Long-term care insurance (介護保険) from age 40: foreign residents

Yes. As of October 2026, foreign residents who are registered at a Japanese address and stay more than 3 months are in long-term care insurance (介護保険, kaigo hoken) from age 40. You do not sign up separately. The premium is added to your health insurance, and you can use the services only for specific illnesses until you turn 65.

Are foreigners in long-term care insurance in Japan?

In principle, yes. Chuo City says foreign nationals registered in the Basic Resident Register are insured. Itabashi City gives the test as lawfully staying more than 3 months and being in the register.

Yokohama adds one point for newcomers. Even if your first period of stay (在留期間) is under 3 months, you are covered if your purpose of entry and living situation show you will stay at least 3 months.

Your visa type matters only for a few statuses. Chuo City lists these as not covered:

• 特定活動 (designated activities) for medical treatment, and the person caring for you
• 特定活動 for sightseeing or recreation, and a spouse with the same purpose
• 外交 (diplomatic) status, and US armed forces members, civilians and their families
• People with no address in Japan
• Short stays with an expected stay of 3 months or less

Chuo’s page does not explain how the last item fits with Yokohama’s rule above. If you are on a short first period, ask your city’s long-term care insurance counter (介護保険課).

How much do I pay from age 40?

From 40 to 64 you are a Category 2 insured person (第2号被保険者). Your premium is worked out by your health insurance and paid together with it. Itabashi and Shinjuku both describe it this way.

The Kyokai Kenpo pages we read do not say how the 1.62% is split with your employer. Other health insurance societies (組合健保) set their own rates. Check your payslip or ask your employer’s HR.

Shinjuku is one example. Other cities set their own amounts, so look at your city’s NHI notice. For the full NHI picture, see National Health Insurance for foreigners. For the payslip view, see take-home pay in Japan.

What does it cover before 65?

Less than most people expect. At 65 and over (第1号被保険者) you can get services whatever the cause. Between 40 and 64 you can get them only if your need for care is caused by one of 16 specified diseases (特定疾病).

Shinjuku City lists them:

• Cancer, only when a doctor judges recovery is no longer expected
• Rheumatoid arthritis
• Amyotrophic lateral sclerosis (ALS)
• Ossification of the posterior longitudinal ligament
• Osteoporosis with fracture
• Early-onset dementia
• Progressive supranuclear palsy, corticobasal degeneration and Parkinson’s disease
• Spinocerebellar degeneration
• Lumbar spinal stenosis
• Progeria
• Multiple system atrophy
• Diabetic neuropathy, nephropathy and retinopathy
• Cerebrovascular disease
• Arteriosclerosis obliterans
• Chronic obstructive pulmonary disease
• Severe osteoarthritis of both knees or both hips

The list names illnesses, so check with the city whether your situation counts. Our sources do not state the share of the service cost you pay yourself, so ask the city when you apply.

How do I apply for care services?

Premiums are automatic. Services are not: you must apply for care-needs certification (要介護・要支援認定). Shinjuku City accepts applications in person or by mail. A care manager agency or a care facility can apply for you.

Shinjuku’s list of documents is from its April 2026 page. Other cities differ slightly. We found no English-language guidance on this process, so ask the city in advance whether it offers interpretation, or bring a Japanese-speaking friend.

What if my status changes or I leave Japan?

People with no domestic address are not covered. If you are a Kyokai Kenpo member or dependent, a form (介護保険適用除外等該当・非該当届) is needed when your status changes for a reason other than turning 40 or 65. The Japan Pension Service lists these reasons: moving abroad or returning to live in Japan, entering or leaving a care facility, and a stay of more than 3 months being decided or not decided under immigration law.

Your employer sends the form to the pension office. For an overseas move you need a certificate of removal from the resident register (住民票の除票) that shows no My Number.

We could not confirm from official pages whether premiums are refunded when you leave. Settle this with your health insurer or city office before you go. Our pension refund guide covers the separate pension lump sum.

More guides: National Health Insurance, take-home pay, Japanese pension for foreigners, life insurance for foreigners.