Long-Term Care Insurance

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What is the Long-Term Care Insurance?

The Long-Term Care Insurance System involves the whole of society and is run by the social insurance system to ensure long-term care for elderly. According to their needs people or families needing long term care are able to choose from medical and welfare services. The City of Nagoya will administer the system as insurer.

Who is enrolled in this insurance program?

All aged 65 and over (Category 1 insured ) and those between the ages of 40 and 64 (Category 2 insured ) who are enrolled in a public medical insurance program.

This is a compulsory insurance program. Therefore every insured person has to be enrolled in it. Thinking that it is not necessary for you to enroll or thinking that the premiums are too expensive are not acceptable reasons for not enrolling in the Long-Term Insurance program. Please understand that the purpose of this insurance program is to support each other from now into the future, so we ask for everyone concerned to join it.

Do foreigners living in Japan have to be enrolled in this program?

Foreigners residing in Nagoya City must enroll if the following applies to them:

  • If they are registered as foreign residents with the Nagoya Municipal Government.
  • If they have a valid visa permitting them to stay for 1 year or more starting from their date of entry into the country. (Diplomatic personnel and other people holding official visas are exempt)
  • If they are over 40 years old. (However, those over 40 and under 65 must be enrolled in one of Japan’s public medical insurance programs in order to enroll  in the system)

When to apply: For those people who have been enrolled in one of the national health insurance programs, they will automatically be enrolled in Long-Term Care Insurance once they reach the age of 65. For new enrollees, those people who are 65 years old should apply for this insurance (within 14 days of completing alien registration procedures) at the Nursing Care and Welfare Division (Kaigo Fukushi-ka) at  your local municipal office or its branch office.

Premium: The premium for people 65 years and older is determined by the individual’s income and the amount of residential tax paid by their household. The premium for people over 40 and under 65 years old is determined by the computation rules of their medical insurance program and is deducted from their monthly salary or must be paid at a bank or post office with the payment notice from the local municipal office.

Who can use the Long-Term Care System?

  • Category 1 insured people who need continuous assistance with everyday activities due to being bedridden or suffering from dementia and/or similar circumstances.
  • Category 2 insured people who need nursing care or support because you suffer from any of the 15 diseases specified by the Long-Term Care Insurance Law.

How to receive assistance

  • Category 1 insured people will have an insurance card delivered to them on their 65th birthday.
  • Category 2 insured people will be handed an insurance card when applying for long-term care approval.

Applications for use of the care services have to be submitted for screening. The process includes a medical examination and an interview. Successful applicants are categorized into 6 levels, set according to the applicant’s needs; Pre Care Level (yoshien), then Care levels 1 to 5, with level 1 being for those with minor care needs through to level 5 for those whose needs are more severe. Those individuals who do not meet required conditions are thus considered to be able to support themselves; in this case approval is not given and such individuals may not receive care.

Cost of service

  • 10% of the cost of services provided must be paid by the user.
  • In the case of residence at a facility, recipients must pay a standard charge to cover food costs.
  • 90% of the total cost of welfare-instruments ( i.e. Wheelchairs etc) or home renovation expenses will be refunded afterwards.

Limited Payment System

A limit on service costs (10 % of the real cost) will be fixed to lessen the burden on the user. Payments shall not exceed 37,200 yen per month, however expenses incurred to purchase welfare devices or a home-reform cost, and meals at facilities are excluded. For people with low income that are receiving welfare or old age pensions have a lower upper limit and the cost of facility meals is reduced.

Services available: You can either select Facility-based care services or Home-based care services; additionally there are “other services”. In this case, the user must pay the full fee for “other services” in cash. (For example, in the case payment exceeds 100,000 yen, the user may receive 90,000 yen back. Or in the case payment exceeds 200,000 yen, the user may receive 180,000 yen back.) According to the care level appointed to an individual, that individual must pay 10% of the cost of services provided.

How much are Premiums for Category 1 insured (65 years and older)?

Premiums are divided into 5 levels as follows. The premium depends on your income bracket or that of your household. The standard annual premium of Nagoya city from 2000 to 2002 was 34,507 Yen).

Levels Discounted Premium Standard Premium Higher Premium
Level 1 Level 2 Level 3 Level 4 Level 5
Person concerned People receiving welfare benefits or old age  pension.  (household is exempt from residential tax) All members of the household are exempt from residential tax Individuals who are exempt from residential tax People who are subject to residential tax, with a total income of less than 2.5 million yen People who are subject to residential tax, with a total income of 2.5 million or more yen


Standard Premium


17,254 yen

Standard Premium


25,881 yen

Standard Premium

34,507 yen

Standard Premium


43,134 yen

Standard Premium


51,761 yen

How are premiums for Category 1 insured (65 years and olderpaid?

In principal premiums for 65 years and older are automatically deducted from the basic old-age pension.

Range Person concerned Payment Method Period of payment
Special Charge Those who receive a monthly basic old-age pension of more than 15,000 yen. Automatic deduction from their pension. April, June, August, October, December, February (every second  month)
Normal Charge Those receiving a pension of less than 15,000 yen Bank transfer (or automatic bank transfer) or payment at Post Office or your local Ward Office. Every month from April to March

How are premiums for Category 2 (40~64 years old) calculated?

The premiums will be paid in lump sums as part of the Medical Insurance premium payments.

Medical Insurance Portion + Care Insurance Portion = Your Medical Insurance Premium

The guidelines for calculating the premiums, and standards for premium rates, will vary depending on the kind of medical insurance you have.

If you are insured by Japanese national health insurance plan;

  • Pay premiums to the city as part of your national health insurance premium.
  • The premium will depend on your income and other factors.
  • The head of the household will pay the premiums of the other members of the household.
  • The national government will pay the amount equal to your premium.

If you are insured by another health insurance plan or mutual aid association;

  • The premium is automatically deducted from your salary as part of the monthly medical insurance premium.
  • The premium will depend on your salary.
  • The premiums of dependents are shared by all those insured.
  • Your employer will pay the amount equal to  your premium.

What is the Exemption System?

If you have some difficulties paying your premiums due to being involved in a disaster or the householder is hospitalized for a long time, you can use the premium Exemption System.  Please contact the Long-Term Care Insurance section of your Ward Office.

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