In-Home Care Services (Homon Kaigo)

In-home care services (homon kaigo) let a certified elder keep living at home with scheduled help for bathing, meals, medication routines, and light housekeeping.¹² For families coordinating care from nearby or from abroad, the system turns a care-level certification into a weekly visit rhythm managed through one coordinator.

Confirm current details with official sources

Procedures, fees, and requirements can change. Confirm current details at the Ministry of Health, Labour and Welfare (厚生労働省) care service pages and the parent's municipal long-term care insurance counter.

Overview

The 訪問介護 (hōmon kaigo, "home-visit care") service sends a ホームヘルパー (hōmu herupā, "home helper") to the elder's home to provide hands-on personal care and defined housework under 介護保険 (kaigo hoken, "Long-Term Care Insurance").¹ It exists so a person who needs care can continue an independent daily life at home for as long as possible, rather than moving into a facility.¹

Coverage is task-based, not companionship. Each visit follows the care plan and covers the parent's own daily living, not the whole household.² Municipalities run certification and local offices deliver the visits, so provider availability and scheduling differ by locality; confirm practical details with the parent's municipality.

What Homon Kaigo Covers

Insured home visits come in three national types: body care, living assistance, and clinic-visit boarding assistance.³ The care plan sets which types appear and how often, within the monthly benefit cap for the certified level.⁴

Body Care Visits

The 身体介護 (shintai kaigo, "body care") visit covers direct physical help: meal assistance and oral care, bathing preparation and washing, wiping when a full bath is not possible, toilet guidance and diaper changes, and dressing.⁴ It also covers grooming such as face washing and nail care, repositioning to prevent bedsores, bed-to-wheelchair transfers, and walking support.⁴

Only qualified staff deliver these visits, including certified care workers and beginner or practitioner training graduates.³⁴ Medication routines such as prompting and observing prescribed doses sit inside this kind of support, while injections and wound care do not; those belong to the nurse (see Visiting Nursing).⁴⁵

Living Assistance Visits

The 生活援助 (seikatsu enjo, "living assistance") visit covers housework the user cannot manage alone: cooking and serving, laundry through to storage, room and toilet cleaning, garbage handling, bed-making, shopping for daily goods, and picking up prescribed medicine.⁴ The care plan must record why the user or cohabiting family cannot do this housework themselves.³

The boundary is strict. Cooking or laundry for other family members, cleaning rooms used only by others, guest reception, and childcare fall outside the insured scope.⁴ Pet care, garden weeding, window glass wiping, repairs, large seasonal cleanups, and New Year preparations are also excluded even when they feel like ordinary housework.¹⁴

Ask what is insured before the first visit

"Can do" versus "cannot do" is the most common source of friction with home helpers. Confirm the insured task list at contract time rather than negotiating extras at the door.⁴

Visit Length and Frequency

Standard homon kaigo serves people certified at 要介護1–5 who live at home, including serviced senior housing without on-site care; people at 要支援1–2 use the preventive form with weekly caps of up to twice a week at 要支援1 and up to three times a week at 要支援2 (as of 2022-12; confirm current figures with the municipal counter).⁴ Frequency scales with certification, from weekly visits at lighter levels to multiple visits per day at heavier levels (as of 2022-12).⁴

Pricing is time-banded per visit. At a 10 percent copayment, body care runs 163 yen for under 20 minutes, 244 yen for 20–30 minutes, 387 yen for 30–60 minutes, and 567 yen for 60–90 minutes; living assistance runs 179 yen for 20–45 minutes and 220 yen for 45 minutes or more; clinic boarding assistance is 97 yen one way (as of 2026-06; confirm current figures with the Ministry of Health, Labour and Welfare).¹³ Regional unit prices and night or early-morning surcharges shift the final yen figure slightly by locality (as of 2026-06).³ Two visits on the same day must normally be spaced at least two hours apart; closer visits count as a single service under the 2-hour rule.⁶

Visit type	Time band	10 percent copay example	As of	Notes
Body care	Under 20 min	163 yen	2026-063	Shortest hands-on visits
Body care	20–30 min	244 yen	2026-063	Common bathing or meal slot
Body care	30–60 min	387 yen	2026-063	Longer personal care
Body care	60–90 min	567 yen	2026-063	Extended support
Living assistance	20–45 min	179 yen	2026-063	Cleaning, cooking, laundry
Living assistance	45 min or more	220 yen	2026-063	Larger housework blocks
Boarding assistance	One way	97 yen	2026-063	Taxi fare itself not covered

Related Home Visit Services

Homon kaigo is one of several home-visit services, and families often combine them. Each has its own staff, entry rule, and insurance logic, so ask the care manager which ones the plan should include.⁴

Visiting Nursing

The 訪問看護 (hōmon kango, "home-visit nursing") service sends licensed nurses to the home for medical and nursing care: vital-sign observation, medication management, blood-sugar measurement and insulin injections, and other doctor-ordered procedures.⁵ Staff may include public-health nurses, midwives, and rehab specialists matched to the patient's condition.⁵

Nothing starts without a doctor's 訪問看護指示書 (hōmon kango shijisho, "home-visit nursing instruction").⁵ The instruction defines the nursing content, and staff coordinate with the medical institution rather than deciding alone.⁵ Certified users aged 65 and above normally route through kaigo hoken, while younger certified users with specified diseases also use kaigo hoken and others use medical insurance.⁵

Visiting Bathing

The 訪問入浴介護 (hōmon nyūyoku kaigo, "visiting bathing care with portable tub") brings a portable tub to the home for elders who cannot bathe even with family help.⁴ A team of about three people, including nursing staff, handles the bath plus preparation and dressing.⁴

This is the service for severe mobility limits, including bedbound status. Nurses check blood pressure, pulse, and temperature around the bath, which also relieves the family of that monitoring burden.⁴ Practitioner sources describe users as concentrated at heavier care levels, though exact shares vary by reporting year.

Visiting Rehabilitation

The 訪問リハビリテーション (hōmon rihabiritēshon, "visiting rehabilitation") service sends licensed physical, occupational, or speech therapists to the home.⁴ Sessions maintain basic movement, support safe daily activity, and practice communication where needed.⁴

Use requires the doctor's instruction note, just as with visiting nursing.⁴ The goal is maintaining function and preventing decline so home life can continue safely.⁴

The Care Manager and the Care Plan

Every certified family gets a coordinator who turns the assessed need into a working weekly schedule. Understanding this role is the fastest way to get value from the system.⁷

A Designated Coordinator From Certification

The 介護支援専門員 (kaigo shien senmon'in, "care manager," commonly ケアマネジャー, kea manējā) takes the case after certification.⁷ Families choose a 居宅介護支援事業所 (kyotaku kaigo shien jigyōsho, "home-care support office"), often from municipal or 地域包括支援センター (chiiki hōkatsu shien sentā, "community comprehensive support center") listings or a hospital referral at discharge.⁴⁷ For preventive levels (要支援1–2), the support center handles planning instead.⁴

Care management itself costs the family nothing extra. Planning, provider coordination, and monthly monitoring are covered in full by kaigo hoken with no user copayment, unlike most covered services where the user pays 10–30 percent.⁷

The coordination cycle runs as a loop rather than a one-time handoff:

How the Care Plan Is Built

Services run on the ケアプラン (kea puran, "care plan") the care manager writes.⁴ The manager assesses daily life in concrete terms: mobility, bathing, toileting, meals, medication, cognition, falls, sleep, shopping, and who can help locally.⁷ Specific detail produces a better plan than general frailty language, so bring dated notes such as fall dates or when bath use stopped.⁷

The draft service mix is settled at a provider conference with the user, family, and offices, and the family must agree before anything starts.⁴ Families then sign a direct contract with each chosen provider office covering content, frequency, fee share, and emergency response.⁴ If the working language at home is not Japanese, translate the key page into Japanese since planning runs in Japanese.⁷

Bring one page the manager can act on

List who lives where, who approves costs and at what threshold, who joins meetings, and how urgent issues escalate across time zones. Managers plan around constraints they know about; put the structure in writing in Japanese.⁷

Adjusting the Service Mix Over Time

The manager visits the home at least monthly to check how the plan is working.⁷ Hospitalization, falls, cognitive change, caregiver burnout, or housing problems all justify a review, and re-certification can be requested early when needs change materially.⁷

Switching offices later is allowed with no fee and no gap in running services, since the case file transfers to the new office.⁷ Treat switching as a remedy for genuine mismatch rather than routine shopping, because continuity carries real value as the manager accumulates knowledge of the person.⁷

How to Start Homon Kaigo

The path from application to first visit has no shortcut, so start early. Allow roughly a month for certification alone before provider selection begins.⁴⁵

Confirm Certification First

Without a care-level certification there are no insured visits.⁴ The family applies at the municipal kaigo-hoken counter, a trained assessor visits the home, and the notice typically arrives by mail around 30 days after the survey.⁴ Certification takes effect retroactive to the application date.⁶

Choose a Provider and Sign a Contract

The care manager introduces candidate offices, and families may also choose through word of mouth or doctor referral.⁴ Once the office is chosen, the family signs a direct contract and the first visit date is set with an introductory meeting.⁴ The manager stays as the contact for later changes of helper or office.⁴

What the First Visit Establishes

The first visit sets the routine: daily-life needs, key handover, record keeping, and a face-to-face introduction with the assigned helper.⁴ Helpers follow the care plan only, so ad hoc extra tasks outside the plan are not added on the spot.² Raise gaps with the care manager, who adjusts the plan rather than the visit.²

Costs and Coverage

Users pay 10 percent of approved service costs as the base, with higher-income users paying 20–30 percent (as of 2024-03; confirm current figures with the Ministry of Health, Labour and Welfare).⁵⁷ Each care level carries a monthly benefit cap in units; for example, 要介護5 allows 36,217 units, roughly 362,170 yen at 10 yen per unit before copay (as of 2024-03).⁵ Amounts above the cap are fully self-paid (as of 2024-03).⁵

Time-based unit bands are set nationally with regional unit-price variation, and night, early-morning, and late-night visits carry surcharges (as of 2026-06).³ Only the boarding assistance portion of clinic trips is insured; taxi fares themselves are not covered (as of 2026-06).³ For tasks outside insurance, private-pay services exist at full self-pay, with provider-market rates around 2,000–4,000 yen per hour by office; practitioner sources report this band inconsistently, so treat it as a planning sketch and confirm with the office (as of 2025-08).⁶

Good to know

Homon kaigo does not cover every household task

Some families expect the helper to clean the whole house or cook for everyone. The insured scope covers the user's own daily living only, so family portions, guest reception, pet care, and large cleanups stay outside even when they feel like ordinary housework.¹⁴ Confirm the task list at contract time and route anything extra to private-pay options.⁴

Medical tasks belong to the nurse, not the helper

Helpers provide body care and housework, while injections, IVs, wound care, and other doctor-ordered procedures belong to visiting nursing under a nursing instruction.⁴⁵ If the parent's needs are shifting toward medical care, ask the care manager to add or expand the nursing visits rather than pressing the helper.⁵

The same helper each time is not guaranteed

Long one-to-one hours make personality fit matter, and offices rotate staff across cases.⁴ When the fit is wrong, tell the care manager and request a change of helper or office; the switch path exists and carries no fee.⁴⁷ An organized family that surfaces issues early competes well for the manager's limited attention.⁷

Missed or refused visits still disrupt the routine

The multi-step flow from application to first visit takes weeks, including roughly one month for the certification notice, so starting late compresses choices.⁴⁵ Once visits run, refused or missed sessions break continuity without lowering the underlying need. Keep the family's own record of changes and concerns between monthly monitoring visits so adjustments have raw material.⁷

See also

• The Long-Term Care Insurance System (Kaigo Hoken)
• Care-Level Certification (Yoshien / Yokaigo)
• Day Services and Short Stays (Day Service / Short Stay)
• Residential Care: Tokuyo vs. Roken vs. Yuryo Rojin Home
• Hospital Admission and the Visitor-Stay Reality
• Finding an English-Speaking Provider

References

Footnotes

1. 厚生労働省. 介護サービス情報公表システム「どんなサービスがあるの？ 訪問介護（ホームヘルプ）」. https://www.kaigokensaku.mhlw.go.jp/publish/group2.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

2. Japan Care Concierge. "home-visit care (訪問介護) glossary". https://japancareconcierge.com/en/glossary/houmon-kaigo/ ↩ ↩² ↩³ ↩⁴

3. 厚生労働省 老健局. 「訪問介護」(社保審 介護給付費分科会 第259回 R8.6.29 資料1). https://www.mhlw.go.jp/content/12300000/001716093.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴

4. SOMPOケア. 「訪問介護とは？特徴や利用条件、受けられるサービス内容を解説」(公開2021-10-01, 更新2022-12-05). https://www.sompocare.com/contents/zaitaku-service/what-is-home-visit-care/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶ ↩²⁷ ↩²⁸ ↩²⁹ ↩³⁰ ↩³¹ ↩³² ↩³³ ↩³⁴ ↩³⁵ ↩³⁶ ↩³⁷

5. SOMPOケア. 「訪問看護とは？利用対象者やサービス内容、費用について紹介」(公開2021-10-01, 更新2024-03-21). https://www.sompocare.com/contents/zaitaku-service/visiting-nursing/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³

6. LIFULL介護. 「訪問介護とは？料金や訪問看護・居宅介護との違い」(更新2026-08-25). https://kaigo.homes.co.jp/manual/homecare/zaitaku_service/visitcare/ ↩ ↩² ↩³

7. Japan Care Concierge. "What a Care Manager in Japan Does for a Foreign Family" (published 2026-06-03, updated 2026-06-12). https://japancareconcierge.com/en/blog/care-manager-japan-foreign-family/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶