RetireJapan

This is another example of the short of unexpected costs that can suddenly hit you and why you should save. My 'father-in-law' recently suffered a series of strokes and heart attacks having had a full and healthy life up to 77. Until the recent trauma he had never had a night in hospital or any serious illness and worked full time til he was 75 because he quite liked the social life at work. He now needs full time care in a specialist home and will never be able to speak, eat or sit up again. The cheapest option we have been quoted is 100,000 yen a month and the average has been 200,000. This is not for medical treatment as that is capped at 25,000 yen a month but for the 'hotel' charges. Fortunately, the 'father-in-law' lived a frugal life and saved most of his salary. Hence this is not a financial shock to us as his own resources will last quite a few years.

Ooof, sorry to hear that. At least you won't have money worries on top of everything else.

Those costs would be pretty bad if both partners had them simultaneously though -something to think about.

Very sorry to hear that, Stewart.

My wife's parents are still quite healthy but are getting on in years (dad is 81, mom is 78), and when my mom passed away last year, we did some researching on the options should something like this happen here in Japan. As noted, most of the places we looked at (介護付き有料老人ホーム, 特別養護老人ホーム, 住宅型有料老人ホーム etc.) charge rent, and also charge for meals, living expenses etc. There are public and private options. Private options are generally more expensive.

Most of the places charge 1- 5 million yen (or more!) up front when you move in, keep that in mind. The nursing care fee is capped at around Y25,000 (介護保険) BUT medical care (not nursing care) is not covered - you still have to pay for doctor visits, medication etc (usually 一割負担, you pay 10% of the cost insurance covers the rest). Note that what is and isn't covered can depend on if you're at a public or private facility.

You can pay up front or pay by the month, we haven't looked to deeply into it, it seems paying up front is cheaper but I'm not sure about getting funds back if the relative passed away etc fairly quickly after moving in.

Other expenses you may not think of: If the resident wants to go out of the facility, there's usually a charge for someone to take them out and stay with them. Haircuts and such. Any other items purchased (books, eyeglasses etc).

Assuming a payment of Y2.5 million on moving in, Y150,000 in rent and Y50,000 a month in other expenses not covered, you'd pay about Y26 million over 10 years. However, the patient (like, assuming my father in law) gets nenkin payments, so the actual amount required is significantly less (pay your nenkin, people).

In our case, there has been no moving in fee for a private facility and all medical fees nursing and doctors visits are capped at 25,000 yen a month because my father in law is over 75 and has only half a state pension to live on. There are doctors employed by the facility that he lives in. Since he is a semi vegetable state there are no extra costs such as you mentioned - he cannot walk, eat, drink, speak or sit up unaided and needs constant medical care. In a shared room with four other men the fee is 200,000 yen a month for the 'hotel charges'

How does/doesn't 介護保険 (that I've been paying) factor into this kind of care?

From what I understand, that will pay for care in the home from support staff. My Grandmother in law had that for a few years - I think three times a week a home helper and / or nurse would visit her in her home since she lived alone but had some problem walking.