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Certification of Long-term Care Need: Process from Application to Service Usage

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1) Applying for Certification of Long-term Care Need

You can apply by bringing or mailing your Certification of Long-term Care/Support Need application and Long-term Care Certification to the section in charge of Long-term Care for Senior Citizens in your local ward or branch office’s Welfare Division.

The family can apply on behalf of the applicant to receive certification, or you can ask designated elderly home care and support company or long-term care facilities, or the Integrated Community Support Center to apply on their behalf. If you do not know where your Long-term Care Certification is, you can apply for re-issue using the Long-term Care Certification (Etc) Re-Issue Application (Japanese).

Note 1: For those in the age range of 40 to less than 65 (Category II Insurance Holders), you will also need to show your medical insurance card.

Note 2: Certifications have a period of validity; please apply to renew your certification as needed.

2) Certification Hearing and 3) Written Opinion from Primary Care Physician

Certification Hearing

In order to determine the physical and mental state of the applicant, as well as the degree to which long-term care is necessary, a staff member from the City of Hiroshima or a City-commissioned care manager from a designated elderly home care and support company will conduct a hearing with the applicant and their family (or similar).

Written Opinion from Primary Care Physician 

The Long-term Care for Senior Citizens section in the Welfare Division of your ward office will send the necessary documents for the written opinion to the applicant. Please have the applicant or someone in their family bring these documents to their primary care physician.

4) Certification of Long-term Care Need

Based on the certification hearing and written opinion from their primary care physician, the Long-term Care Certification Board of Review will conduct a review and make a decision. When a decision has been reached, a notification of the results of the review will be sent to the applicant from the Long-term Care for Senior Citizens section in the Welfare Division of your ward office.

  • Applicants will be sent a Notification of Results of Certification of Long-term Care Need, as well as a Long-term Care Certification listing what has been certified
  • The certification will be considered valid from the day of application.

Note: if you would like to file a complaint about the certification results, you may request an inquiry of the Prefectural Long-term Care Board of Review (Kaigo Hoken Shinsa-kai/介護保険審査会).

5) Use of Services

A variety of services are available to you depending on the classification of your Certification of Long-term Care Need.

It is possible to begin using services at the same time you apply for Certification of Long-term Care Need. However, if you do not receive your certification, you will need to pay full price for services used.

Long-term Care Needed 1-5

Long-term care services (benefits) available for use.

Support Needed 1, 2

Preventative care services (benefits) for the elderly, preventative care and everyday support services available for use.

Not certified

General preventative care services for the elderly are available for use. Those 65 years or older deemed eligible for services using the Basic Checklist* will also be able to use preventative care and everyday support services.

 *The Basic Checklist is a survey of 25 questions created by the Ministry of Health, Labor, and Welfare to assess whether there has been a decline in daily functionality. Please fill in the checklist at the Mutual Community Support Division of your local ward office or at the Integrated Community Support Center to see whether or not you are eligible for services.

Flowchart for Certification of Long-Term Care Need (from application to use of services)

flowchart

How to use services available

 Services are available for use based on your personalized care plan/preventative care plan.

Those classified as Long-term Care Needed 1-5

You can request care management by a care manager from an elderly home care and support company. The following procedures are necessary for using this service.

1) Assessment

  • During assessment, we work to understand the users mental and physical health, living environment, and personal history, and then to analyze issues.

2) Discussions with service liaison

  • Users and their families will hold discussions with a service liaison about the services needed to support them living at home.

3) Create a care plan

  • Decide the types of service they will use and how frequently they will use them.

4) Begin using services

  • Begin using long-term care services (benefits).

Support Needed 1, 2 and Those Eligible for Services

You can request preventative care management at the Integrated Community Support Center. The following procedures are necessary for using this service.

1) Assessment

  • Based on discussions with the user and their family, as well as the evaluation of their assessment sheet, we will work to understand the user’s mental and physical health, living environment, and personal history, and then to analyze issues.

2) Discussions with service liaison

  • Set goals and hold discussions with the user, their family, and their service liaison to formulate a support plan to achieve them.

3) Create a preventative care plan

  • Decide the types of service they will use and how frequently they will use them to achieve their goals.

4) Begin using services

  • Those classified as Needing Support 1, 2: can use preventative care services and preventative care/daily support services
  • Those eligible for services: can use preventative care/daily support services

About the Individual Number (My Number) System

With the introduction of the Individual Number system in January 2016, you will need to fill out your Individual Number on forms related to Long-term Care Insurance and we will require ID during the paperwork process. For more information about the paperwork process, please see Submitting your Individual Number for Long-term Care Insurance Paperwork (Japanese).

Inquires About This Page​

健康福祉局 高齢福祉部 介護保険課 認定・給付係

Tel:082-504-2363  Fax:082-504-2136

E-mail:kaigo@city.hiroshima.lg.jp

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