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Nursing-care Insurance
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| Nursing-care Insurance @The Nursing-care Insurance is the social security program that was established in 2000 in order to reduce the anxiety and burden of nursing, by sharing these burdens amongst everyone in society. All citizens aged 40 and older must enroll in the nursing-care insurance and pay the insurance premiums so that they can receive services when they begin to require nursing care. @This program is managed by the town that collects the nursing-care insurance premiums, certifies the eligibility for nursing care and provides insurance benefit. |
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| Issuing of insurance card @When you reach 65, you will be given an insurance card for the nursing-care insurance. The card is issued in the month in which the day before your 65th birthday falls. @In case of second insured persons aged between 40`64, the insurance card will be issued for people who were given certification of eligibility for nursing care and who requested the issuing of an insurance card. Please click here for details of receiving nursing-care insurance services. |
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| How to pay the insurance premiums @The insurance premiums are the important financial resources for the Nursing-care Insurance. Please make sure to pay the insurance premiums for the time when you may need nursing care and to support the nursing care system. @If you fall behind in your insurance premium payments, you may be required to cover the full expense when you receive nursing care services or the full insurance benefits may be withheld. For those who pay the premium with "Futsu Choshu" (The ordinary collection method: This method usually applies to those who pay the insurance premium with the statement of payment), we recommend an account transfer payment. @Please note that the payment method and premiums are different between the first and second insured First insured person @The first insured persons aged 65 or older pay the premium in either "Tokubetsu Choshu" (The special collection method: This method usually applies to company employees, the insurance premium is withheld from their salary.) or "Futsu Choshu" The insurance premium will be calculated based on the municipal nursing care services provision level and the number of the elderly residents. To minimize the financial burden of each insured person, the premiums are categorized into five levels according to income.
How to calculate the insurance premiums
Second insured person @Those who are 40 to 64 years of age pay the Nursing-care Insurance premium in addition to their health insurance premium. If you are under the health insurance program at your workplace, the premiums are deducted from your salary.
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| Reduction and exemption of insurance premiums @When you are experiencing difficulty in paying the premiums temporarily due to natural disasters etc, you may be granted reduction and exemption, or a postponement of the insurance premium payment. |
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How to receive the nursing-care
insurance services
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| People who are eligible for the nursing care services
@People who are certified that they require nursing care or support can receive the services. The following are those eligible; (1) People aged 65 and older (First insured person) Regardless of the reason, when they are certified that they require nursing care or support for daily life, they become eligible for the nursing care insurance services. (2) People aged 40 and older, but younger than 65 (Second insured person) When they are certified that they require nursing care or support for daily life due to diseases that are believed to be caused by the process of aging (specified diseases), they become eligible for the services. @Diseases that are believed to be caused by the process of aging @(1)Amyotrophic lateral sclerosis @(2)Ossification of posterior longitudinal ligament @(3)Osteoporosis with a fracture @(4)Shy-Drager syndrome @(5)Dementia rheumatism at the early stage of aging process @(6)Spinocerebellar degeneration @(7)Osteoarthritis with significant deform to the spinal canal stenosis @(8)Progeria syndrome @(9)Diabetic neuropathy, Diabetic nephropathy and Diabetic retinopathy @(10)Cerebrovascular disease @(11)Parkinson's disease @(12)Arteriosclerosis obliterans @(13)Chronic arthritis @(14)Chronic obstructive pulmonary disease @(15)Arthritis in both knees, or coxitis |
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| How to apply @When you start noticing that you require nursing-care insurance services, please apply for a certification of eligibility for nursing care at the subsection of nursing-care insurance at the town hall or the home care support center. @At the time of application, you will be asked if you have a family doctor. If you do, please make sure that you have the correct name of their medical institution, address and phone number. If you do not have a family doctor, we will recommend you to a doctor.
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| Certification of eligibility for nursing care @After your application is submitted, the extent of your nursing care requirements will be assessed. This is called a certification of eligibility for nursing care. To make a fair and correct judgment, you will be visited at home for a medical examination. In this examination, your mental and physical health will be checked against 79 items including such things as standing up, walking and dementia, through the use of questions. The examination results will be inputted into a computer system for the initial assessment results and be submitted to the nursing care eligibility certification committee with a report from the applicant's family doctor. @The nursing care eligibility certification committee will then evaluate in a comprehensive manner as to the extent of nursing care requirements of the applicant based on the initial assessment results (from the home visit medical examination) and their family doctor's report. Then the results will be given in the categories of "Support required", "Nursing care required 1`5" and "Not eligible (independent)" according to the degree of nursing care requirements. List of nursing care requirement level
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| Notification of the certification results @You will receive a notification of your certification results from the town, which is based on the evaluation by the nursing care eligibility certification committee. The notification should arrive generally within 30 days after your application is submitted. @Once you receive this notification, please check "Nursing care requirement conditions category" and "The expiration date for certification" etc. on the notification. @If you are certified that you fall under either the "Support required" or "Nursing care required" categories, you are eligible for the nursing care insurance services. If you are assessed as "Not eligible (independent)", you are not eligible for the nursing-care insurance services, but you are able to receive health and welfare services for the elderly that are provided by the town. |
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| If you are dissatisfied with your certification results @If you are dissatisfied with your certification results, you may request an examination to the "Nursing-care insurance committee" which is located in Nagano @@Prefecture within 60 days after your receive the notification. @Please enquire to the subsection of nursing care insurance first. |
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| Renewing the certification of eligibility for nursing
care @The expiration date of the certification of eligibility for nursing care is generally six months. If you wish to continue to receive the nursing-care insurance services, application is accepted from 60 days before the expiration date. @You will receive an "Application form for renewing the certification of eligibility for nursing care and support" from the town when it is time for renewal. Please submit an application promptly if you require renewal. |
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| Selecting services @The nursing-care insurance services offer "Home care services" which are provided mainly at your home, and "Facility care services" that are provided for those who stay at a facility. @You can choose which service you wish to receive yourself or upon discussion with your family. However, please be informed that, depending on the degree of your nursing care requirements, the service you are able to receive and the monthly service fees vary. The larger the extent of your nursing care requirements is, the higher the service fees are. |
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| Home care services You are able to choose from the following services that are mainly for home care. Home care service list
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| Facility care services There are three types of facilities, and you can select a facility based on the purpose and requirements, for example, if you require nursing care services in the areas of daily life most or if you require medical treatment. Facility care service list
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| Care plan @After you decide to choose either home care services or facility care services, the next step is to make a plan to maximize the benefits from receiving services that are best suited to your needs. This is called care plan (nursing care service planning). If you choose home care services, although you can make a plan yourself, we recommend that you request your care manager with special knowledge to make a plan for you. If you choose facility care services, your care plan will be made by the facility. @After you make a request to a nursing care support organization with your nursing care insurance card, a care manager who is commissioned will make a care plan that includes types and frequency of services according to your needs or your family's. Based on this care plan, services will be provided by the nursing care insurance service providers. |
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| Care manager @Care managers are specialists who support the entire nursing insurance services. They play a very important role for people who receive nursing care insurance services. |
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| Service fees @The maximum allowable limit of service fees per month is set out for those who are under "Support required" and "Nursing care required 1`5". When you receive services within the maximum allowable limit, you cover only 10% of the expenses yourself. When you receive services beyond the maximum allowable limit, you are required to cover the full portion above the limit. @In case of facility care services, the total of (1) 10% of the service fees (2) Average co-payment for meals (3) Daily life expenses such as hair cuts etc, must be covered by the service recipients. The maximum allowable limit and co-payment for home care service fees
Cost for house renovation: up to 200,000 per house The maximum allowable limit and co-payment for facility care service fees
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| When the co-payment exceed the maximum limit When the 10% co-payment exceeds the certain amount (maximum limit), the amount exceeding the maximum limit will be reimbursed. This is called the nursing care service fees over the maximum limit. Additionally, the monthly maximum limit may be lowered depending on income in order to reduce financial strain.
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| Home care support center @Home care support center liaises and coordinates with various institutions so that people who are engaging in the nursing of elderly people are able to receive general consultations regarding home care nursing, and that the elderly can access the various health and welfare services comprehensively according to their needs. |
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