This is a translation of the Japanese original. The Japanese version is authoritative; figures follow Japanese tax law.
When a parent enters a special nursing home for the elderly (特別養護老人ホーム), meals and the room charge come on top of the care fees. The scheme that cuts those two is the burden-limit certification under long-term care insurance (負担限度額認定). Thirty days in a multi-bed room at a special nursing home costs roughly ¥73,800, and with the certification that falls to ¥9,000 at Stage 1 and ¥24,600 at Stage 2. The lines dividing the stages are that every member of the household is exempt from resident tax, and that the person's own pension income and the like is ¥826,500 or ¥1,200,000. You apply to your municipality, and the certification takes effect from the first day of the month in which you applied.
The short answer: four stages, and this is how far 30 days of meals and room fall
The figures are for 30 days in a multi-bed room at a special nursing home. Between Stage 1 and Stage 3-2 the gap is ¥49,500 a month.
| Stage | The person's pension income and the like (every household member exempt from resident tax) | Meals + room (30 days) | Amount saved |
|---|---|---|---|
| Stage 1 | Recipients of public assistance or the old-age welfare pension | ¥9,000 | ¥64,800 |
| Stage 2 | ¥826,500 or less | ¥24,600 | ¥49,200 |
| Stage 3-1 | Over ¥826,500 up to ¥1,200,000 | ¥33,300 | ¥40,500 |
| Stage 3-2 | Over ¥1,200,000 | ¥58,500 | ¥15,300 |
| Stage 4 | Someone in the household pays resident tax | (guide) ¥73,800 | ¥0 |
Our own calculation. We multiplied the standard cost amount of ¥1,545 for meals and ¥915 for a multi-bed room, and the burden limit for each stage, by 30 days[MHLW leaflet]. Stage 4 is set by the contract with the facility.
This is a benefit called long-term care service expenses for specified admitted persons (特定入所者介護サービス費), and the difference from the standard cost amount is paid to the facility by long-term care insurance[MHLW]. It covers special nursing homes, long-term care health facilities (介護老人保健施設), long-term care medical facilities (介護医療院) and short stays. Rent at a fee-based home for the elderly is not covered.
What sets the stage: everyone in the household exempt, and pension income
The test has two parts. First, whether every member of the household is exempt from resident tax. Then, the person's own pension income and the like. One alone is not enough.
The household here is not only the household on the residence record. A spouse counts even if the households have been separated, and even in a de facto marriage[MHLW]. Only in cases such as divorce mediation, a missing spouse or domestic violence can the spouse be left out.
The other pitfall is what counts as pension income and the like. These three are added together.
- Last year's gross public pension income (the payment amount on the withholding slip)
- Total income other than pensions (employment income, real estate income and so on)
- Tax-exempt pensions such as the disability pension and the survivor's pension (since August 2016)[MHLW notification]
Tax-exempt pensions are not income for tax purposes. They still count as income in this test. They are the pensions printed as "survivor" or "disability" on the transfer notice[Koto City].
We set out the conditions for an exempt household in the conditions for a resident-tax-exempt household, and the income lines for life on a pension in tax and insurance premiums for people living on a pension alone.
The ceiling on savings: life insurance and cars are not counted
Even an exempt household fails the test if savings and deposits are too large. The ceiling differs by stage.
| Stage | Ceiling on savings and deposits (the person) |
|---|---|
| Stage 1 (old-age welfare pension) | ¥10,000,000 or less |
| Stage 2 | ¥6,500,000 or less |
| Stage 3-1 | ¥5,500,000 or less |
| Stage 3-2 | ¥5,000,000 or less |
Source: the MHLW's information leaflet[MHLW leaflet]. With a spouse, add ¥10,000,000 to each figure. Recipients of public assistance face no asset test, and Category 2 insured persons (aged 40 to 64) face a flat ¥10,000,000 or less[Koto City].
Counted as savings and deposits
- Ordinary and time deposits
- Securities such as shares, government bonds and corporate bonds
- Investment trusts, and gold or silver with a known market value
- Cash on hand (self-declared)
Not counted as savings and deposits
- Life insurance
- Cars
- Watches and jewellery, whose market value is hard to establish
- Paintings, antiques and household goods
Debts such as a mortgage can be deducted from the total[MHLW]. Conversely, a large withdrawal just before you apply will draw a question about what the money was used for[Koto City].
What rose in August 2026 was only Stages 3-1 and 3-2
Meals and the room charge were revised on 1 August of Reiwa 8 (2026). Stages 1 and 2 did not rise by a single yen.
| Category (per day) | Through July 2026 | From August 2026 | Change |
|---|---|---|---|
| Standard cost amount for meals | ¥1,445 | ¥1,545 | +¥100 |
| Meals, Stage 3-1 | ¥650 | ¥680 | +¥30 |
| Meals, Stage 3-2 | ¥1,360 | ¥1,420 | +¥60 |
| Room, Stage 3-2, multi-bed room (special nursing homes etc.) | ¥430 | ¥530 | +¥100 |
Source: the MHLW leaflet with the old and new figures side by side[MHLW leaflet] and Notification No. 88[MHLW notification]. For the room charge at Stage 3-2, a conventional private room went from ¥880 to ¥980 and a unit-type private room from ¥1,370 to ¥1,470: ¥100 a day more whatever the room.
Over 30 days that is ¥4,800 a month more at Stage 3-2 in a multi-bed room at a special nursing home, and ¥900 a month more at Stage 3-1 (our own calculation).
On the same day, the line between Stage 2 and Stage 3-1 moved from ¥809,000 to ¥826,500, because the full basic old-age pension for Reiwa 7 went above ¥809,000[MHLW]. When pensions rise, the lines in the system follow them up.
The opinion of the Long-Term Care Insurance Subcommittee points towards dividing Stage 3-1 at ¥1,000,000 and Stage 3-2 at ¥1,400,000[MHLW subcommittee]. The basic plan is to start in fiscal Reiwa 9 (2027), but the actual amounts have not been published yet. No conclusion has been reached on a room charge for multi-bed rooms at long-term care health facilities and long-term care medical facilities.
You apply to your municipality, and it takes effect from the first of that month
You cannot receive this without applying. The official notice states that municipalities cannot confirm eligibility in advance on their own[MHLW]. Once admission is decided, file it alongside the paperwork for the facility.
- Get the application form for the burden-limit certification. It has boxes for the amount of savings and deposits and for the type of tax-exempt pension.
- Prepare copies of your bank passbooks. As a rule they must have been updated within the two months before the date of application.
- Attach the consent form for enquiries to financial institutions. It is a required attachment under the ministerial regulations.
- Show the certificate to the facility when it arrives. The amount billed falls only once you have shown it.
The period of validity runs from 1 August to 31 July of the following year, and renewal is needed every year. Apply in September or later and it runs from the first day of the month of application to the end of the following July[Koto City]. If the person stays in the facility and their savings have not changed, the passbooks can be omitted from the second year on[MHLW].
Where a benefit is obtained by a false declaration, the municipality can collect a surcharge of up to 200% of the amount paid (Article 22, paragraph 1 of the Long-Term Care Insurance Act)[LTCI Act]. On the other hand, a clerical mistake with no intent to defraud is not caught[MHLW]. The safe course with an asset you are unsure about is to raise it at the counter rather than hide it.
The "special reduction measure" puts a taxed household at Stage 3-2
With a taxpayer in the household you are at Stage 4 and, as a rule, get no reduction. The exception is the special reduction measure (特例減額措置), relief for the case where one of a married couple enters a facility and the household left behind is squeezed[MHLW]. Meet all six of the following and the Stage 3-2 limits apply even while the household is taxed.
- The household has two or more members (add one if the spouse is in a separate household)
- The person is admitted to a long-term care insurance facility and pays Stage 4 meal and room charges
- Total income less a year of user charges, meals and room comes to ¥826,500 or less
- Cash, savings, securities and the like total ¥4,500,000 or less
- There are no usable assets apart from the home the household lives in and the like
- Long-term care insurance premiums are not in arrears
This measure too depends on an application; the municipality will not raise it with you. Its validity ends when the person leaves the facility.
The medical expense deduction uses what you actually paid after the reduction
Facility costs qualify for the medical expense deduction. What you use is the amount you actually paid after the certification brought it down. The part paid to the facility by long-term care insurance does not count.
| Facility | Amount qualifying for the medical expense deduction |
|---|---|
| Special nursing home for the elderly | One half of your own payments for care, meals and room |
| Long-term care health facility | The same, in full |
| Long-term care medical facility | The same, in full |
Source: the National Tax Agency's Tax Answer[NTA No.1125]. Daily living costs and charges for special services do not qualify. The receipt states the amount that qualifies.
Meals at ¥1,420 × 30 days = ¥42,600 and the room at ¥530 × 30 days = ¥15,900, so ¥58,500 in total. Assume ¥27,000 for your own share of the care fees (10%) and the total is ¥85,500. Because one half qualifies at a special nursing home, the amount you can use for the medical expense deduction is ¥42,750.
If you receive a refund of high-cost long-term care service expenses, deduct it from your medical expenses. For a refund against the facility service fee alone at a special nursing home, one half is deducted[NTA No.1125]. Note that high-cost long-term care service expenses do not include meals or the room charge[MHLW].
It is also worth checking high-cost combined medical and long-term care expenses, which adds up a year of medical and care costs, and the disability deduction for a parent needing long-term care.
Two things to do first. Check the amounts for meals and the room on the facility's invoice, and ask at the counter which stage you are in.
Frequently asked questions (the burden-limit certification)
If I apply after admission, what happens to the earlier months?
The certification only goes back to the first day of the month in which you applied. If the municipality accepts that the delay was unavoidable, for example because the passbooks took time to prepare, Article 83-8 of the enforcement regulations allows it to go back further.
Summary
- A program that lowers meal and housing costs at care facilities. For a shared room at a special nursing home over 30 days, the standard cost of ¥73,800 drops to ¥9,000 under Tier 1.
- The tier is determined by whether the entire household is exempt from resident tax, and by the individual's pension income threshold of ¥826,500 or ¥1.2 million.
- Pension income also includes tax-exempt pensions such as survivor pensions. The savings cap for Tier 2 is ¥6.5 million or less.
- Apply at your city, town, or ward office; the certification takes effect from the 1st of the month you apply. The validity period runs from August 1 to July 31 of the following year and is renewed annually.
- Only Tier 3 ① and ② rose in August 2026. The medical expense deduction is calculated based on the actual burden after the certified reduction.
Reference links (sources)
- MHLW, Handling of the administration of user charges - the household and spouse test, and the scope of savings and deposits
- MHLW, Revision of meal and room charges from August of Reiwa 8 - the limits by stage, with old and new figures
- MHLW, Promulgation of the amending regulations to the Long-Term Care Insurance Act enforcement regulations - why the line moved to ¥826,500
- MHLW, Partial amendment of the burden limits for the room charge (Notification No. 88) - ¥100 a day added at Stage 3-2
- Opinion of the Long-Term Care Insurance Subcommittee of the Social Security Council - finer stages from fiscal Reiwa 9
- Long-Term Care Insurance Act, Article 22 (collection of unjust gains) - the ceiling on the surcharge
- Koto City, the burden-limit certification - the period of validity, and how to spot a tax-exempt pension
- NTA, No.1125 Consideration for facility services under the long-term care insurance system - one half at a special nursing home, in full at the other two
Note: the calculations in this article multiply the published standard cost amounts and burden limits by 30 days. For a multi-bed room at a long-term care health facility or a long-term care medical facility, the room charge depends on whether the facility charges for the room, so check with the facility. For an individual decision, go to your municipality's counter, the tax office or a tax accountant.
