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 care services, you need to apply and receive certification for nursing care (or support) needs.

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 over

・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 Documents for Application

Persons aged 65 and over

1. Long-Term Care Insurance Insured Person Certificate
2. A document showing the attending physician's name, medical institution name, department name, address, and phone number (a note or similar is also acceptable)

Persons aged 40 to 64

Note: You must be enrolled in health insurance.

1. My Number Card
2. Health Insurance Card (valid period) or Qualification Confirmation Document
3. Information such as the name of the attending physician who is well acquainted with the physical and mental condition of the person suffering from a specific disease (one of the 16 specified diseases), the medical institution name, department name, address, and phone number (a memo is 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 Nursing Care and Support Certification (Word 51.1KB)
• [Example of Filling Out] 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)