Research Article

Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates

Volume: 8 Number: 1 December 29, 2025

Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates

Abstract

This study develops and analyzes an agent-based model (ABM) of long-term care insurance (LTCI) demand, focusing on whether “healthy aging” (prolonged well-being and slower functional decline) diminishes overall LTCI coverage and delays insurance purchases. Compared to standard econometric methods, our ABM framework captures heterogeneous agent attributes and boundedly rational behaviors, which includes a calibrated myopia parameter that discounts future care risks. In simulated baseline and healthy-aging scenarios, we find that extended health spans do not significantly reduce final LTCI uptake rates; by the end of a 30-year horizon, coverage converges to roughly 25–26% in both models. Although healthier agents may defer purchasing slightly, this effect is marginal, which indicates that late-life risk perceptions ultimately override earlier confidence in health. Sensitivity analyses substantiate these core findings: premium adjustments induce substantial shifts in LTCI coverage, while variations in public and informal care substitution or myopia exert lesser impacts on final outcomes. Hence, premium affordability emerges as the principal lever for increasing LTCI adoption, whereas moderate modifications to healthy aging or behavioral assumptions do not substantially alter late-life coverage levels. Despite simplifying assumptions—such as exogenous informal care and a single LTCI product—the study underscores the power of ABMs to explore complex “what-if” scenarios and emergent market behaviors. Future extensions might incorporate dynamic insurer policies, more nuanced family interactions, and heterogeneous risk aversion to further enrich the understanding of LTCI uptake in aging societies.

Keywords

References

  1. Akaichi, F., Costa-Font, J., & Frank, R. (2020). Uninsured by choice? A choice experiment on long term care insurance. Journal of Economic Behavior & Organization, 173, 422-434. https://doi.org/10.1016/j.jebo.2019.07.012
  2. Brown, J. R., & Finkelstein, A. (2008). The interaction of public and private insurance: Medicaid and the long-term care insurance market. American Economic Review, 98(3), 1083–1102. https://doi.org/10.1257/aer.98.3.1083
  3. Brown, J. R., & Finkelstein, A. (2004a). Supply or demand: Why is the market for LTC insurance so small? (NBER Working Paper No. 10782). National Bureau of Economic Research. https://doi.org/10.3386/w10782
  4. Brown, J. R., & Finkelstein, A. (2004b). The interaction of public and private insurance: Medicaid and the LTC insurance market (NBER Working Paper No. 10989). National Bureau of Economic Research. https://doi.org/10.3386/w10989
  5. Brown, J. R., Coe, N., & Finkelstein, A. (2007). Medicaid crowd-out of private long-term care insurance demand: Evidence from the Health and Retirement Survey. Tax Policy and the Economy, 21, 1–34. https://doi.org/10.1086/tpe.21.20061913
  6. Brown, J. R., Goda, G., & McGarry, K. (2012). Long-term care insurance demand limited by beliefs about needs, concerns about insurers, and care available from family. Health Affairs, 31(6), 1294–1302. https://doi.org/10.1377/hlthaff.2011.1307
  7. Chhatwal, J., & He, T. (2015). Economic evaluations with agent-based modelling: An introduction. PharmacoEconomics, 33(5), 423–433. https://doi.org/10.1007/s40273-015-0254-2
  8. Coe, N. B., Goda, G. S., & Van Houtven, C. H. (2015). Family spillovers of long-term care insurance (NBER Working Paper No. 21483). National Bureau of Economic Research. https://doi.org/10.3386/w21483

Details

Primary Language

English

Subjects

Microeconomics (Other)

Journal Section

Research Article

Publication Date

December 29, 2025

Submission Date

March 24, 2025

Acceptance Date

August 8, 2025

Published in Issue

Year 2025 Volume: 8 Number: 1

APA
Özbuğday, F. C. (2025). Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates. Journal of Aging and Long-Term Care, 8(1), 37-60. https://doi.org/10.51819/jaltc.2025.1664327
AMA
1.Özbuğday FC. Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates. J Aging Long Term Care. 2025;8(1):37-60. doi:10.51819/jaltc.2025.1664327
Chicago
Özbuğday, Fatih Cemil. 2025. “Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates”. Journal of Aging and Long-Term Care 8 (1): 37-60. https://doi.org/10.51819/jaltc.2025.1664327.
EndNote
Özbuğday FC (December 1, 2025) Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates. Journal of Aging and Long-Term Care 8 1 37–60.
IEEE
[1]F. C. Özbuğday, “Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates”, J Aging Long Term Care, vol. 8, no. 1, pp. 37–60, Dec. 2025, doi: 10.51819/jaltc.2025.1664327.
ISNAD
Özbuğday, Fatih Cemil. “Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates”. Journal of Aging and Long-Term Care 8/1 (December 1, 2025): 37-60. https://doi.org/10.51819/jaltc.2025.1664327.
JAMA
1.Özbuğday FC. Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates. J Aging Long Term Care. 2025;8:37–60.
MLA
Özbuğday, Fatih Cemil. “Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates”. Journal of Aging and Long-Term Care, vol. 8, no. 1, Dec. 2025, pp. 37-60, doi:10.51819/jaltc.2025.1664327.
Vancouver
1.Fatih Cemil Özbuğday. Does Healthier Aging Alter Long-Term Care Insurance Demand? An Agent-Based Model of Coverage Timing and Rates. J Aging Long Term Care. 2025 Dec. 1;8(1):37-60. doi:10.51819/jaltc.2025.1664327

For inquiries regarding JALTC and its publishing process, please contact the JALTC Secretariat at editor-in-chief@jaltc.net

Creative Commons License

This journal operates under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).

The National Association of Social and Applied Gerontology (NASAG) is a leading non-profit organization in Türkiye, dedicated to promoting healthy aging through evidence-based research and policy development. NASAG emphasizes the integration of research, practice, and policy to improve the quality of life in later years.

The NASAG has been a member of the International Association of Gerontology and Geriatrics (IAGG) since 2007.