Long Term Care Insurance Cost Age 65 – The long-term care insurance system began in 2000 as a system for the community to support long-term care for the elderly. The municipality acts as an insurer, and all citizens over the age of 40 are covered by this system. Compared to other countries, this system is very generous in terms of coverage and benefits. As of April 2016, more than 5 million people were eligible for long-term care insurance.[16]
The basics of Japanese long-term care insurance are explained in detail in Part 1. Under the old welfare system that existed in the past, the municipal governments were given the final authority in the selection of services, and since the users could not choose the services, the content of the services was the same. In addition, because service fees depend on the patient’s ability to pay, middle- and high-income people bear a heavy burden, and general hospitals have problems with long-term care for long-term care. have faced
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With the rapid aging of the population, the number of people requiring long-term care, as well as the length of care, has increased, and the needs for long-term care have increased. At the same time, the situation, in which the family traditionally met the needs of the elderly, began to change, with the shift towards nuclear families and the aging of the foster generation.[17]
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After considering such issues and changes, Japan developed the long-term care insurance system as a way for society to support the long-term care of the elderly.
○ Independence Support: Beyond simply providing long-term care and supporting the independence of older people.
○ User-oriented system: To provide users with integrated access to health and welfare services from various agencies according to their own preferences.
○ Social Security System: Establishing a social security scheme that has a clear link between benefits and burdens.
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Enrollees in long-term care insurance are divided into two categories – those aged 65 and over (Category 1 insured) and those aged 45 to 64 who are at the same time Enrolled in other medical insurance schemes (category 2 insured).
○ Category 1 Insurance: Eligible for services unless they receive certification for long-term care needs or certification for supportive care needs.
○ Category 2 Insurance: Eligibility for services only after receiving certification for long-term care needs or support needs due to age-related illnesses (special illnesses).
By the end of the 2015 fiscal year, category 1 insured people reached 33.82 million people, and category 2 insured people reached 42.04 million people (according to the monthly average published in 2017).
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Category 1 enrollees (age 65 and older) pay for their health insurance and long-term care insurance separately. Premiums and insurance rates are set by the municipality and set to nine standard income levels. For category 2 enrollees (ages 40 to 64), health insurance and long-term care insurance premiums are paid jointly.[21]
Around the creation of the long-term care system, there was much debate about the justification behind targeting people over the age of 40. Among the various opinions, there was support for targeting people over 20 years of age or over 60 years of age, but it was decided in 1996 at the Conseil de la Santé et de la Conseil d’Eeler on long-term care insurance. It was pointed out during the consultation. If people pass. At the age of 40, it is more likely that they will take care of their parents and thus need social support. As a result, it was decided to register people over the age of 40, because the costs of long-term care should be supported by the community. Through these discussions, the current system was created. (MHLW, 2006)
As shown in Figure 3-2-1, half of the funding for long-term care insurance comes from enrollment premiums, while the other half comes from public funding. The budget for paying long-term care benefits was set at 9.6 trillion yen in 2016. Funds are generated from category 1 premium (2.1 trillion yen), category 2 premium (2.7 trillion yen), national treasury (2.2 trillion yen), prefecture (1.4 trillion yen), and municipalities (1.2 trillion yen).
Similar to medical costs, long-term care costs continue to increase with benefit costs each year, and this trend is expected to continue in the future as society ages in Japan.
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The disparity in funding and financial burden exists between provinces with a high proportion of people over 75 years of age facing benefit payments, and provinces with lower average income levels facing a decline in revenue. are Financial measures are taken, subject to financial adjustments, with a 26% share of funding provided by the National Treasury with a five percent share. The system of adjustments is very similar to the innovations in the medical care system for the elderly (described in section 1.2) in the sense that both systems are designed to reduce the imbalance between the financial resources of different insurers.
To use long-term care services, applications are submitted to municipal government offices or comprehensive community support centers. In order to qualify, applicants must obtain a certification of long-term care needs or certification of essential support. Upon receiving certification, care managers prepare plans for applicants, allowing them to use various services.
The level of care required by a person (preventive support level 1 or 2, or chronic care level classified from 1 to 5) is determined by a committee of experts, which takes into account the written diagnosis of the attending physician. take in – Site survey. It addresses 74 items related to a person’s daily activities. A person’s level of care is reassessed every two years or after a significant deterioration in health.[23] The annual trend of people requiring care is shown in Figure 3-2-2.
To address the fact that demand for long-term care is not decreasing and to combat the continued growth of the population requiring less care (Preventive Support Level 1 / Long-Term Care Level 1), the 2006 review – The Term Care Insurance Act introduced preventive care services. At this point, recipients who were previously certified to receive care level 1 are divided into long-term care level 1 or preventive support level 2, depending on whether their condition is likely to improve or similar. remains
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Before the creation of the long-term care system, parental care was divided between the Social Security system and the elderly health care system. To ensure that people who have received social services can continue to use the same services in the new system, the certification criteria have been relaxed. This has led to an immediate increase in the number of users requiring home care or light care (preventive support level 1 / long-term care level 1), thus creating bottlenecks and long waiting lists in intensive care homes. does (Naoki Ikigami, 2017)
[16] Ministry of Health, Labor and Welfare (2016) “A Survey on the Current Status of Nursing Care” http://www.mhlw.go.jp/toukei/saikin/hw/kaigo/kyufu/16/index. html (accessed 19 November 2017)
[17] Ministry of Health, Labor and Welfare “Current and Future Role of the Public Long-Term Insurance System” http://www.mhlw.go.jp/file/06-Seisakujouhou-12300000-Roukenkyoku/201602kaigohokenntoha_2. pdf (accessed 19 November 2017)
[18] Ministry of Health, Labor and Welfare (2015) “Annual Report on Long-Term Insurance” http://www.mhlw.go.jp/topics/kaigo/osirase/jigyo/15/dl/h27_gaiyou.pdf (Accessed 25 January 2018)
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[19] Ministry of Health, Labor and Welfare “Long-Term Care Insurance Premiums for Category 2 Insured Persons” http://www.mhlw.go.jp/topics/kaigo/osirase/jigyo/15/dl/h27_hihokensha . pdf (accessed 25 January 2018)
[20] Ministry of Health, Labor and Welfare “2018 Budget Overview (Draft) (Health and Welfare Administration for the Elderly)” https://www.mhlw.go.jp/wp/yosan/yosan/18syokanyosan/ dl/gaiyo-13.pdf (accessed 6 July 2018)
[22] Ministry of Health, Labor and Welfare “Current and Future Role of Public Long-Term Insurance System” http://www.mhlw.go.jp/file/06-Seisakujouhou-12300000-Roukenkyoku/201602kaigohokenntoha_2. pdf (accessed October 21, 2017) What if I asked you, “Do you want to grow old?” I’m sure the answer would be, “Um, no thanks!” And I get it. A walker in old lady fashion
My cup too. But old age is coming whether you like it or not, and wouldn’t it be nice to know you’re ready?
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) is expensive and getting more expensive (is that a word?). You need to have a plan to pay it off so you don’t end up financially devastated. This is where long-term care comes in
Long-term care insurance is a policy that covers expenses related to nursing home care, assisted living facilities or caregivers who come to your home. It pays to support people who can no longer carry out daily activities as they age.
It also covers things like home repairs, home caregivers, medical equipment and care coordination (or care management). Care coordination is a service that manages all aspects of long-term care, including finding and managing appointments. All of this means you can potentially live longer in the comfort of your own home. And who doesn’t want that, right?
Because your regular health insurance doesn’t cover these costs—and Medicare only steps in for hospitalization and short-term rehabilitation insurance—long-term care insurance is essential. Even Medicaid (a government program for low-income people) only covers the specific costs of long-term care, and not for the long term. No matter how you slice it, y’all, these options shouldn’t be your first choice.
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Figuring out where to get long-term care can be confusing—there are so many
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