution is tax-free.9Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans
The caps are the ceiling. If you’re 55 and your annual premium is $2,500, only $1,860 can come tax-free from the HSA. Anything above the cap is treated as a non-qualified distribution, taxable as income and subject to a 20% penalty if you’re under 65. For 2026, HSA contribution limits are $4,400 for self-only coverage and $8,750 for family coverage.10Internal Revenue Service. Notice 26-05
Don’t confuse HSAs with Flexible Spending Accounts. FSAs cannot pay any insurance premium, including long-term care premiums.11HealthCare.gov. Using a Flexible Spending Account (FSA)
Premiums You Pay for a Spouse or Parent
Premiums you pay on behalf of a spouse or a qualifying dependent count in your own medical expense total, and each covered person gets their own age-based cap.5Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses A 52-year-old paying premiums for both themselves and a 78-year-old dependent parent could include up to $1,860 for the child and $6,200 for the parent, for $8,060 in eligible premiums feeding the medical expense calculation.
The dependency test for medical expenses is looser than for other tax purposes. Someone who would qualify as your dependent except that they filed a joint return or had gross income above the dependency threshold ($5,200 for 2025, adjusted annually) still counts.5Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses That matters for aging parents whose Social Security or small pension income disqualifies them from full dependent status but who still rely on your support.
Hybrid Life and Long-Term Care Policies
Combination policies that bundle life insurance with a long-term care rider are treated as two separate contracts for tax purposes.2Office of the Law Revision Counsel. 26 USC 7702B – Treatment of Qualified Long-Term Care Insurance Only the premium attributable to the LTC portion is potentially deductible. The base life insurance premium is not.
One restriction shuts down a large share of hybrid policies: you cannot deduct the LTC portion if the premium is paid as a charge against the cash surrender value of the life insurance contract.2Office of the Law Revision Counsel. 26 USC 7702B – Treatment of Qualified Long-Term Care Insurance Many hybrid products are single-premium contracts, and how much of that one payment is deductible depends on how the insurer allocates it between components. Your insurer should provide a breakdown identifying which agreements within the contract carry a deductible premium; the LTC acceleration and extension riders are typically the deductible parts. The age-based caps still apply to whatever portion qualifies.
State Deductions and Credits
State income tax treatment of long-term care premiums varies. Some states offer a tax credit that reduces tax owed dollar for dollar. Others allow a full or partial deduction from state taxable income without requiring you to clear the federal 7.5% floor. Because state rules operate independently of the IRS calculation, you may pick up a state benefit even in a year when your federal deduction produces nothing. State rules change often, so your state’s own tax instructions or a local preparer is the reliable place to check what’s available where you live.