Long-Term Care Insurance Act

The term "Condition of Need for Long-Term Care" as used in this Act means a condition assumed to require care on a continual and steady basis for the whole or a part of basic movements in daily activities such as bathing, bodily waste elimination, meals, etc., due to physical or mental problems during the period specified by Order of the Ministry of Health, Labour, and Welfare, and said condition that conforms to any of the categories stipulated by Order of the Ministry of Health, Labour, and Welfare according to the degree of needed care (herein referred to as a "Category of Condition of Need for Long-Term Care") (except when said condition is subject to a Needed Support Condition).

The term "Needed Support Condition" as used in this Act means a condition assumed to require care on a continual and steady basis during the period specified by Order of the Ministry of Health, Labour, and Welfare that especially contributes to the reduction or prevention of the aggravation of the condition requiring care for the whole or a part of basic movements in daily activities such as bathing, bodily waste elimination, meals, etc., due to physical or mental problems, or a condition assumed to cause continual difficulties in performing daily activities due to physical or mental problems during the period specified by Order of the Ministry of Health, Labour, and Welfare, and said condition that conforms to any category as stipulated by Order of the Ministry of Health, Labour, and Welfare according to the degree of needed support (herein referred to as "Category of Needed Support Condition").

The term "Person Requiring Long-Term Care" as used in this Act means a person defined by any of the following items:

a person that is in a Condition of Need for Long-Term Care and is the age of 65 or older;

a person that is in a Condition of Need for Long-Term Care and is the age of 40 to less than the age of 65, and the physical or mental problems that are the causes of said Condition of Need for Long-Term Care are a result of diseases that are caused by the physical or mental changes due to aging, specified by a Cabinet Order (herein referred to as "Specified Disease").

The term "Person Requiring Support" as used in this Act means a person defined by any of the following items:

a person that is in a Needed Support Condition and is the age of 65 or older;

a person that is in a Needed Support Condition and is the age of 40 to less than the age of 65, and the physical or mental problems that are the cause of said Needed Support Condition are caused by a Specified Disease.

The term "Long-Term Care Support Specialist" as used in this Act means a person that provides consultation to a Person Requiring Long-Term Care or to a Person Requiring Support (herein referred to as a "Person Requiring Long-Term Care, etc."), and communicates with and coordinates Municipalities, a person performing In-Home Service Business, a person performing Community-Based Service Business, a Facility Covered by Long-Term Care Insurance, a Long-Term Care Insurance Facility in a Specified Area, a person performing Preventive Long-Term Care Service Business, a person performing Community-Based Preventive Long-Term Care Business, a person performing a Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Support, etc., in order for a Person Requiring Long-Term Care, etc., to be able to use appropriate In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service or Community-Based Service for Preventive Long-Term Care, or a Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Support (meaning the category 1 home-visit project prescribed in Article 115-45, paragraph (1), item (i), (a), the category 1 outpatient project prescribed in (b) of that item, or the category 1 daily life support project prescribed in (c) of that item; the same applies hereinafter) according to the mental and physical conditions, etc., of a Person Requiring Long-Term Care, etc., and who received Long-Term Care Support Specialist Certification as set forth in Article 69-7, paragraph (1) as a person possessing professional knowledge and skills regarding support necessary for a Person Requiring Long-Term Care, etc., to live an independent daily life.

The term "Medical Insurance Acts" as used in this Act means the following acts:

Health Insurance Act (Act No. 70 of 1922);

Seaman's Insurance Act (Act No. 73 of 1939);

National Health Insurance Act (Act No. 192 of 1958);

National Public Servants Mutual Aid Association Act (Act No. 128 of 1958);

Local Public Service Mutual Aid Association Act (Act No. 152 of 1962);

Private School Personnel Mutual Aid Association Act (Act No. 245 of 1953).

The term "medical insurer" as used in this Act means the Japan Health Insurance Association, health insurance societies, prefectures and Municipalities (including special city wards), National Health Insurance Societies, mutual aid Associations, or the Promotion and Mutual Aid Society for Private Schools of Japan that provide medical benefits pursuant to the provisions of the Medical Insurance Acts.

The term "Medical Insurance Subscriber" as used in this Act means the following persons:

an insured person pursuant to the provisions of the Health Insurance Act, however, provided that this does not apply to specially-insured day laborers pursuant to the provision of Article 3, paragraph (2) of the same Act;

an insured person pursuant to the provisions of the Seaman's Insurance Act;

an insured person pursuant to the provisions of the National Health Insurance Act;

a member of a mutual aid association pursuant to the National Public Servants Mutual Aid Association Act or the Local Public Service Mutual Aid Association Act;

a subscriber to a Private School Personnel Mutual Aid System pursuant to the provisions of the Private School Personnel Mutual Aid Association Act;

an insured person's dependent pursuant to the provisions of the Health Insurance Act, Seaman's Insurance Act, National Public Servants Mutual Aid Association Act (including cases when applied mutatis mutandis pursuant to other Acts), or the Local Public Service Mutual Aid Association Act, however, provided that this does not apply to a dependent pursuant to the provisions of Article 3, paragraph (2) of the Health Insurance Act of a specially-insured day laborer pursuant to the provisions of the same Act;

a person that received a specially-insured day laborer certificate book pursuant to the provisions of Article 126 of the Health Insurance Act and within a certain period until the term when all of the blank space for stamps for proof of health insurance of said certificate book are filled, and said dependent pursuant to the provisions of the same Act, however, provided that this does not apply to a person that is within the period when said person is not a specially-insured day laborer pursuant to the provision of Article 3, paragraph (2) of the same Act with the approval pursuant to the proviso of the same paragraph, and a person that has returned said specially-insured day laborer certificate book pursuant to the provisions of Article 126, paragraph (3) of the same Act, and said dependent pursuant to the provisions of the same Act.

The term "social insurance Acts" as used in this Act means the following Acts:

This Act;

The Acts listed in the items of paragraph (6) (excluding item (iv));

Employees' Pension Insurance Act (Act No. 115 of 1954);

National Pension Act (Act No. 141 of 1959).

In this Act, "presentation of the certificate of insured person, etc." means the presentation of a Certificate of Insured Person, electronic eligibility confirmation (meaning that an Insured Person Requiring Long-Term Care, etc. (meaning the Insured Person Requiring Long-Term Care, etc. prescribed in Article 62) who seeks to receive In-Home Service, etc. (meaning the In-Home Service, etc. prescribed in Article 23) makes an inquiry to a Municipality or special city ward (hereinafter simply referred to as a "Municipality") about information pertaining to the eligibility of that Insured Person Requiring Long-Term Care, etc. (including information necessary for claims for expenses pertaining to insurance benefits) by a method of transmitting an electronic certificate for user verification (meaning the electronic certificate for user verification prescribed in Article 22, paragraph (1) of the Act on Certification Business of the Japan Agency for Local Authority Information Systems in Relation to Electronic Signatures, etc. (Act No. 153 of 2002)) recorded on an Individual Number Card (meaning the Individual Number Card prescribed in Article 2, paragraph (7) of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures (Act No. 27 of 2013)) or by any other method specified by Order of the Ministry of Health, Labour and Welfare, receives a response from the Municipality by a method using an electronic data processing system or other method using information and communications technology, provides that information to the Business Office or facility providing that In-Home Service, etc., and has that information confirmed by that Business Office or facility), or any other method specified by Order of the Ministry of Health, Labour and Welfare.