Journal article: Private insurance for long-term care is underdeveloped in European countries and in the US. This paper tries to understand why the market is underdevelopped by using a theoretical approach and putting the emphasis on insurance demand. It shows that demand for long term care insurance can be low because current and expected health condition of individuals have a strong effect on wealth utility and thus insurance demand. Individual preferences may lead some persons to be uninsured. The underdevelopped market of long-term care insurance might not be only due to insurance supply, market failures, family impacts or institutional design. It is analyzed as a direct consequence of individual preferences.