Care Cost Reductions for Resident-Tax-Exempt Households in Japan

One label, many systems

Japanese care offices use one phrase again and again: juminzei hikazei setai (住民税非課税世帯), a household in which nobody owes municipal resident tax. A parent who falls into it pays a lower care insurance premium and can apply for cheaper facility meals. A lower monthly cap on care co-payments and lower medical caps from age 70 also open up.

This page maps the whole set, showing which reductions may apply and in what order to seek them. The details of each one live on their own pages, such as facility meal and room reductions and the high-cost care refund. Whether separating a parent's resident registration changes the result is covered in household separation to lower care costs.

What the law exempts

Municipal resident tax has two parts. The per-capita levy (kintowari) is a flat charge, and the income levy (shotokuwari) rises with income. Article 295 of the Local Tax Act says a municipality cannot charge resident tax to a person on the livelihood assistance part of public assistance. The same applies to a person with a disability, a minor, a widow or a single parent whose total income for the previous year is ¥1,350,000 or less.

Everyone else is judged against a per-capita line set by local ordinance. Article 47-3 of the Local Tax Act Enforcement Order builds that line from a base amount of up to ¥350,000. The base is multiplied by the number of people counted (the person plus a dependent spouse and dependants), and ¥100,000 is added. A further addition of up to ¥210,000 applies when there is a dependent spouse or dependant.

At the full ¥350,000 base, the line for a single person is ¥450,000 of total income. Municipalities in lower grades of the public assistance cost scale can set a lower base, so the line differs by city. The test uses income after deductions, not money received. A pension is reduced by the public pension deduction first, so comparing a bank statement with ¥450,000 tells you nothing.

The per-capita-only case

Some people fall between the two lines. Their income is too high to escape the per-capita levy but too low to owe any income levy, so they pay only the flat charge. Care rules do not treat them as exempt. The Enforcement Regulation of the Long-Term Care Insurance Act asks whether municipal tax is charged at all, and a per-capita charge is still a charge.

One person in this position is enough to turn the whole household into a taxed household for the systems that look at everyone on the resident record. A person whose municipal tax was waived under a local ordinance is counted the same as an untaxed person for the facility reduction and the high-cost care cap. The certificate from the city tells you which case applies.

Which year and household

Resident tax goes to the municipality where a person was registered on January 1 (Local Tax Act Articles 294 and 318). It is based on the previous calendar year's income. In November 2026 the year that matters is fiscal 2026. That tax is based on 2025 income and runs from April 2026 to March 2027.

The household is the household on the resident record (juminhyo). The national care service information site notes that a household means the members on the basic resident register. A taxed adult child living in the same registered household makes the household taxed, even if the parent is exempt. A child living abroad with a separate registration is not counted.

The facility meal and room reduction goes one step further. It also counts a spouse registered in a different household, and it adds up the savings of both spouses.

Foreign pensions and returnees

Foreign nationals living in Japan are taxed on the same rules once they are on the resident register on January 1. The National Tax Agency lists a pension from a foreign social insurance system similar to Japan's national or employees' pension as a public pension. The care rules that measure pension income borrow that tax definition.

Japan does not withhold tax on such a pension. The agency states that a person receiving one cannot use the rule that lets small pensioners skip the income tax return. It also notes that a resident tax declaration can be needed even when no return is due. If the foreign pension is never declared, the city's record of the parent's income may not include it. How treaties and non-permanent residence change the tax itself is explained in pension and tax for foreign retirees.

Parents who move back to Japan after January 1 raise a separate point. A parenthetical in Article 83-5 of the care regulation, with matching wording in Enforcement Order Article 22-2-2, leaves out people who had no address in Japan on the January 1 reference date. Owing no Japanese resident tax for that year may therefore not count as exemption. Ask the care insurance section how it will judge the first year and what proof of income it wants.

The hub table

The table lists each reduction that exemption can trigger, with figures that apply from August 2026. Premium tiers and base amounts are set by each municipality, so the premium row shows the national standard.

Care premium tiers

A person aged 65 or over in a fully exempt household is placed in premium tier 1, 2 or 3 under Article 38 of the Long-Term Care Insurance Act Enforcement Order. The lines are pension income plus other income of ¥826,500 and ¥1,200,000 a year. After public subsidy the multipliers are 0.285, 0.485 and 0.685 of the base premium (MHLW notice Vol. 1190).

The national average base for fiscal 2024 to 2026 is ¥6,225 a month. On that average, tier 1 comes to about ¥21,290 a year and tier 3 to about ¥51,170. A parent who is exempt but lives with a taxed relative moves to tier 4 or 5 at 0.9 or 1.0, which is about ¥23,500 to ¥46,000 a year more at the same pension. Missing premium payments has its own consequences, set out in unpaid care insurance premiums.

Facility meals and rooms

The burden limit certificate cuts meal and room charges at a special nursing home, a geriatric health facility, a care medical institution and during short stays. Paid nursing homes are outside it. The household head, every member and the spouse must be exempt, and savings must sit under a ceiling.

From August 1, 2026 the daily meal cap for residents is ¥300 at Stage 1 and ¥390 at Stage 2. It is ¥680 at Stage 3-1 and ¥1,420 at Stage 3-2, against a standard cost of ¥1,545 (MHLW notice Vol. 1506). A multi-bed room at a special nursing home costs ¥0, ¥430, ¥430 or ¥530 a day on the same scale. For a single person the savings ceiling falls from ¥10 million at Stage 1 to ¥5 million at Stage 3-2, with ¥6.5 million and ¥5.5 million in between. A couple may hold ¥10 million more.

The line between Stage 2 and Stage 3-1 rose from ¥809,000 to ¥826,500 in August 2026. Unlike the premium test, this income figure also includes non-taxable survivor and disability pensions.

Monthly care cap

The high-cost care service benefit refunds co-payments above a monthly ceiling. A fully exempt household has a ceiling of ¥24,600, against ¥44,400 for an ordinary taxed household. A member whose pension income plus other income is ¥826,500 or less, or who receives an old-age welfare pension, has a personal ceiling of ¥15,000.

Meals, room charges and the purchase of care equipment are not counted. The refund needs an application to the city, and Article 200 of the Long-Term Care Insurance Act allows two years to claim. When care and medical bills are both heavy over a year, the combined medical and care cost refund adds a further layer.

Exemption also decides the co-payment rate itself. A user who is exempt is never placed at 20 or 30 percent, as explained in how the care co-payment rate is decided.

Welfare corporation reduction

Some facilities and services run by social welfare corporations reduce charges further for households that still struggle. The national guidelines require a resident-tax-exempt household, annual income of ¥1.5 million or less for one person and savings of ¥3.5 million or less. Each extra household member adds ¥500,000 to the income line and ¥1 million to the savings line.

The household must also have no usable assets beyond daily needs and no unpaid premiums, and must not be supported by a relative able to pay. The standard cut is a quarter of the user's charge, or half for an old-age welfare pension recipient. Only corporations that have signed up offer it, so ask the facility first. Eligibility and the card are covered in social welfare corporation cost reduction.

A last safety net is the boundary-layer measure (kyokaiso gaito). A household that would still need public assistance after these reductions can get a welfare office certificate that applies a lower tier instead. For the monthly care cap, that can mean ¥24,600 or ¥15,000 (Enforcement Order Article 22-2-2). The door is a public assistance consultation at the welfare office, not the care insurance desk.

Medical costs from 70

For people aged 70 and over, an exempt household is Category II under the high-cost medical expense benefit. Category I is the subset whose incomes are each zero. In Chigasaki City's guidance the pension deduction is counted as ¥826,500, and for national health insurance the household means the head and every enrolled member.

For treatment from August 2026 to July 2027 the Category II ceilings are ¥11,000 a month for outpatient care per person and ¥25,700 for the household. A new annual outpatient cap of ¥96,000 applies to Category II. Category I ceilings are ¥8,000 and ¥15,700, against ¥22,000 and ¥61,500 for General.

Hospital meals are cheaper too. In the Kanagawa association's schedule from June 1, 2026, a meal costs ¥550 for General and ¥270 for Category II. It drops to ¥220 after more than 90 days in hospital within 12 months, and Category I pays ¥130. New limit certificates stopped on December 2, 2024 in that association, so a parent shows the My Number insurance card or an eligibility certificate that states the category. The full table is in the high-cost medical benefit over 70.

The yearly calendar

Exemption is decided again every year, and a small rise in income can move a parent up a tier the following year. The dates below are the points to watch.

• January 1: the resident tax reference date. The address on this day and last year's income decide the new year.
• April 1: the household is fixed for the care premium tier (Koto City and Setagaya City guidance).
• June: resident tax is set, and Koto City mails the care premium notice to everyone aged 65 or over.
• July (around): the co-payment rate certificate arrives. Check the end dates printed on the facility and welfare corporation certificates.
• August 1: the facility reduction, the high-cost care cap and the co-payment rate switch to the new year.

Documents to collect

A family abroad rarely sees the letters, so agree in advance who in Japan will photograph them on arrival. These are the papers that answer most questions.

A 10 percent co-payment certificate alone does not prove exemption, because many taxed people are also at 10 percent. The tax certificate settles it.

• The resident tax certificate (kazei or hikazei shomeisho) for the latest fiscal year.
• The care insurance premium notice, which shows the tier and the yearly amount.
• The co-payment rate certificate, valid from August 1 for a year.
• The burden limit certificate and any welfare corporation confirmation card, each with an end date.
• The high-cost care refund application, if the city has sent one.
• The My Number insurance card or an eligibility certificate showing the medical category.

Handling it from abroad

Most steps can be handled by mail or through a care manager, but the rules for proxies differ by city. Before anything else, phone or email the city to ask which forms it accepts from a relative and whether a proxy letter is needed.

A workable split is for the parent or a relative in Japan to receive and sign, while the family abroad tracks dates and reads the notices. The care manager can confirm which certificates are in force and when they end.