When a parent can no longer wash, eat or move about alone, the first term families hear in Korea is the “long-term care grade.” The Long-Term Care Insurance for Older Persons Act lets people 65 or older apply, as well as those under 65 with geriatric diseases such as dementia or cerebrovascular disease, and article 7 of its Decree splits six grades by a long-term care recognition score. We read the Act and Decree as written.
1. Grades are set by score. 95 or more is grade 1, 75–95 grade 2, 60–75 grade 3, 51–60 grade 4, and for dementia patients 45–51 grade 5 and under 45 the cognitive support grade.
2. Co-payments are 15% at home and 20% in a facility. Home visits for care, bathing and similar cost 15% of the benefit cost; nursing homes and other facilities 20%. Recipients under item 1 of article 3(1) of the Medical Aid Act pay nothing, and low-income users get up to 60% off.
3. The first recognition lasts 2 years. On renewal, grade 1 lasts 5 years, grades 2 to 4 last 4 years, and grade 5 and the cognitive support grade 2 years.
Who can apply — Act articles 2 and 12
“Older persons and similar” in article 2 item 1 means people 65 or older, or people under 65 with geriatric diseases such as dementia or cerebrovascular disease (Decree Annex 1). They must also be health insurance subscribers or dependants, or medical aid recipients (art. 12). Benefits go to those recognised as unable to manage daily life alone for 6 months or more (art. 2 item 2).
You apply to the National Health Insurance Service with an application and a doctor’s opinion from a doctor or Korean medicine doctor. The opinion may be submitted until the Service passes the file to the grading committee, and people with severe mobility problems may be exempt (art. 13).
Grades — Decree article 7
| Grade | Recognition score | Condition |
|---|---|---|
| Grade 1 | 95 or more | Needs others’ help entirely in daily life |
| Grade 2 | 75 to under 95 | Needs help for a considerable part |
| Grade 3 | 60 to under 75 | Needs help partly |
| Grade 4 | 51 to under 60 | Needs help for some part |
| Grade 5 | 45 to under 51 | Dementia (geriatric disease) patients |
| Cognitive support grade | Under 45 | Dementia (geriatric disease) patients |
Scores are calculated by the method for measuring decline in physical and mental function set by the Minister of Health and Welfare (Decree art. 7(2)). Grade 5 and the cognitive support grade are open only to dementia patients, so without dementia a score under 51 falls outside the grades.
How long recognition lasts — Decree article 8
| Case | Validity | Basis |
|---|---|---|
| First recognition | 2 years | Art. 8(1), main text |
| Renewal — grade 1 | 5 years | Item 1 |
| Renewal — grades 2 to 4 | 4 years | Item 2 |
| Renewal — grade 5 and cognitive support | 2 years | Item 3 |
The grading committee may lengthen or shorten validity by up to 6 months depending on the applicant’s condition (art. 8(2)).
Benefits and co-payments — Act articles 23 and 40, Decree article 15-8
| Benefit | What it covers | Co-payment |
|---|---|---|
| Home-based | Home care visits · bathing visits · nursing visits · day and night care · short-term care · other home benefits (equipment) | 15% |
| Facility | Long-term stay in a care institution | 20% |
| Special cash | Family care allowance · special care allowance · care hospital nursing allowance | Outside the co-payment article |
Recipients under item 1 of article 3(1) of the Medical Aid Act pay no co-payment (Act art. 40(2)); other medical aid recipients, people whose income and assets are below a notified amount, and people in hardship from natural disasters get graded reductions of up to 60/100 of the co-payment (para. 4). Benefits above the monthly limit, the difference when choosing benefits other than those on the recognition certificate, and non-covered items are paid in full by the user (para. 3).
Checklist
- ☐ 65 or older, or under 65 with a geriatric disease diagnosis
- ☐ Doctor’s opinion ready (may be filed before the Service’s decision)
- ☐ With a dementia diagnosis, check grade 5 and the cognitive support grade
- ☐ 15% at home · 20% in a facility — anything above the monthly limit is paid in full
- ☐ Apply for renewal before validity ends
Questions that remain
I am in my early 60s with after-effects of a stroke. Can I apply?
Under 65, a geriatric disease listed in Decree Annex 1, such as cerebrovascular disease, brings you within “older persons and similar” (Act art. 2 item 1). Check the list in the annex.
What if I disagree with the grade?
This post covers only grade standards and co-payment rates. Ask the Service about objections and review requests.
Sources
- Long-Term Care Insurance for Older Persons Act [in force 26 May 2026] [Act No. 21690] — original text (checked 30 September 2026). Source for article 2 (older persons, 6 months), articles 12 and 13 (applications), article 23 (benefit types) and article 40 (co-payments, exemption, 60% reduction).
- Enforcement Decree of the Act [in force 12 May 2026] [Presidential Decree No. 36325] — original text. Source for article 2 (geriatric diseases, Annex 1), article 7 (grade scores), article 8 (validity) and article 15-8 (15% and 20%).
Where to check further
- Applications and grade checks — the National Health Insurance Service’s long-term care website or a local branch.
- Health insurance after retirement — retiree health insurance.
Written on 30 September 2026. Articles are from the National Law Information Center; the tables are ours.
