Japan (since 2000)

Germany (since 1996)

Insurer

Municipality

Care Funds

Insured

Persons aged 65 or older (Category 1), and persons aged 40 to 64 years old and subscribers of health insurance (Category 2)

All subscribers of health insurance

Contribution (rate)

Category 1: about 5000 yen per month on average

2.55% (+0.25% if childless)

Category 2

Health Insurance Association: 1.55%

Financial source

User charge: 10 (20)%

Contribution: 100%

Government subsidy: 50% of LTC benefits

Contribution: 50% of LTC benefits

Beneficiaries

All Category 1 after care assessment + those Category 2 who suffer from age-induced illness (exceptional), both after care assessment.

All insured and their family who need long-term care of middle level or above.

Care assessment

Municipal committee

MDK (Medizinische Dienst der Krankenversicherung)

Care management

since April 2000

since July 2008

Insurance benefits

Benefit in kind only.

Benefit in kind or in cash or in combination.

Home care services:

Home care services:

Frail 1 - 2

Level 1 - 5 (since 2017)

Level 1 - 5

Facility-based services:

Facility-based services:

Skilled nursing facilities

Level 1 - 5 (since 2017)

Health service facilities for the elderly

Skilled nursing wings of geriatric hospitals

Expenditure

1.8% of GDP in 2015

0.9% of GDP in 2015

Responsible authority

Municipality

Provincial Government