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The hardest part is not knowing what comes first. FREE

Long-term care insurance covers 80–85% of the cost — but only if you apply. Many families pay everything themselves for years simply because nobody told them. Here is the order of things, what to say at the home assessment, and how nursing homes differ from care hospitals.

#장기요양등급신청#요양원vs요양병원#방문조사#주야간보호#치매

Start here: 1577-1000

Call the National Health Insurance Service and say you want to apply for long-term care. It is free, takes about ten minutes, and a family member can do it on the elder’s behalf. Everything below is easier once this is started.

Can we apply?

Age

Diagnosed with any of these?

Alzheimer’s dementia · vascular dementia · other dementia · stroke (뇌졸중, 중풍) · cerebral haemorrhage · cerebral infarction · Parkinson’s disease · subarachnoid haemorrhage · intracerebral haemorrhage · degenerative disease of the basal ganglia · after-effects of stroke

What happens, in order

📞 Apply

National Health Insurance Service (국민건강보험공단) 1577-1000 · any branch in the country can take the application. You can also apply online (longtermcare.or.kr), in the The건강보험 app, by post or by fax. ★Even if the elder cannot go in person, a family member, relative or social welfare official (사회복지전담공무원) can apply on their behalf.

🏠 An NHIS staff member visits your home (assessment, 인정조사)

★ This step decides the grade. An NHIS staff member visits and checks 90 items. It takes about 30 minutes to 1 hour. A family member who knows the elder’s usual condition well must be there.

🩺 Submit a doctor’s opinion (의사소견서)

When the NHIS sends you an issuance request form (발급 의뢰서), get it from a hospital at that point. ★You do not need to get one in advance. (If it is judged unnecessary for the grade decision, it may be skipped altogether.)

⚖️ The Grading Committee (등급판정위원회) decides

As a rule, within 30 days of the application date. The result is sent by post as a long-term care certificate (장기요양인정서) and a standard long-term care use plan (표준장기요양이용계획서).

🤝 Sign a contract with a provider and start using it

Take the certificate and sign a contract with the provider you want. ★The family chooses the provider. The NHIS does not assign one.

The home assessment decides everything

Families most often lose grades here — by softening the truth in front of the elder.

🗣️

Do not make it sound better because the elder is listening

★ This is where families lose the most. If you say "they get by all right" to spare the elder’s pride, it is recorded exactly that way and the grade comes out lower. The assessment is based on "the worst it usually gets". If the elder is likely to be upset, write it down beforehand and show it to the assessor separately.

📝

"Can do it" is not the same as "does it safely alone"

Even if they can hold a spoon, if they spill, do not notice when something is hot, or cannot remember whether they have eaten, that means they need help. Say specifically how you help them.

🌙

Be sure to mention what happens at night

★ The assessor visits during the day. But the hard part is often the night. Whether they wake and wander, cannot find the toilet, or shout — if you do not mention it, it is not recorded.

🧠

Dementia has separate "cognition" items

Whether they know what day it is and where they are, remember what was just said, and recognise family members. Wandering, delusions, aggression and hoarding are also items. Do not be embarrassed; describe things as they are.

📔

Keeping notes for just two weeks makes it far more accurate

Write down meals, bathing, toilet, sleep and medication briefly, day by day. If you rely on memory during the assessment, things will be left out. Also show medical certificates, prescriptions and hospital admission/discharge records.

↩️

If the result does not seem right, you can file an objection

You can file an objection (이의신청) within 90 days of the day you are notified. If their condition gets worse, you can also apply for a grade change (등급변경 신청) at any time. The first grade is not the end.

Make a note to hand the assessor FREE

We do not predict a grade — only the assessment committee can decide that. We turn what you write into the concrete, itemised language the assessment uses.

Who

Diagnosis (if any)

What is a normal day like?

★ Be sure to write about what happens at night and any falls. The assessor visits during the day, so if you do not mention them they are not recorded.

What worries you most? (optional)

What each grade means

Grade 1

Needs help from others for almost everything

Can use a nursing home (facility care, 시설급여) · home-based care (재가급여) also available

Grade 2

Needs help with a large part of daily life

Can use a nursing home (facility care, 시설급여) · home-based care (재가급여) also available

Grade 3

Needs help with some things

As a rule, home-based care (재가급여). A facility requires an approved exception

Grade 4

Needs help to a certain extent

As a rule, home-based care (재가급여)

Grade 5

A person with dementia (special dementia grade, 치매특별등급)

Home-based care (재가급여) · mainly day/night care

Cognitive support grade (인지지원등급)

Mild dementia

Mainly day/night care (주야간보호) · dementia programmes

It is not “home or nursing home”

Besides moving the elder into a nursing home, there is all this you can use. At the stage before a nursing home, it can let you manage for much longer.

🏠

Home-visit care (방문요양)

A care worker (요양보호사) comes to the home and helps with meals, washing, cleaning and company.

🛁

Home-visit bathing (방문목욕)

A bathing vehicle comes and helps with bathing at home. A great help when moving around is difficult.

💉

Home-visit nursing (방문간호)

A nurse comes and manages blood pressure, blood sugar, wounds, bedsores and medication. A doctor’s order (의사 지시서) is required.

🌤️

Day/night care (주야간보호, day care)

★ The most underrated service. The elder is picked up by car in the morning and brought home in the evening. Meals, bathing and activities are included, and the family can work during that time. A good step before a nursing home.

🛏️

Short-term respite care (단기보호)

Looks after the elder for a few days when the family cannot because of travel, a hospital stay, or a wedding or funeral.

🦽

Welfare equipment (복지용구)

★ You can buy or rent beds, wheelchairs, non-slip mats, diapers and more up to KRW 1,600,000 a year. A great many people pay the full price themselves because they do not know this.

Nursing home vs care hospital

	🏡 Nursing home (요양원, 노인요양시설)	🏥 Care hospital (요양병원)
What it is	A place to live. Care is the focus.	A hospital for treatment. Medical care is the focus.
Which insurance	Long-term care insurance (장기요양보험)	National health insurance (건강보험)
Is a grade needed	★ As a rule, long-term care grade 1–2 (grades 3–5 need an approved exception)	Not needed. Admission is by a doctor’s decision
Is there a doctor	No doctor on site (a contracted doctor, 촉탁의, visits regularly)	Doctors and nurses are on site
Who provides care	Care workers (요양보호사)	Nurses and nursing assistants + a private caregiver (간병인, hired separately)
Rough cost	Co-payment 20% + meals and snacks are not covered (비급여) Around KRW 600,000–900,000 a month	Co-payment 20% + caregiver fees paid in full by you Around KRW 1,000,000–2,000,000 a month
Right when	Everyday care is needed for moving, eating and toileting	Ongoing treatment or procedures are needed (feeding tube, oxygen, bedsore treatment, rehabilitation, etc.)

★ Costs vary widely by region, facility, grade and non-covered items. The amounts above are only to give you a rough idea; they are not a quote. Always get the list of non-covered items (비급여 항목표) and check it before signing a contract. Basic livelihood security recipients (기초생활수급자) pay no co-payment, and near-poverty (차상위) and reduced-rate recipients get a 40–60% reduction (ask the NHIS).

Before you choose a facility

People end up deciding on distance and price alone because they do not know what else to look at. Write the points below on paper and take them with you.

Ratings

Did you first check the facility’s evaluation grade (평가등급, A–E) on the NHIS website (longtermcare.or.kr)?Did you ask about the actual number of residents against capacity and the number of care workers?★ Did you ask how many staff work at night? (Accidents happen at night)

What to look at in person

★ How does it smell as soon as you walk in? (This tells you most honestly how often diapers are changed)How do the residents’ faces and clothes look? Are they all just lying down during the day?★ Did you ask whether they use restraints (신체 억제)? Ask also in what cases they use themAre there windows and sunlight? Is there a space where residents can go outside?Did you listen to how staff address the residents? (The way they address them shows their whole attitude)

What to ask

If the elder is ill, which hospital do they take them to, and how? When do they contact the family?When and how can you visit? Are video calls possible?Who prepares the meals? Can they provide meals for dysphagia (연하곤란, difficulty swallowing)?★ Did you get the list of non-covered items (비급여 항목표) on paper? (meals, snacks, diapers, activity fees)Did you check in what cases the elder may be asked to leave?

Before signing

Did you take the contract home and read it? Do not sign it on the spot★ Did you go once more without notice? (A day you arranged in advance is not like other days)Did several family members each visit?

Where to ask

📞

National Health Insurance Service, long-term care insurance (국민건강보험공단 노인장기요양보험) 1577-1000

Applications, grades, benefits and provider search are all handled here. longtermcare.or.kr

🧠

Dementia counselling call centre (치매상담콜센터) 1899-9988

24 hours · dementia-related counselling. Korean memory aid for the number: "18세부터 99세까지 88하게" (from 18 to 99, staying hale)

🏥

Dementia support centre (치매안심센터) At every public health centre (보건소)

Free cognitive screening · wandering-detection devices · ID tags · care supplies · family classes

👵

Customised care service for older adults (노인맞춤돌봄서비스) Community service centre (주민센터)

Even without a care grade, the elder can receive regular check-ins and help with housework

🆘

Elder protection agency (노인보호전문기관) 1577-1389

When abuse is suspected · reports can also be made anonymously

General guidance, not medical or legal advice. We do not predict care grades — only the NHIS grading committee decides. Rules, costs and coverage change; confirm with the National Health Insurance Service (1577-1000).