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| How
to use the long-term care insurance services |
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Insured persons wishing to use the long-term care insurance
system need to file an application (or have a family member
fill out an application) with the relevant municipality
(meaning city, town, village or ward section of Tokyo).
The application requires a long-term care insurance card
(category 2 insured persons who have not yet received the
long-term care insurance card may use their health insurance
cards for purposes of the application).
 Long-term care insurance
card
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Category 1 insured
persons
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Category 2 insured
persons
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The long-term care insurance card will be sent from the
concerned municipality in their places of residence when
they reach 65 years of age.
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The long-term care insurance card will be delivered when
they apply for a health insurance card or when their need
for long-term care is authorized.
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2. Pre-authorization
examination |
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Specialized examiners visit homes to study and make note of
physical conditions, mental states, and degrees of daily self-reliance.
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3. Written
opinions of doctors in charge |
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Family doctors are contacted for opinions. Doctors designated
by municipalities will provide diagnoses in the absence of family
doctors.
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4. Examination
and judgment |
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Computers are used for primary judgment. Then, the "long-term
care approval board" determines the level of long-term care
requirement comprehensively, based on the primary judgment and
on doctors' opinions. This committee in charge of secondary judgment
is comprised of health, medical, and welfare experts.
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5. Notification
of judgment |
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Based on examination and judgment results, patients are grouped by need into one of seven categories: 1 or 2 in the category of those requiring daily living support or 1 through 5 in the category of those requiring long-term care.
Individuals will be notified of the results of this categorization through its appearance on their long-term care insurance certificates (in principle, within 30 days).
* Although persons determined not to be applicable(self-reliance requirements) cannot receive long-term care insurance benefits, elderly persons with a high likelihood of requiring long-term care or assistance can use long-term care preventive services provided by municipalities. |
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6. Drawing
up the care plan |
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Insured persons must ask care managers to prepare care plans
in the event they are judged as needing long-term care.
In municipalities providing new preventive-care benefits, in principle
healthcare specialists such as public health nurses at comprehensive
regional assistance centers will prepare long-term care preventive plans
for individuals categorized as persons needing assistance 1 - 2.
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7. Care
plan finalization |
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Care managers finalize care plans by consulting insured persons
and their family members to determine what kind of services shall
be provided by whom on what schedule.
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Insured persons in need of long-term care begin
receiving service according to care plans.
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