Long-Term Care Insurance in Japan - OLIS · •Public Long-Term Care Insurance •Private Long-Term Care Insurance •Private Long-Term Care Business 7. Certified Ratio of Long-Term

Long-Term Care Insurance in Japan

Oriental Life Insurance Cultural Development Center

1

Agenda

• Risk and Insurance of Long-Term Care

• Public Long-Term Care Insurance

• Private Long-Term Care Insurance

• Private Long-Term Care Business

2

4.9% 5.3% 5.7%6.3%

7.1%7.9%

9.1%10.3%

12.1%

14.6%

17.4%

20.2%

23.0%

26.6%

28.9%30.0%

31.2%

32.8%

35.3%

36.8%37.7% 38.0% 38.1%

0.0%

10.0%

20.0%

30.0%

40.0%

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 2055 2060

0-14ys 15-65ys 65ys- Aging Rate

3

Population in Japan

Aging Rate(% of 65ys-/Total)

Source: “Population census” by the Ministry of Internal Affairs and Communications, “Japanese future population estimate”

by National Institute of Population and Social Security Research

(thousands)

Life Span in Japan4

(ys)

Source：Life Tables by the Ministry of Health, Labour and Welfare

59.6

63.6

65.3

67.7

69.3

71.7

73.4

74.8 75.9 76.4

77.7 78.6

79.6 80.8

63.0

67.8

70.2

72.9

74.7

76.9

78.8

80.5

81.9 82.9

84.6 85.5

86.3 87.0

50

60

70

80

90

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015

Male Female

Life Expectancy by Ages5

(ys)

80.8

61.1

41.8

19.4

12.0

4.3

87.0

67.3

47.7

24.2

15.6

5.6

0

20

40

60

80

100

0ys 20ys 40ys 65ys 75ys 90ys

2015Male 2015Female

Source：Life Tables by the Ministry of Health, Labour and Welfare

New Business as Number6

Source：Overview of the life insurance business by the Life Insurance Association of Japan

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1970 1980 1990 2000 2010 2017

Endowment Term Whole Life Medical Long-Term Care Annuity Others

Agenda

• Low Birthrate and Aging in Japan




7

Certified Ratio of Long-Term Care Needed8

Source: “Nursing Care Insurance Report” by the Ministry of Health, Labour and Welfare, “Population census” by the Ministry of Internal Affairs and Communications

(thousands)

17.7%

2.9%

6.0%

12.8%

27.9%

49.4%

73.4%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

0

2,000

4,000

6,000

8,000

10,000

12,000

65-69ys 70-74ys 75-79ys 80-84ys 85-89ys 90ys-

Population Certified number Certified ratio Certified ratio (65ys-)

9

Cause of Long-Term Care

Source：Comprehensive Survey of Living Conditions by Ministry of Health, Labour and Welfare

18.0%

4.6%

24.8%

16.6%

13.1%

18.4%

13.3%

16.2%

12.1%

12.1%

15.2%

10.8%

10.2%

17.2%

7.0%

4.6%6.7%

3.8%

25.3% 27.0%23.2%

T O T A L N E E D E D S U P P O R T N E E D E D L T C

Others

Heart Diseases

Joint Diseases

Bone Fracture

Weakness by Age

Cerebral Diseases

Dementia

10

Household Structure of LTC Needed

15.7%20.2%

24.0% 26.1% 27.4% 29.0%

18.3%

19.5%

20.2%19.3%

21.5%21.9%11.0%

10.9%

12.5% 12.1%

13.9%

16.0%32.5%

29.4%

23.2% 22.5%

18.4%14.9%

22.4%20.0% 20.1% 20.1% 18.7% 18.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2001 2004 2007 2010 2013 2016

Others

Three Generations

Two Generations

Couple

Single


11

Status of Supporters

Spouse25%

Child22%

Spouse of Child10%

Parent1%

Others Living Together

1%

Relatives Living Apart12%

LTC Worker13%

Others Living Apart

1% Unknown15%

Relation of Supporter

Male34%

Female66%

Gender of Supporter Living Together-39ys

2%40-49ys

7%

50-59ys21%

60-69ys32%

70-79ys22%

80ys-16%

Age of Supporter Living Together


12

Questionnaire to Supporters

Source：Questionnaire How to Manage of Job and LTC by Sompo Japan Nippon-Kowa Himawari Life Insurance

-1ys12%

1ys-23%

2ys-24%

3ys-19%

5ys-13%

10ys-9%

Period of LTC

1-2day/week27%

3-4day/week24%

5-6day/week8%

every day41%

Frequency of LTC

Feel Unrest Much38%

Feel Unrest44%

Not Feel Unrest Much

11%

Not Feel Unrest

3%Unknown

4%

Manage of Job and LTC

Have Thought about Job

Resignation55%

Have Not Thought about

Job Resignation

45%

Job Resignation by LTC

Agenda





13

14

Social Insurance Schemes in Japan

➢Medical Insurance

➢Pension Insurance

➢Unemployment Insurance

➢Workers Accident Insurance

➢Long-Term Care Insurance (2000)

Beneficiary of Public LTC Insurance15

1,236

2,583

3,019

3,894

604

787

842

912

264

410

2 0 0 0 2 0 0 5 2 0 1 0 2 0 1 5

Home Care Service Facility Service Community-Based Service

Thousands

Source: “Nursing Care Insurance Report” by the Ministry of Health, Labour and Welfare

16

Scheme of Public LTC Insurance

Insurer Cities, Towns or Villages

Insured 1st Insured 65ys or moreavailable for services regardless to cause of LTC state

2nd Insured between 40ys and 64ysavailable for services limited to specified diseases like dementia etc.

Premium Set by Insurer according to income amount

Resource Halved by premium and public money

Benefit LTC service in kind as general rule

Own 10% of necessary expense

Expense 20-30% in case of defined income or more

17

Process of Public LTC Insurance

Apply Investigation Certification

Care Plan・ServiceRenewal

-Investigation-Judged by Committee

-Support Needed 1-2-LTC Needed 1-5-Rejection

-Home Care Service-Facility Service-Community-Based Service

Every 6 months or 12 months

18

LTC Needed Level

LTC Level Physical StateBenefit

Limit

Support1 Support needed for a part of daily life 50,030 yen

Support2 LTC needed for a part of daily life / recoverable 104,730 yen

LTC1 LTC needed for a part of daily life / unrecoverable 166,920 yen

LTC2 LTC needed to light level 196,160 yen

LTC3 LTC needed to middle level 269,310 yen

LTC4 LTC needed to severe level 308,060 yen

LTC5 LTC needed to most severe level 360,650 yen

19

Own Expense

ServiceOwn Expense to Income Amount

Full Own Expense

Home Care Service(Home Visit LTC etc.)

10%-30% of Service Expense

Facility Visit Service(Day Service etc.)


+ Food + Living Cost

Facility Stay Service(Short Stay etc.)


+ Food + Living Cost + Stay Cost

Facility Service(Nursing Home Care etc.)


+ Food + Living Cost + Residential Cost

Other Service(Private Residential Home

etc.)


+ Food + Living Cost + House Rent

20

Home Care and Community-Based Service

Home Care Service

①

Home Visit LTC

Home Visit Bathing

Home Visit Nursing

Home Visit Rehabilitation

Home LTC Advice

②

Facility Visit LTC (Day Service)

Facility Visit Rehabilitation (Day Care)

Facility Stay LTC (Short Stay)

Facility Stay Medical Care (Short Stay)

Specified Facility Stay LTC

③

Rental of Welfare Device

Payment for Welfare Device

Payment for Home Renovation

Community-Based Service

①Nighttime Home Visit LTC

Patrol/Daytime Home Visit LTC

②

Facility Visit LTC for Dementia

Facility Stay LTC for Dementia (Group Home)

Small-sized Multifunctional Facility Stay LTC

Complex Type Service

① Home Care② Facility Visit/Stay③ LTC Environment

21

Facility Service and Out of LTC Insurance

Facility Service Average Fee(Own Expense)

LTC Welfare Facility (Special Nursing Home) LTC for Daily Living 75,855 yen

LTC Health facility LTC and Rehabilitation 86,594 yen

LTC Medical Center (April 2018-) Complex Needs for Medical and LTC

LTC Nursing Care Center Medical care 92,983 yen

Facility Out of LTC Insurance

Private Residential Home Own Expense for Residential Lamp-sum, Monthly Fee (House Rent, Fuel/Light Expense etc.) and Food

Residence for Elder People with Services Rental House for Elder People

22

LTC as Self-Supporting Efforts

-10,000yen7%

10,000yen-18%

30,000yen-27%

50,000yen-21%

100,000yen-10%

200,000yen-6% Unknown

11%

Monthly Expense for LTC

68.9

51.4

50.2

49.5

33.8

30.5

6.2

10.4

LTC Insurance

Dementia Insurance

Medical Insurance

Annuity

Death Protection

Damage Compensation Insurance

Others

Unknown

Private Insurance Needed

Source：Questionnaire How to Manage of Job and LTC by Sompo Japan Nippon-Kowa Himawari Life Insurance

Coffee Break23

Agenda





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25

LTC Insurance in Life Insurance Company

Cover Risk

・LTC Protection under 40ys and uncovered diseases in 40-64ys

・Cost and income decline which is not covered by public LTC insurance

Contract Type

Benefit Lump-sum or Annuity or (Lump-sum + Annuity)

Condition of ①LTC needed in activity of daily living

Payment ②Diagnosed as dementia and got impaired orientation

③Linked with public LTC Insurance

Contract Main product or Rider

Protection (LTC + Death) or LTC only

Term Limited period or Whole life

LTC Annuity Limited period or Whole life

26

Private LTC Insurance (Case1)Outline

● Needed prescribed LTC

LTC Lump-sum : 500,000 yenLTC Annuity : 500,000 yen

Annuity Period : Whole Life● Death

Death Benefit : 2,500,000 yen(Deduct LTC Benefit paid)

● Insurance PeriodWhole Life

Scheme

Lump-sum

500,000yen

Annuity

500,000yen

Annuity

500,000yen

Annuity

500,000yen

Annuity

500,000yen

⇒no Death Benefit

Needed LTC

Death Benefit 2,500,000 yen

(LTC Annuity×5)

LTC benefit paid is deducted

from death benefit

LTC Annuity

continued to pay during needed prescribed LTC state

27


● Needed prescribed LTCLTC Lump-sum : 5,000,000 yen

● Death/Total DisabilityDeath Benefit : 5,000,000 yen


Scheme

Needed prescribed LTC state

LTC Lump-sum 5,000,000 yensame amount in case of death/total disability

28

Private LTC Insurance (Case3)

Scheme

180日 MCI/Dementia

protection

Bone Fructure/Accidental Death

protection

Outline

● Mild Cognitive ImpairmentMCI Lump-sum : 100,000 yen

● DementiaLump-sum : 1,900,000 yen (MCI paid)Lump-sum : 2,000,000 yen (no MCI paid)

● Medical Cure for Bone FractureBF Benefit : 50,000 yen (Limit 10 times)

● Accidental DeathAccidental Death Benefit : 500,000 yen


29


● Needed prescribed LTC orFell prescribed Disorder StateDisability Annuity : 1,200,000 yenAnnuity Period : up to age 65ysMinimum Guarantee Period : 5ys

● DeathDeath Benefit : 1,200,000 yen

● Insurance PeriodUp to age 65ys

Scheme

Minimum Guarantee Period

5ys

Age 65ysContract

Total Payment of

Disability Annuity1,200,000/a year

Agenda





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31

LTC Business in Life Insurance Company

Life Insurance Company

FoundationHome Visit

LTC

Private Residential

Home

Ｎ Life July 1989 2 offices 760 rooms

M Life Dec. 1987 - 137 rooms

G Life Sep. 1965 - 200 rooms

32

LTC Services in Life Insurance Company

LTC Consultation LTC consultation by care managers etc. through phone

Introduction/use of LTC facilities etc.

Introduction of LTC facilities or preferential utilization of LTC equipment/housekeeping agency etc.

Information provide/searchProvide information useful for LTC/search for LTC facilities etc.

Mental support Phycological counseling by doctors/clinical phycologist

Security servicePreferential utilization of security products provided by security company

Training service Preferential utilization of Home Helper course

Application provide Provide application to find risk indication of Dementia

33

(App.)Dementia Insurance by Non-Life

Compensate LTC cost born by child to support parent

Aim to prevent that child resign job for LTC➢ When insured used services provided by affiliated of Sompo Japan,

insurance money is paid directly to affiliated as service fee.

Safety package product for person with Dementia and family➢ Expense to search missing person with Dementia

➢ Indemnity for injury etc. caused by person with Dementia

➢ Indemnity for failure of railroad operation in case person with dementia cross the line (Upper limit 100 mil yen)

34

(App.)Dementia Control by Kobe City

1st in Japan “Kobe Model” 4 Points

① Free 2 step type Dementia diagnosis in medical institution for people aged 65ys or more

② Provide warm support like indemnity insurance (Max 200 mil yen) for people with Dementia

③ Pay solatium (Max 30 mil yen) to Kobe citizen for accident caused by people with Dementia

④ All Kobe citizen pay small amount of fee to cover the system without any postpone to future generation

Documents

Long-Term Care Insurance in Japan - OLIS · •Public Long-Term Care Insurance •Private Long-Term Care Insurance •Private Long-Term Care Business 7. Certified Ratio of Long-Term