Long-term care insurance is a public system administered by municipalities, and people over the age of 40 are mandated to be members to enable the system to provide services to eligible people. The Coca-Cola Bottlers Japan Health Insurance Association deputizes the collection of long-term care insurance premiums for long-term care insurance for secondary insured persons to the members of the Health Insurance Association.
People over the age of 40 become insured by long-term care insurance, and are divided by age, etc., as below. There are no schemes that correspond to “dependent” in health insurance, and all members become insured.
* There may be cases where those who are aged over 40 are exempted from long-term care insurance.
|Person aged 65 or over||Primary insured person|
|Medical insurance scheme member aged 40 to 64
(insured person, dependent)
|Secondary insured person|
When you use a long-term care service, you will have to copay 10% (20% or 30% for those with high income) of the cost involved according to the co-payment ability of the person who receives the service. Your co-payment percentage is stated on the “long-term care insurance co-payment percentage certificate” issued to the certified person who requires assistance or nursing care.
|Co-payment percentage||Income level|
|20%||①Total income amount of the insured person is over 1.6 million yen, and
②The “pension income + other total income amount” of the primary insured person belonging to the same household is over 2.8 million yen for a single-person household and over 3.46 million yen for a household with more than two people.
(From August 2018)
|①Total income amount of the insured person is over 2.2 million yen, and
②The “pension income + other total income amount” of the primary insured person belonging to the same household is over 3.4 million yen for a single-person household and over 4.63 million yen for a household with more than two people.
Amount and collection method of long-term care insurance are decided by the category of insured person as below.
|Collection method||Collected by municipalities. Collected directly from pensions of people receiving pension of more than 15,000 yen per month. Collected individually from people receiving less than 15,000 yen per month.|
|Calculation method||The insurance premiums will be calculated by multiplying the standard amount established by the municipality ordinances by the graded insurance premium rate in accordance with income.|
|Calculation method||Calculated by multiplying Standard monthly remuneration amount and standard bonus amount by long-term care insurance premium rate (varies by health insurance association).|
In long-term care insurance business services, there are “home-care services,” “in-facility services,” and “community-based services”, as below.
Only people judged as being in need of such care can use these services.
* Residents newly admitted to a home for elderly persons requiring special care are limited in principle to the elderly persons requiring nursing care level 3 or more.
This is a framework to provide diverse and flexible services in order for people requiring nursing care to continue their lives in a familiar environment. These business services are administered by municipalities, and residents can in principle receive these services in their municipality.
Secondary insured persons aged 40 to 64 are able to receive long-term care service under long-term care insurance only if they fall into a “special disease” category listed below. Primary insured persons of age 65 or over are not asked whether they suffer from a “special disease” or not.
Community support business services are provided by municipalities to people that may require support or long-term care, and the “Community General Support Center” plays a large role in providing these services.
The Community General Support Center is a core institution that focuses on maintaining life functions of the elderly persons in the community, improving health, welfare and medical care, and providing aid and support necessary for the stability of life, and it provides consultation on the consistent adjustment of services.
Home-visit care and preventive day-care of elderly persons requiring support are going to be transferred to community support business service within fiscal year 2017.