It's a product many consumers don't even want to think about, and who can blame them? Long-term-care insurance isn't exactly designed for the best of times: Payments kick in to cover nursing home and other costs if the policyholder can no longer live independently. Buying it means thinking about things like growing old and losing control over your mind, your body or both. It can also be expensive: an average premium of $2,100 a year for the 7 million policies now in force.

If that's not unsettling enough, recent developments make the market for long-term-care insurance more confusing. Although many financial advisers consider the product an important tool as retirement approaches, a profit crunch is leading to some big changes. Several providers are seeking rate increases of as much as 44 percent, and MetLife says it will stop selling policies altogether. Some insurers are stepping in with offerings to help fill the void, but they are far different from standard long-term-care policies. "Long-term care is definitely not going away," says Bret Howlett, an insurance industry analyst at Standard & Poor's, "but the industry is rapidly evolving."

Experts say the industry's latest solution has some appeal, thanks to help from Uncle Sam. Under changes that took effect last year, consumers can now tap the death benefit of their whole or universal life insurance or the balance in an annuity to cover long-term-care expenses tax-free. The result is a new emphasis on so-called combo products, or life-insurance policies or annuities that double as vehicles to cover nursing home and home-care expenses. Limra, an industry-funded research firm, says the policies appeal to consumers who don't like the idea of paying for traditional long-term-care insurance they might never need. Another plus: Money not withdrawn from the accounts still passes on to the policyholder's heirs.

Of course, not everyone has or wants a whole life policy or an annuity. And the new options come at a price. The Hartford's LifeAccess Rider, a life-insurance rider that lets consumers pay even family members for offering care, can add as much as 15 percent a year to life-insurance premiums. Robert Pokorski, the insurer's chief medical strategist, says most customers pay about 10 percent more. "It's affordable for middle-income folks," he says.

Scott Witt, a consumer insurance adviser in New Berlin, Wis., says riders don't provide the same peace of mind as a standard long-term-care policy, mostly because riders usually have a limit on what they can pay out. Wind up in a nursing home and a $500,000 annuity can be exhausted in just a few years. Some advisers get around that by purchasing yet another rider that shifts a consumer to a standard long-term-care policy if they exhaust their annuity balance. Still, Witt isn't recommending any combo products to his clients just yet. "The jury is still out" on whether they will be a good deal, he says.