Application for Long-Term Care Insurance Certification for Nursing Care and Support Needs

If it is recognized that care or support is needed in daily life, you can use care services.
To use nursing care services, you need to apply and receive certification for nursing care (support needed).

For the process from application to service use, please see the link below.

• Please tell me the process from applying for long-term care and support certification to using the services.

Eligible Applicants

・Persons aged 65 and older

・Among those aged 40 to 64, individuals who fall under 16 specific diseases (the 16 specific diseases can be confirmed from the link below)

• Can I use Long-Term Care Insurance services even if I am under 65 years old?

Required Items for Application

Persons aged 65 and over

1. Long-Term Care Insurance Insured Person Certificate
2. Name of the primary physician, name of the medical institution, name of the department, location, and phone number (can be noted, etc.)

Persons aged 40 to 64

Note: You must be enrolled in health insurance.

1. My Number Card
2. Health Insurance Card (valid within the effective period) or Qualification Confirmation Document
3. The name of the attending physician who is well aware of the patient's physical and mental condition regarding the specific disease the patient is suffering from (one of the 16 specific diseases), along with the name of the medical institution, department, address, and phone number (notes are also acceptable).

Download Form

• Long-Term Care Insurance Application Form for Nursing Care and Support Certification (PDF 517.1KB)
• Long-Term Care Insurance Application Form for Certification of Need for Care (Word 51.1KB)
• [Example] Long-Term Care Insurance Application Form for Nursing Care and Support Certification (PDF 649.6KB)
• Questionnaire for Creating an Opinion Statement by the Attending Physician (PDF 279.9KB)

Submission Method

Submit by mail or at the counter

Submission Destination / Contact Information

2111 Higashi-Naganuma, Inagi City, Tokyo 206-8601
Care Certification Section, Senior Welfare Division, Welfare Department of Inagi City
(City Hall 2nd Floor, Window 4)