Nursing Care Insurance System

The Nursing care Insurance system (KAIGO HOKEN) is a public insurance system, implemented in 2000. This is to secure nursing care for the elders and the disableds. This is a different system from the public health insurance system. But, it is closely connected to it. Actually, it is not easy nor proper to seperate medical services from nursing care services.

The enrollment in this insurance plan is mandatory. People at the age of 40 and over are supposed to join it.

The main benefit of this system is to provide nursing care expenses in case his/her physical/mental conditions get bad and he/she obtains the qualification. The qualification is classified into 7 grades according to the conditions. I sometimes hear the screening of the qualification is getting more strict. If this change is caused by an intention to decrease the financial burden of the public insurance sysytem, it sounds horrible.

〔In Japanese〕

介護保険制度は、2000年に導入された公的保険制度で、老年者や障碍者の介護サービスを確保するためのものです。 これは、健康保険制度とは別個のものですが、健康保険制度と密接な結びつきがあります。 実際のところ、介護サービスと医療行為とを厳格に切り分け区別するということは、難しく、また、適切でもないのです。


主な保険給付は、加入者が体調を崩し、所定の認定を受けた際に介護費用を給付することです。この認定は、その者の状態に応じて7段階に区分されています。 近年、この介護認定が厳格化されていると噂されることがあります。それが介護保険制度の財政負担圧縮のために行われているとすると、恐ろしいことです。

Insurance Premiums

One of the major characteristic of this plan is to classify its insureds into following 2 types by the age;

  1. TYPE 1 Insured (age at 65 and over)
  2. TYPE 2 Insured (age from 40 through 64)

(1) Premiums for TYPE 1 Insureds

The Insurance premiums of the Nursing Care Insurance system on TYPE 1 insureds are calculated and notified by a local body, which is responsible for the operation of this system. You shall receive the notice in every April.

The premiums shall be paid by yourself with the payment slips. You are supposed to pay them in 10 installments at the end of the each month from June through next March. You can pay it by the automatic transfer from your bank account. If you receive public pensions which amount to 180 thousands yen or more per year, the premiums are deducted from your public pensions under the Special Collection method.

(2) Premiums for TYPE 2 Insureds

For the TYPE 2 Insured, the Nursing care Insurane plan may look as if it is an accessory to the public health insurance plan. The premiums are collected together with the premiums of the public health insurance plan in a lump sum.

If you are coverd by the Social Health Insurance plan through the Tokyo branch of Japan Health Insurance Association, the premium rate is 1.79%. It is collected together with the 9.87% of the Social health insurance premiums. A half of the both is borne by the employer. As for the case of the National Health Insurance plan, please refer to the relevant page.

〔In Japanese〕

  1. 第1号被保険者 (65歳以上)
  2. 第2号被保険者 (40歳以上65歳未満)

(1) 第1号被保険者の介護保険料


第1号被保険者にかかる介護保険料は、6月から翌年3月までの各月末に10回に分けて、賦課通知書とともに送付される納付書を使って、保険者自身が納付します。 銀行口座からの自動引落によって納めることもできます。 もし、年間18万円以上の公的年金を受け取っている場合には、特別徴収制度の下、その年金からの天引きにより、介護保険料の納付が行われます。

(2) 第2号被保険者の介護保険料


もし、東京で協会けんぽ に加入している場合には、介護保険料率は1.79%であり、その介護保険料は9.87%の健康保険料とあわせて徴収され、かつ、その半分は雇い主によって負担されます。