Long-Term Care Insurance in Japan: How It Works [2026]

Long-term care insurance lets you receive care services with a small co-payment when you need care. You join at age 40 and pay premiums. Foreign residents are covered too if registered. This guide covers how it works, premiums, certification and services.

① Who is insured

• Category 1: everyone aged 65+
• Category 2: ages 40–64 enrolled in public health insurance

Foreign residents who are registered and aged 40+ also join and pay premiums (no procedure needed).

② How premiums are paid

• Category 1 (65+): in principle deducted from pension; income-tiered premiums set by your municipality
• Category 2 (40–64): added to your health-insurance premium (deducted from salary and split with the employer for employees; added to NHI for others)

③ When you can use services

• Category 1: can use services if certified as needing care/support, regardless of cause
• Category 2: only when care is needed due to one of 16 "specified diseases" (e.g. terminal cancer, early-onset dementia, rheumatoid arthritis)

④ The care-certification process

1. Apply at your municipal office (by yourself, family or a community support center)
2. Home assessment + a doctor's opinion
3. Review → certified as Support Level 1–2 / Care Level 1–5
4. A care manager makes a care plan and services begin

⑤ Services and co-payment

• Home care (home help, day service), facilities (special nursing homes), community-based services, etc.
• The co-payment is 10% in principle; 20% or 30% for higher incomes
• If costs are high, high-cost care benefit refunds the amount over a ceiling

If you are interested in working in nursing care, or considering a career change into care work, you can also use a job-change service specializing in nursing care and welfare to look for positions.

This site (Zainichi Life Navi) does not provide job placement or recruitment matching. The link below takes you to "Kaigo JJ," a job-change site specializing in nursing-care and welfare, where registration, job introductions, and career support are provided.

💼 Want to use your qualifications and experience to find a care-work job? PR

Search for nursing-care and welfare jobs that match your qualifications, experience, preferred location and way of working. Consultations and support are conducted mainly in Japanese. Check whether each workplace meets your residence-status requirements as you go. Available jobs vary by qualification, area and timing.

Find nursing-care jobs (Kaigo JJ) →

FAQ

Do foreign residents join long-term care insurance?Yes — if registered and aged 40+, you join and pay premiums. 65+ is Category 1, 40–64 is Category 2.

Can people aged 40–64 use care services?Only when care is needed due to one of 16 'specified diseases' such as terminal cancer or early-onset dementia.

How much is the co-payment?10% in principle, or 20%/30% depending on income. A high-cost care benefit refunds amounts over a ceiling.

Where do I apply?At your municipality's long-term care section or your local community comprehensive support center.

For the four routes for foreigners to work in nursing care, including the "Kaigo" residence status, see foreign worker nursing-care guide. Long-term care insurance premiums for employees are collected through social insurance.