Upload
others
View
6
Download
0
Embed Size (px)
Citation preview
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
• Public Long-Term Care Insurance
• Private Long-Term Care Insurance
• Private Long-Term Care Business
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
Source:Comprehensive Survey of Living Conditions by Ministry of Health, Labour and Welfare
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
Source:Comprehensive Survey of Living Conditions by Ministry of Health, Labour and Welfare
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
• Low Birthrate and Aging in Japan
• Risk and Insurance of Long-Term Care
• Private Long-Term Care Insurance
• Private Long-Term Care Business
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.)
10%-30% of Service Expense
+ Food + Living Cost
Facility Stay Service(Short Stay etc.)
10%-30% of Service Expense
+ Food + Living Cost + Stay Cost
Facility Service(Nursing Home Care etc.)
10%-30% of Service Expense
+ Food + Living Cost + Residential Cost
Other Service(Private Residential Home
etc.)
10%-30% of Service Expense
+ 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
• Low Birthrate and Aging in Japan
• Risk and Insurance of Long-Term Care
• Public Long-Term Care Insurance
• Private Long-Term Care Business
24
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
Private LTC Insurance (Case2)Outline
● Needed prescribed LTCLTC Lump-sum : 5,000,000 yen
● Death/Total DisabilityDeath Benefit : 5,000,000 yen
● Insurance PeriodWhole Life
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
● Insurance PeriodWhole Life
29
Private LTC Insurance (Case4)Outline
● 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
• Low Birthrate and Aging in Japan
• Risk and Insurance of Long-Term Care
• Public Long-Term Care Insurance
• Private Long-Term Care Insurance
30
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