by Category I, 29% by Category II) and 50% by public expenditure (for in-home services 25% by national
treasury, 12.5% by prefectures, and 12.5% by municipalities, and for facility services 20% by national
treasury, 17.5% by prefecture and 12.5% by municipalities). Within this framework the municipality can
determine the rate of premium for the insured of Category I. The premium for Category I is charged based
on total income of the insured, and reviewed once every three years. It was around ¥2,900 per month on
average in 2000-2002 then the amount increased to ¥4,972 in FY2012-2014. For the Category II insured
the rate will be 1.55% of salary and annual bonus in case of the Japan Health Insurance Association.
As a fiscal support for municipalities, prefectures set up the Fiscal Stability Foundation (financed from
national treasury, prefecture and municipality) to give a temporary loan or grant when insurance budget
deficit occurs because of more-than-expected service increase and unpaid premiums.
Figure 5.1 The overview of the Long-Term Care Insurance
5.2.6 Assessment of the care-needs
The users are classified into seven categories (“Support Level 1 and 2” and “Care Level 1 to 5”),
depending on the severity of the care need. The limit of services provided is determined according to these
categories. The user must be assessed by the municipality into one of the categories before applying for the
services. For example, when a person faces a condition requiring support or care, the person or a family
member must first submit an application for a long-term care requirement certification to the municipal
office. Upon receipt of this application, a municipal investigator visits the applicant’s home for an interview
on the physical/mental state, and aspects of daily life. The interview results are analyzed based on computer
system so as to generate a preliminary assessment.
This assessment and opinion letter of the primary physician are then reviewed by the Certification
Committee of Long-Term Care Needs, comprised of health, medical, and welfare experts. This Committee
conducts a secondary assessment and decides the required care/support level. The municipality notifies the