UPDATED LTC Tax Info from The LTCpro®
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LTC Insurance
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NOTE: Generally, "hybrid" or "linked-benefit" (life+LTCI/annuity+LTCI) policies do NOT qualify for a premium deduction, but if the contract is LTC "Tax Qualified" any benefits paid for care are received tax-free - subject to the per diem (indemnity) limitations noted below. Internal LTC benefit charges may reduce a hybrid policy's tax "basis" if cash values are withdrawn during life or for the cash beneficiaries of a LTC-annuity.
IF a portion of a Hybrid LTC plan's premium qualifies for a deduction (e.g., as a separately-designated TQ LTC rider) - and many of the LTC-focused "linked-benefit with LTC extension" hybrid plans now do this - the separate TQ LTC portion of the premium follows the premium deduction guidelines below.* Premiums for life insurance death benefits are not tax deductible.
IF a portion of a Hybrid LTC plan's premium qualifies for a deduction (e.g., as a separately-designated TQ LTC rider) - and many of the LTC-focused "linked-benefit with LTC extension" hybrid plans now do this - the separate TQ LTC portion of the premium follows the premium deduction guidelines below.* Premiums for life insurance death benefits are not tax deductible.
* The LTC insurance tax guide information presented here is for general information only and should not be used nor relied upon as specific tax advice. Taxpayers should consult with their CPA or qualified tax professional for advice regarding their own tax situation and the tax status of LTC premiums and benefits.
The tax advantages noted only apply to Tax-Qualified (TQ) policies also known as "7702B" contracts after the controlling federal Tax Code section.*
Key Point: TQ LTCI = Health Insurance
Generally Tax Qualified (TQ) LTC insurance is considered a form of medical/health insurance and the tax benefits generally follow health insurance rules. There are two exceptions: 1) Individuals are limited in the amount of premium (based on age) that is considered an Eligible medical expense, and 2) voluntary premiums paid through payroll reduction at work can not be withheld on a pre-tax basis. [HIPAA, 1997 - Sec. 7702B; Sec. 125(f)]
BENEFIT PAYMENTS ON CLAIM
Benefits paid from a TQ LTC insurance plan during a claim are paid income tax-free. This can include receipt of gains in payment for qualified long-term care services from an annuity contract IF the annuity is specifically designed as and meets the criteria for TQ LTC benefits.
Form 1099-LTC
Any benefits paid from a LTC insurance policy will generate an informational Form 1099-LTC for the policy owner. Like other 1099s a copy is sent to the IRS. Box 3 shows if the benefits were "reimbursement" or "Per diem" (more commonly called "indemnity" or "cash benefit").
Reimbursement Benefits
If "reimbursement," then benefits are tax-free and NO tax return reporting of the amounts reported on the 1099-LTC is required. (NOTE that if benefits are received from both a Reimbursement and a per-diem/indemnity policy then benefits paid from both contracts must be reported on Form 8853, and the combined benefits will be subject to the per-diem tax-free limitation below.)*
Per diem/Indemnity/Cash Benefits
However, if the benefits are "indemnity" or "cash benefits" (marked as "Per diem" on 1099-LTC), tax return reporting of the Form 1099-LTC amount IS required and a portion of the benefits may be taxable. (Reported on IRS From 8853)
Tax-Free Per Diem Limit INCREASING to $420/day ($12,775/month) for claims paid in 2023.
For tax year 2022, for the first time ever, the daily tax-free "per diem" (indemnity) benefit payment limit DECREASED for claims paid in 2022. This is due to the fact that the IRS must now use a "chained" CPI calculation that averages the indexing percentage. Effectively, the "per diem" (indemnity) limit has grown faster over past years than the new averaging method allows, creating the need for the reduction in 2022.
For "Per diem"/"indemnity"/"cash benefit" payments where the full benefit is paid regardless of any expense incurred, the benefits are tax-free up to $390 per day ($11,862 per month) in 2022 even if actual expenses are less. If the benefit is higher than $390/day, the excess is taxable income unless an equal amount of paid care expenses above $390/day can be shown. (For claims in 2021, the limit was $400/day.)
Example: In 2022, an indemnity benefit of $430 per day would produce a taxable income of $40 per day unless paid care expenses also equal or exceed $430 per day.
NOTE: If benefits are received from BOTH a reimbursement and a per diem (indemnity) contract in the same year, the reimbursement benefits must then also be reported on Form 8853 and reconciled along with the per diem benefits, potentially exposing the total benefits received to taxation above the per diem limit.
DEDUCTION OF PREMIUMS
Individual Taxpayer
A portion of Tax Qualified long-term care insurance premiums paid by an individual - for yourself, your spouse, and your eligible tax dependents (e.g. your children or dependent parents) are includable as personal medical expenses IF you itemize your taxes on Schedule A [IRC Sec. 213(a)]. Total Medical Expenses in excess of 7.5% of your adjusted gross income (AGI) are tax deductible. This means that the "Eligible" portion of your LTC insurance premium can help you reach the 7.5% threshold and may even help you to exceed that threshold to receive a tax deduction.
If you have a Health Savings Account (HSA) - or an employer-funded Health Reimbursement Account (HRA) - you can pay your Eligible LTC insurance premiums (or be reimbursed) tax-free from your HSA, but only up to the age-based, Eligible premium noted below. You do not have have to itemize and do not have to meet the 7.5% of AGI threshold. You can pay both your Eligible Premium and a spouse's Eligible Premium from your HSA/HRA.
Below is a table of the amount of TQ LTC insurance premiums qualifying as an Eligible Medical Expense for the 2022 & 2023 tax years. These numbers adjust each year based on the Medical Consumer Price Index. Starting in 2022, the IRS is required to use a "chained" CPI calculation which resulted in NO CHANGE to most LTC premium deductibility limits and a REDUCTION in the amount of Eligible premium deductible for taxpayers aged 61-70 as of the end of 2022. All of the Eligible Premium limits are increasing for tax year 2023:
Key Point: TQ LTCI = Health Insurance
Generally Tax Qualified (TQ) LTC insurance is considered a form of medical/health insurance and the tax benefits generally follow health insurance rules. There are two exceptions: 1) Individuals are limited in the amount of premium (based on age) that is considered an Eligible medical expense, and 2) voluntary premiums paid through payroll reduction at work can not be withheld on a pre-tax basis. [HIPAA, 1997 - Sec. 7702B; Sec. 125(f)]
BENEFIT PAYMENTS ON CLAIM
Benefits paid from a TQ LTC insurance plan during a claim are paid income tax-free. This can include receipt of gains in payment for qualified long-term care services from an annuity contract IF the annuity is specifically designed as and meets the criteria for TQ LTC benefits.
Form 1099-LTC
Any benefits paid from a LTC insurance policy will generate an informational Form 1099-LTC for the policy owner. Like other 1099s a copy is sent to the IRS. Box 3 shows if the benefits were "reimbursement" or "Per diem" (more commonly called "indemnity" or "cash benefit").
Reimbursement Benefits
If "reimbursement," then benefits are tax-free and NO tax return reporting of the amounts reported on the 1099-LTC is required. (NOTE that if benefits are received from both a Reimbursement and a per-diem/indemnity policy then benefits paid from both contracts must be reported on Form 8853, and the combined benefits will be subject to the per-diem tax-free limitation below.)*
Per diem/Indemnity/Cash Benefits
However, if the benefits are "indemnity" or "cash benefits" (marked as "Per diem" on 1099-LTC), tax return reporting of the Form 1099-LTC amount IS required and a portion of the benefits may be taxable. (Reported on IRS From 8853)
Tax-Free Per Diem Limit INCREASING to $420/day ($12,775/month) for claims paid in 2023.
For tax year 2022, for the first time ever, the daily tax-free "per diem" (indemnity) benefit payment limit DECREASED for claims paid in 2022. This is due to the fact that the IRS must now use a "chained" CPI calculation that averages the indexing percentage. Effectively, the "per diem" (indemnity) limit has grown faster over past years than the new averaging method allows, creating the need for the reduction in 2022.
For "Per diem"/"indemnity"/"cash benefit" payments where the full benefit is paid regardless of any expense incurred, the benefits are tax-free up to $390 per day ($11,862 per month) in 2022 even if actual expenses are less. If the benefit is higher than $390/day, the excess is taxable income unless an equal amount of paid care expenses above $390/day can be shown. (For claims in 2021, the limit was $400/day.)
Example: In 2022, an indemnity benefit of $430 per day would produce a taxable income of $40 per day unless paid care expenses also equal or exceed $430 per day.
NOTE: If benefits are received from BOTH a reimbursement and a per diem (indemnity) contract in the same year, the reimbursement benefits must then also be reported on Form 8853 and reconciled along with the per diem benefits, potentially exposing the total benefits received to taxation above the per diem limit.
DEDUCTION OF PREMIUMS
Individual Taxpayer
A portion of Tax Qualified long-term care insurance premiums paid by an individual - for yourself, your spouse, and your eligible tax dependents (e.g. your children or dependent parents) are includable as personal medical expenses IF you itemize your taxes on Schedule A [IRC Sec. 213(a)]. Total Medical Expenses in excess of 7.5% of your adjusted gross income (AGI) are tax deductible. This means that the "Eligible" portion of your LTC insurance premium can help you reach the 7.5% threshold and may even help you to exceed that threshold to receive a tax deduction.
If you have a Health Savings Account (HSA) - or an employer-funded Health Reimbursement Account (HRA) - you can pay your Eligible LTC insurance premiums (or be reimbursed) tax-free from your HSA, but only up to the age-based, Eligible premium noted below. You do not have have to itemize and do not have to meet the 7.5% of AGI threshold. You can pay both your Eligible Premium and a spouse's Eligible Premium from your HSA/HRA.
Below is a table of the amount of TQ LTC insurance premiums qualifying as an Eligible Medical Expense for the 2022 & 2023 tax years. These numbers adjust each year based on the Medical Consumer Price Index. Starting in 2022, the IRS is required to use a "chained" CPI calculation which resulted in NO CHANGE to most LTC premium deductibility limits and a REDUCTION in the amount of Eligible premium deductible for taxpayers aged 61-70 as of the end of 2022. All of the Eligible Premium limits are increasing for tax year 2023:
TQ LTCI Eligible Premium - UPDATED with 2023 tax year premium deduction limits:
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Age at end of tax year:
40 and younger
41 to 50 51 to 60 61 to 70 71 and older |
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Rules for Business-Paid LTC Insurance:
Self-Employed Business Owners
Qualified long-term care insurance premiums are treated like health insurance for the Self-Employed Health Insurance tax deduction. Self-employed individuals may deduct up to the eligible long-term care premium shown above [IRC Sec. 162(1)]. The definition of self-employed includes a sole proprietor, partners, "greater than 2% shareholder/employee" of S-corporations, or Limited Liability Corporation members taxed as any of these "self-employed" entities.
This is an "above-the-line" deduction taken on Form 1040, Schedule 1, Line 16 (2020) as part of the "Self-Employed Health Insurance Deduction". Itemization and the 7.5% of AGI threshold are NOT required.
Example: Bob, age 61, owns his own consulting firm. His long-term care insurance premium is $4,000 per year. Based on the chart listed under the INDIVIDUAL section above, in 2022 he is eligible to deduct up to $4,510. Therefore, he can deduct his entire $4,000 premium. (If Bob were 55, he could only deduct $1,690 for tax year 2022 as a Self Employed Health Insurance Deduction for LTC insurance.)
This deduction is also available for the business owner's spouse as part of the self-employed health deduction just like for the owner. Bob's wife would qualify for her own age-based Eligible premium deduction amount based on her age.
Qualified long-term care insurance premiums are treated like health insurance for the Self-Employed Health Insurance tax deduction. Self-employed individuals may deduct up to the eligible long-term care premium shown above [IRC Sec. 162(1)]. The definition of self-employed includes a sole proprietor, partners, "greater than 2% shareholder/employee" of S-corporations, or Limited Liability Corporation members taxed as any of these "self-employed" entities.
This is an "above-the-line" deduction taken on Form 1040, Schedule 1, Line 16 (2020) as part of the "Self-Employed Health Insurance Deduction". Itemization and the 7.5% of AGI threshold are NOT required.
Example: Bob, age 61, owns his own consulting firm. His long-term care insurance premium is $4,000 per year. Based on the chart listed under the INDIVIDUAL section above, in 2022 he is eligible to deduct up to $4,510. Therefore, he can deduct his entire $4,000 premium. (If Bob were 55, he could only deduct $1,690 for tax year 2022 as a Self Employed Health Insurance Deduction for LTC insurance.)
This deduction is also available for the business owner's spouse as part of the self-employed health deduction just like for the owner. Bob's wife would qualify for her own age-based Eligible premium deduction amount based on her age.
- S-corporation shareholder/employees should have the business pay the premium and then add the total premium paid to W-2 compensation - this follows the rules for ensuring that an individual medical plan is considered an "employer plan" for tax purposes. (If the premium is paid personally, it must be formally reimbursed with a written agreement in order for the plan to be deductible as an employer plan on the owner's individual tax return.)
- A partner can pay the premium personally and take the Self Employed Health Insurance age-based, Eligible premium deduction; it does not have to run through the partnership. If the premium is paid by the partnership, the premium paid must be added to the partner's K-1 as a "guaranteed payment".
- A sole proprietor can pay the premium personally and take the Self Employed Health Insurance age-based, Eligible premium deduction; it does not have to run through the sole proprietorship. If the premium is paid by the sole proprietorship, the owner must take the total premium paid as a draw.
GOOD NEWS / BAD NEWS for self-employed business owners' LTCI premiums:
- Good news: An "above-the-line" deduction, NOT subject to Schedule A.
- Bad news: Limited to the age-based, Eligible premium amount.
C-Corporations
Premium payments are fully (100%) deductible from the corporate tax return as a reasonable and necessary business expense - similar to traditional health and accident insurance premiums [IRC Sec. 213(d)1]. This can apply to shareholder/employees (W-2), their spouses and dependents, and all coverage paid for by the business for employees.
Employer-paid long-term care insurance is excludable from an employee's gross income - including a shareholder/employee's income [IRC Sec. 106(2)] - and the benefits received remain tax-free.
C-corp-paid premiums cannot be allocated against a shareholder/employee's income, bonus, expense accounts, or by any other means that would create, in effect, a "salary reduction agreement". To be deductible the premium must be a 100% corporate expense.
Non-Owner Employees
In ANY business entity, premiums paid by the business for a NON-owner employee (and spouse) are always 100% deductible - without limit - as a reasonable and necessary business expense -- similar to traditional health insurance premiums [IRC Sec. 162(2)].
Employer-paid long-term care insurance is excludable from the employee's gross income and the benefits received are tax-free [IRC Sec. 106(2)].
This provides an opportunity for a significant tax-free "key-person" LTC benefit. Using a limited-pay premium structure, for example a 10-pay plan, could create a valuable "golden handcuff" plan.
Voluntary Worksite Premiums
Premiums paid by an employee through payroll or any type of salary reduction agreement in the workplace must be paid after-tax. LTC insurance is not allowed in a pre-tax, "125" cafeteria plan [IRC Sec. 125(f)].
Premium payments are fully (100%) deductible from the corporate tax return as a reasonable and necessary business expense - similar to traditional health and accident insurance premiums [IRC Sec. 213(d)1]. This can apply to shareholder/employees (W-2), their spouses and dependents, and all coverage paid for by the business for employees.
Employer-paid long-term care insurance is excludable from an employee's gross income - including a shareholder/employee's income [IRC Sec. 106(2)] - and the benefits received remain tax-free.
C-corp-paid premiums cannot be allocated against a shareholder/employee's income, bonus, expense accounts, or by any other means that would create, in effect, a "salary reduction agreement". To be deductible the premium must be a 100% corporate expense.
Non-Owner Employees
In ANY business entity, premiums paid by the business for a NON-owner employee (and spouse) are always 100% deductible - without limit - as a reasonable and necessary business expense -- similar to traditional health insurance premiums [IRC Sec. 162(2)].
Employer-paid long-term care insurance is excludable from the employee's gross income and the benefits received are tax-free [IRC Sec. 106(2)].
This provides an opportunity for a significant tax-free "key-person" LTC benefit. Using a limited-pay premium structure, for example a 10-pay plan, could create a valuable "golden handcuff" plan.
Voluntary Worksite Premiums
Premiums paid by an employee through payroll or any type of salary reduction agreement in the workplace must be paid after-tax. LTC insurance is not allowed in a pre-tax, "125" cafeteria plan [IRC Sec. 125(f)].
NOTE: Generally, "hybrid" or "linked-benefit" (life+LTCI/annuity+LTCI) policies do NOT qualify for a premium deduction, but if they are "Tax Qualified" any benefits paid for care are tax-free. Internal LTC-specific premium charges may reduce a Hybrid LTC policy's tax "basis" if cash values are withdrawn during life or for the cash beneficiaries of a LTC-annuity.
IF a portion of a Hybrid LTC plan's premium qualifies for a deduction (e.g., as a separately-designated TQ LTC rider) - and many of the LTC-focused "linked-benefit with LTC extension" hybrid plans now do this - the separate TQ LTC portion of the premium follows these same premium deduction guidelines.* Premiums for life insurance death benefits are not deductible.
IF a portion of a Hybrid LTC plan's premium qualifies for a deduction (e.g., as a separately-designated TQ LTC rider) - and many of the LTC-focused "linked-benefit with LTC extension" hybrid plans now do this - the separate TQ LTC portion of the premium follows these same premium deduction guidelines.* Premiums for life insurance death benefits are not deductible.
PENSION PROTECTION ACT 2006
The Pension Protection Act of 2006 (PPA) created substantial tax advantages for funding LTC benefits with existing funds in life insurance and annuity cash values by expanding the opportunities for tax-free "1035 exchanges," and the PPA allows for otherwise taxable gains in a Tax Qualified LTC annuity's cash value to be received tax-free if used for qualified long-term care expenses.
Life Insurance exchange:
Cash value from existing life insurance policies can be transferred (exchanged) without paying any taxes on the cash value's "gain" for a new life insurance policy with expanded LTC benefits. The new policy's death benefit is still paid tax-free, but in addition, any benefits paid for qualified long-term care services are also received tax-free.
These "linked-benefit" Life+LTC insurance "hybrid" or "combo" policies may consider coverage for medical histories that traditionally would not be insurable for LTC coverage.
Life insurance cash value can also be exchanged into a LTC annuity or now even a "traditional" LTC insurance policy.
Annuity exchange:
Annuity cash value cannot be exchanged into a life insurance contract, BUT the PPA offers a huge tax incentive for annuity owners to convert their existing annuities into a LTC-qualified annuity.
If a deferred annuity has had significant earnings growth or "gain," when it is annuitized or left to heirs, that gain will be taxed as regular income. BUT if the annuity's cash value is transferred, tax-free under the 1035-exchange rules for a LTC-qualified annuity, and the LTC-annuity's cash value is used to pay for qualified long-term care expenses, then the gain is received income tax free! Even without any additional LTC "insurance" extension of benefits beyond the basic cash value, this tax savings could provide a tremendous value on its own.
LTC Annuities have simplified or "reduced" underwriting criteria, so these plans are available to many people who have been or may be declined for "traditional" LTC insurance or even hybrid life+LTC policies.
A New Exchange Opportunity:
The PPA expanded the 1035 exchange provisions to also allow life or annuity cash values to also be transferred into a "traditional" type of LTC insurance policy. While this option is limited due to companies' restrictions on disbursing and receiving partial 1035 exchanges, there is one traditional LTC policy that accepts a single-payment that would qualify for a one-time 1035 tax-free cash value exchange from either a life insurance policy or an annuity.
Contact Us to learn more about these PPA funding options.
The Pension Protection Act of 2006 (PPA) created substantial tax advantages for funding LTC benefits with existing funds in life insurance and annuity cash values by expanding the opportunities for tax-free "1035 exchanges," and the PPA allows for otherwise taxable gains in a Tax Qualified LTC annuity's cash value to be received tax-free if used for qualified long-term care expenses.
Life Insurance exchange:
Cash value from existing life insurance policies can be transferred (exchanged) without paying any taxes on the cash value's "gain" for a new life insurance policy with expanded LTC benefits. The new policy's death benefit is still paid tax-free, but in addition, any benefits paid for qualified long-term care services are also received tax-free.
These "linked-benefit" Life+LTC insurance "hybrid" or "combo" policies may consider coverage for medical histories that traditionally would not be insurable for LTC coverage.
Life insurance cash value can also be exchanged into a LTC annuity or now even a "traditional" LTC insurance policy.
Annuity exchange:
Annuity cash value cannot be exchanged into a life insurance contract, BUT the PPA offers a huge tax incentive for annuity owners to convert their existing annuities into a LTC-qualified annuity.
If a deferred annuity has had significant earnings growth or "gain," when it is annuitized or left to heirs, that gain will be taxed as regular income. BUT if the annuity's cash value is transferred, tax-free under the 1035-exchange rules for a LTC-qualified annuity, and the LTC-annuity's cash value is used to pay for qualified long-term care expenses, then the gain is received income tax free! Even without any additional LTC "insurance" extension of benefits beyond the basic cash value, this tax savings could provide a tremendous value on its own.
LTC Annuities have simplified or "reduced" underwriting criteria, so these plans are available to many people who have been or may be declined for "traditional" LTC insurance or even hybrid life+LTC policies.
A New Exchange Opportunity:
The PPA expanded the 1035 exchange provisions to also allow life or annuity cash values to also be transferred into a "traditional" type of LTC insurance policy. While this option is limited due to companies' restrictions on disbursing and receiving partial 1035 exchanges, there is one traditional LTC policy that accepts a single-payment that would qualify for a one-time 1035 tax-free cash value exchange from either a life insurance policy or an annuity.
Contact Us to learn more about these PPA funding options.
* The tax information presented here is for general information only and should not be used nor relied upon as specific tax advice. Taxpayers should consult with their CPA or qualified tax professional for advice regarding their own tax situation and the tax status of LTC premiums and benefits.
UPDATED 10/25/2022 with indexed Eligible Premium values for tax year 2023.
For more information on the 2023 IRS inflation-indexed values, see Revenue Procedure 2022-38.
For more information on the 2023 IRS inflation-indexed values, see Revenue Procedure 2022-38.
