How AI Search Is Recommending Long-Term Care Insurance: Monthly Trends

Executive Summary

New York Life now leads AI recommendation coverage in Long-Term Care Insurance, holding steady at a 72.7% valid recommendation coverage rate in September 2026, with Mutual of Omaha close behind at 70.4%, a gap of 2.3 points. This marks a shift from August 2026 when Mutual of Omaha led with 79.6% coverage against New York Life's 73.5%. The category saw significant movement this month, with the gap between leader and second place narrowing considerably.

Transamerica emerged as the strongest upward mover, rising 14.5 points from 3.1% coverage in August 2026 to 17.6% in September 2026. This significant rise was driven by a 20.0-point increase in raw mention presence (from 4.1% to 24.1%) and a 6.8-point increase in top-three recommendation rate (from 2.0% to 8.8%). Transamerica gained its first rank-one recommendation in September 2026, appearing first in 2 valid recommendations out of 216 observations.

The sharpest declines came from Nationwide and National Guardian Life. Nationwide fell 20.4 points from 75.5% to 55.1% coverage, while National Guardian Life dropped 16.3 points from 31.6% to 15.3%. Mutual of Omaha also declined 9.2 points (79.6% to 70.4%), though this movement was not classified as significant. The overall month was mixed, with significant risers and decliners reshaping the competitive landscape.

Each monthly run begins with 800 prompt-surface observations (533 unique questions in August 2026; 531 in September 2026) across the benchmark's defined AI/search surface universe. Of those, 800 mentioned a tracked brand or competitor; 141 were relevant and 659 were irrelevant in August 2026, while 268 were relevant and 532 were irrelevant in September 2026. The public metrics use the 98 (August 2026) and 216 (September 2026) observations that survive both qualification stages.

Key Findings

Benchmark Context

The report separates the raw collection universe from the qualified analysis set. Brand-level recommendation percentages are calculated within the qualified benchmark set.

The qualified observation pool grew from 98 in August 2026 to 216 in September 2026, more than doubling the analysis set. This expansion provides a broader evidence base for the September 2026 findings.

Benchmark-Level Metrics

AI Recommendation Trend

A Competitive Shift at the Top of Long-Term Care Insurance Recommendations

The September 2026 benchmark shows a reordered leadership structure. New York Life took the top position with 72.7% coverage, while Mutual of Omaha, the August 2026 leader at 79.6%, settled into second at 70.4%. Transamerica's significant rise and Nationwide's significant decline represent the largest competitive repositioning in the tracked set.

The category-level change in September 2026 came from a combination of significant individual movements and several smaller shifts. Transamerica's 14.5-point rise and Nationwide's and National Guardian Life's declines of 20.4 and 16.3 points respectively exceeded normal month-to-month variation, while most other brands moved within expected ranges.

What Changed This Month

New York Life: Assumed the Leadership Position

New York Life's valid recommendation coverage held effectively flat, moving from 73.5% in August 2026 to 72.7% in September 2026, a decline of 0.8 points that was within normal variation. This stability, combined with Mutual of Omaha's larger decline, elevated New York Life to the category lead in September 2026.

Presence remained strong: New York Life appeared in 87.5% of September 2026 observations (189 of 216), down slightly from 88.8% in August 2026 (87 of 98). The brand held 10 rank-one recommendations in September 2026, up from 4 in August 2026, and its top-three rate settled at 44.0% (95 of 216 observations), down 2.9 points from 46.9%.

New York Life maintains high positive sentiment at 0.9 net sentiment score, with 175 positive mentions and zero negative mentions in September 2026. The distinction to notice: New York Life's coverage stayed consistent even as the observation pool more than doubled, suggesting broad-based rather than narrow recommendation strength.

Highest-priority diagnostic: Which prompt categories drive New York Life's rank-one placements, and how do those compare with the prompts where Mutual of Omaha retains the top slot?

Transamerica: Significant Rise from a Low Base

Transamerica emerged as the largest riser, climbing 14.5 points from 3.1% valid recommendation coverage in August 2026 to 17.6% in September 2026, a significant increase. This movement came alongside a 20.0-point rise in raw mention presence from 4.1% to 24.1%.

In absolute terms, Transamerica moved from 3 valid recommendations in August 2026 (out of 98 observations) to 38 valid recommendations in September 2026 (out of 216 observations). Top-three appearances rose from 2 to 19, and the brand earned 2 rank-one recommendations in September 2026, up from zero. Its average recommended rank improved from 3.33 to 3.04.

The important distinction: Transamerica's rise in coverage is real but began from a very low August 2026 base. The brand's presence rate of 24.1% remains well below the leaders, meaning over three-quarters of observations still do not mention Transamerica at all.

Highest-priority diagnostic: Which specific prompts and surfaces drove Transamerica's 38 valid recommendations, and are these concentrated in particular question types that could indicate a durable shift or a one-off pattern?

Nationwide: Significant Decline in Coverage

Nationwide experienced the sharpest decline, falling 20.4 points from 75.5% valid recommendation coverage in August 2026 to 55.1% in September 2026, a significant drop. Raw mention presence also fell significantly, down 24.6 points from 90.8% to 66.2%.

In absolute terms, Nationwide earned 119 valid recommendations in September 2026 out of 216 observations, compared with 74 out of 98 in August 2026. The top-three rate fell 35.4 points from 67.3% to 31.9%, though rank-one recommendations actually increased from 4 to 10 (4.1% to 4.6%).

Despite the coverage decline, Nationwide's net sentiment score held at 0.9 with 132 positive mentions and zero negative mentions. The distinction to notice: Nationwide remains highly visible and well-regarded when mentioned, but AI systems are recommending it less frequently as a top choice in September 2026.

Highest-priority diagnostic: Which competitor is appearing in the recommendation slots Nationwide vacated, and what evidence sources are associated with those replacement recommendations?

National Guardian Life: Significant Decline

National Guardian Life fell 16.3 points from 31.6% valid recommendation coverage in August 2026 to 15.3% in September 2026, a significant drop. Raw mention presence declined 19.5 points from 35.7% to 16.2%.

The brand earned 33 valid recommendations in September 2026 out of 216 observations, compared with 31 out of 98 in August 2026. Top-three placements fell from 10 to 5, and the brand gained 2 rank-one recommendations in September 2026, up from zero. Its average recommended rank held about the same, at 4.15 compared with 4.16 in August 2026.

National Guardian Life's positive sentiment remained high at 0.9 net sentiment score, with 33 positive mentions and zero negative mentions. The small-count caveat applies: while the percentage decline is steep, the absolute movement represents a shift from 31 to 33 valid recommendations over a much larger observation pool.

Highest-priority diagnostic: Which surfaces previously recommended National Guardian Life at higher rates, and what changed in those surfaces' September 2026 responses?

Mutual of Omaha: Narrowing Lead to Second Place

Mutual of Omaha declined 9.2 points from 79.6% valid recommendation coverage in August 2026 to 70.4% in September 2026, moving from category leader to second place. While the coverage change was not classified as significant, the supporting metrics showed significant movement: raw mention presence fell 17.1 points from 99.0% to 81.9%, and top-three rate fell 31.2 points from 77.5% to 46.3%.

Mutual of Omaha still holds the strongest rank-one position at 29.2% (63 of 216 observations), down from 56.1% (55 of 98) in August 2026. The brand appeared first in 63 September 2026 observations, far ahead of New York Life's and Nationwide's 10 each.

The distinction: Mutual of Omaha remains the most frequent first-choice recommendation in the category, even as its overall coverage and top-three rates declined. The brand's average recommended rank of 2.31 is still the best in the tracked set.

Highest-priority diagnostic: Where did Mutual of Omaha lose top-three placements, and did those losses concentrate in specific prompt types where other brands gained ground?

Buyer-Intent Interpretation

All 216 qualified observations in September 2026 (and all 98 in August 2026) fell into the Brand Recommendation cluster, which captures discovery and consideration intent. No qualified observations were recorded for Pricing & Value or Multi-Brand Comparison clusters in either month.

The public benchmark therefore speaks clearly to which carriers AI systems recommend when buyers ask directly for a provider. It does not yet answer how AI systems weigh price, value, or cost considerations, nor how carriers are positioned in head-to-head comparisons, because the qualified set contains no observations in those categories. The 25 comparison-analysis and 3 pricing-analysis responses collected in September 2026 were not validated into the qualified benchmark set.

Brand Opportunity Summary

The benchmark identifies where attention is warranted; a company-level analysis is needed to explain why.

Evidence Behind the Benchmark

The aggregate metrics are built from prompt-level observations (query, surface, recommendation outcome, rank, sentiment, and citations where exposed). Company-level analysis can go deeper into prompt, competitor, surface, and evidence patterns. Source presence is not automatically treated as proof of causation.

About This Benchmark

This report is part of the CiteWorks Studio AI Market Discovery research program.

• AI Industry Market Discovery Methodology
• AI Industry Market Discovery Metrics
• AI Industry Market Discovery Standards

Report-Specific Interpretation Notes

• Expanded observation pool: The qualified benchmark set grew from 98 to 216 observations between August and September 2026. Percentage movements should be read against this larger denominator.
• Small-count movements: Some brand movements (for example, Genworth rising from 1 to 3 valid recommendations) represent changes of only a few observations and are directional rather than definitive.
• Qualified denominator vs raw collection: All brand-level percentages use the qualified benchmark set (98 observations in August 2026; 216 in September 2026), which is a subset of the 800 prompt-surface observations collected each month.
• Directional analysis: Month-over-month movement identifies changes worth investigating; it does not by itself establish the cause of those changes.
• Presence vs coverage: A brand can be present in AI responses without being recommended. Coverage measures valid recommendations specifically, not mere mentions.

Next Step

The Public Benchmark Shows Where a Brand Is Winning or Losing. A Company-Level Audit Shows Why.

The aggregate percentages in this report raise questions that the benchmark alone cannot answer: Which high-intent prompts is each carrier actually winning? When a brand loses a recommendation, which competitor takes its place? What attributes do AI systems associate with each option, and which external sources are shaping those answers?

A company-specific AI visibility audit maps those prompt, surface, competitor, ranking, sentiment, and evidence-source patterns into a prioritized visibility strategy. Rather than reacting to percentage movements, an audit identifies the underlying drivers and the specific opportunities to improve recommendation outcomes.

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