Following are answers to some common questions about the national nursing-care insurance plan and how it works:

Why did the government create the national nursing-care insurance plan?

The government launched the plan in April 2000 to help deal with Japan's aging society, following the enactment in 1997 of the nursing-care insurance law.

The plan is to help seniors receive the care they need as they get older and to ease the workload and costs on families with elderly members.

Prior to the new system being put into place, people would have to pay for care themselves or if they couldn't, municipal governments had their own programs for the elderly in dire need of care, but only a fraction of those in need were receiving care.

According to the Health, Labor and Welfare Ministry, the number of people aged 65 and older in Japan stood at 26.6 million as of October, accounting for 20.8 percent of the population. This ratio is projected to grow to 40.5 percent in 2055.

How do people get nursing care through the plan?

Anyone aged 40 and older can apply to their municipal government for services. Each office has a screening committee of three or four medical and welfare professionals who interview the applicants and view the medical assessments from their doctor. If the committee agrees an applicant needs assistance, they decide what level.

As of March, 4.5 million people were certified as nursing-care services beneficiaries on the plan.

What services can people get?

People can get home care, which includes daily living help and having their houses cleaned, physical therapy, equipment such as wheelchairs and automatic beds.

Payments for services depend on the category of care a person is placed under in terms of need. The lowest levels of care are called "support required 1" and "support required 2." The scale then goes to "care level 1" and ends with "care level 5" at the high end.

Those certified for "support required 1" can receive home services worth up to 49,700 yen a month, while the payment for people who need the most care at "care level 5" is 358,300 yen.

Beneficiaries must pay 10 percent of all costs.

Who pays for the national nursing-care system?

The cost to run the system was budgeted at 7.1 trillion yen in fiscal 2006, up from 3.6 trillion yen in fiscal 2000, due to the increasing number of elderly people.

The central and local governments pay half of the total cost, while people aged 40 and over, including pensioners and foreign residents, pay the remainder in the form of monthly premiums. Companies pay half of the premiums of their salaried employees.

Some people are exempt from having to pay premiums, including housewives who do not work.

The premiums are calculated based on income. The average amount paid by people aged 40 to 64 in fiscal 2006 was 3,965 yen, up from 2,410 yen in fiscal 2000. People aged 65 and over paid an average 4,090 yen in fiscal 2006, up from 2,911 yen in fiscal 2000.

Who can offer nursing services under the plan?

All groups, including private companies, nonprofit organizations and public welfare foundations, can offer the services if their office or facility has been licensed by their municipal governments.

To be licensed, a provider must meet a number of requirements, including a minimum number of caregivers at a particular type of facility. There were 27,644 licensed home-care service organizations as of the end of May.

The government revised the nursing-care insurance plan in April 2006. What were the major changes?

The government said it overhauled the system mainly to curb the increase in spending in the system, improve the quality of the services offered and correct abuses of the system.

Services have been reduced for seniors in the "support required" categories, meaning a cut in payments. Beneficiaries are now required to pay all costs for meals and rents at nursing homes.

Service providers are now required to renew their licenses every six years, as well as disclose such operational information as how many caregivers they have working for them and their work experience as well as details on how facilities are being run.

Service providers that break the rules are now punished more severely. Comsn Inc., which submitted false information to municipal governments, inflating the number of employees it had working at some of its offices and facilities, will not have the licenses of those places renewed again as punishment.

The system also now allocates more money for preventive care such as exercise to strengthen seniors' weakening muscles and nutritional counseling at new support centers run by local governments.