The FLTCIP is closed: what the federal long-term care insurance suspension means for you
Quietly, the government’s own long-term care insurance program has been shut to new enrollees since December 2022 — and the freeze has been extended through at least December 19, 2026, with no promise it will ever reopen in a usable form. That leaves a hole most federal employees don’t realize exists: neither Medicare nor FEHB covers custodial long-term care, the daily help with bathing, dressing, and eating that most care actually involves. Long-term care is the single largest uninsured risk in the entire federal benefits package. Here’s why the FLTCIP is frozen, what current enrollees should know, and — with the federal option off the table — how to plan around the gap, including a calculator for the shortfall you’d have to cover yourself.
1. The program is closed
The Federal Long Term Care Insurance Program (FLTCIP) — underwritten by John Hancock and administered by Long Term Care Partners — stopped accepting new enrollments on December 19, 2022. In November 2024, OPM extended the suspension another 24 months, through at least December 19, 2026. While it’s frozen, no one new can apply, and existing enrollees can’t apply to increase their coverage. The earliest possible reopening is December 2026 — but OPM has not committed to reopening at all.
2. Why it’s suspended
OPM cited “ongoing volatility in long-term care costs and a diminished insurance market.” The long-term care insurance industry has been battered by rising care costs, longer lifespans, and years of low interest rates, making policies extremely hard to price. John Hancock has faced the same pressures across its private book. The result inside FLTCIP was steep premium hikes for existing enrollees — and eventually a decision that the program couldn’t responsibly take on new members at sustainable rates.
3. If you’re already enrolled
The suspension doesn’t change existing coverage: if you’re enrolled, your benefits, eligibility, and claims process continue as long as you pay premiums. You just can’t increase coverage. The real issue for enrollees has been premium spikes — up to 86% in 2024, following earlier rounds up to 126% in 2016. When a hike lands, your options are to accept it, reduce coverage to hold the premium, or leave. Review whether your current plan still fits before the next increase forces a rushed choice.
4. The coverage gap nobody sees
Here’s the misconception that costs families the most. People assume Medicare or FEHB will cover long-term care. They don’t:
- Medicare covers skilled nursing for up to 100 days after a qualifying hospital stay — only the first 20 fully — and pays nothing for ongoing custodial care.
- FEHB covers medical and surgical care. It does not cover custodial long-term care — help with daily activities.
Custodial care — help with bathing, dressing, eating, and getting around — is what most long-term care actually is, and with FLTCIP closed, there’s no federal insurance product to cover it. See the full cost picture in long-term care costs & planning and what Medicare doesn’t cover.
5. Your self-funding gap
With no federal insurance to lean on, estimate what you’d need to cover yourself. Enter a monthly cost of care, how many years you want to plan for, and anything you’ve already earmarked.
The gap
A planning estimate in today’s dollars; actual costs rise with inflation, and average care needs run roughly 2–3 years (some far longer). Medicare/FEHB cover essentially none of custodial care. Not financial advice.
6. Your alternatives now
With the federal program off the table, the practical routes are:
- Private standalone long-term care insurance. Traditional coverage; medically underwritten and pricier at older ages, but purpose-built for care.
- Hybrid / linked-benefit products. Life insurance or an annuity with a long-term care rider — if you never need care, value passes to heirs, which addresses the “use it or lose it” objection.
- Self-funding. Earmark savings or investments specifically for care — the gap number above is your target.
- HSA. If eligible, a health savings account builds tax-advantaged dollars usable for qualified care.
7. Should you wait for it to reopen?
It’s tempting to wait for FLTCIP to return — but OPM hasn’t promised it will, and if it does reopen, expect higher premiums, stricter underwriting, or reduced benefits. Meanwhile, private coverage gets more expensive and harder to qualify for every year you age and every time your health changes. Betting your long-term care plan on a suspended program that may not come back — while your own insurability erodes — is the expensive choice. Build a plan now; adjust if the program returns.
8. What actually triggers coverage
Whatever route you choose, know the standard trigger. Long-term care benefits generally begin when you can’t perform at least 2 of 6 activities of daily living — bathing, dressing, toileting, continence, eating, and transferring — or have a severe cognitive impairment such as Alzheimer’s. Covered settings typically include nursing homes, assisted living, in-home care, and adult day care. Match any policy’s daily or monthly benefit to 60–80% of the cost of care in your area, and plan to cover the rest from savings.
9. Frequently asked questions
Is the FLTCIP still accepting new enrollments in 2026?
No. OPM suspended new enrollments in the Federal Long Term Care Insurance Program on December 19, 2022, and extended the suspension in November 2024 for another 24 months — through at least December 19, 2026. During the suspension, no one new can apply, and current enrollees cannot apply to increase their coverage. OPM cited ongoing volatility in long-term care costs and a diminished insurance market. The earliest the program could reopen is December 2026, but OPM has not committed to a reopening date, and its future is genuinely uncertain.
What happens to my FLTCIP coverage if I'm already enrolled?
If you’re already enrolled, nothing changes because of the suspension. Your coverage, benefit eligibility, and claims process continue as before, as long as you keep paying your premiums. The one restriction is that you cannot apply to increase your coverage during the suspension. Separately, current enrollees have faced significant premium increases in recent years — up to 86% in 2024 — so review whether your plan still fits your budget and needs, since your choices when a hike hits are to accept it, reduce coverage, or leave.
Does Medicare or FEHB cover long-term care?
Essentially no — this is the most common and most costly misconception in federal benefits. Medicare covers skilled nursing care for up to 100 days after a qualifying hospital stay, and only the first 20 days are fully covered; it pays nothing for ongoing custodial care, which is what most long-term care actually is. FEHB covers medical and surgical care but does not cover custodial long-term care — help with daily activities like bathing, dressing, and eating. With FLTCIP closed, federal employees have no federal long-term care insurance option and must plan privately.
What are my long-term care options with FLTCIP closed?
With the federal program suspended, the main routes are private standalone long-term care insurance, hybrid or linked-benefit products that combine life insurance or an annuity with a long-term care rider, self-funding through earmarked savings or investments, and using an HSA (if eligible) to build tax-advantaged funds for care. Private policies are medically underwritten and can be costly, especially at older ages, so the general advice is to evaluate options now rather than wait for FLTCIP to possibly reopen — and even if it does reopen, expect higher premiums and stricter underwriting than before.
Should I wait for FLTCIP to reopen?
Waiting is risky. OPM has not committed to reopening the FLTCIP, and if it does reopen after 2026, the offerings are likely to carry higher premiums, stricter underwriting, or reduced benefits than earlier versions. Meanwhile, long-term care is the single largest uninsured risk in the federal benefits package, and private insurance gets more expensive and harder to qualify for as you age and your health changes. For most people, building a plan now — through private coverage or dedicated savings — beats betting on a program that may not return in a usable form.