Long-term care insurance’s high costs and array of benefit levels and deductible periods are keeping some people from buying it, an examination has found.

Long-term care advocates and public policy makers generally are in favor of promoting LTC insurance because it can be means for pumping more private funding into the reimbursement stream, which would take pressure off of taxpayer supported sources.

Only 10% of U.S. residents aged 65 and older have the insurance, according to The New York Times investigation. Because it often requires a lifetime commitment to one insurer, premiums can increase dramatically if the policyholder switches insurers. Policyholders can also pay premiums for decades without knowing if they will need it.

They can spend more than $10,000 annually on premiums for full coverage. However, more and more specialists are recommending more modest policies, the Times reported.