When an older parent or spouse begins having difficulty bathing, walking, eating, using the toilet, or staying safely at home, families in Korea often hear the term Janggi Yoyang deunggeup for the first time.
In Korean:
- Janggi Yoyang (장기요양) means long-term care.
- Deunggeup (등급) means a grade or classification.
- Janggi Yoyang deunggeup (장기요양등급) means a government-assessed long-term care grade.
The grade affects which publicly supported services a person may use, including home-visit care, adult day care, home nursing, bathing assistance, assistive equipment, and residential nursing-home care.
Korea’s Long-Term Care Insurance system is administered by the National Health Insurance Service, usually abbreviated as NHIS. It is separate from ordinary hospital treatment covered by National Health Insurance.
Quick answer: A Korean long-term care grade is not simply a diagnosis or disability rating. It measures how much help a person needs to manage everyday life over an extended period.
Under Korea’s Long-Term Care Insurance Act, long-term care benefits are intended for people recognized as having difficulty performing daily activities independently for at least six months.
Information in this guide was reviewed against current NHIS guidance and Korean regulations in July 2026.
What Is a Long-Term Care Grade in Korea?
A long-term care grade represents a person’s assessed level of care need.
The NHIS considers practical questions such as:
- Can the person get out of bed without assistance?
- Can they wash, dress, eat, and use the toilet safely?
- Can they walk or transfer to a wheelchair?
- Do they have memory loss, wandering, confusion, or behavioral symptoms?
- Do they require nursing procedures?
- Do they have limited joint movement or other rehabilitation needs?
- How much assistance does a family member or caregiver provide?
The grade therefore focuses on the person’s actual physical and cognitive function, not only the name of the disease.
For example, two people may both have had a stroke. One may still walk, eat, and use the bathroom independently, while the other requires assistance throughout the day. Their diagnoses may be similar, but their long-term care grades may be different.
The Most Important Rule: Grade 1 Is the Highest-Need Grade
The numbering system can be confusing for foreign residents.
In some grading systems, a higher number means a higher level. Korea’s long-term care system works in the opposite direction:
- Grade 1 represents the greatest level of care need.
- Grade 5 represents a lower assessed level of physical care need and is specifically connected to dementia.
- The Cognitive Support Grade is a separate dementia-related category.
A person does not receive “better” benefits simply because the grade number is lower. A lower grade number indicates that the person has been assessed as needing more assistance.
Korea’s Six Long-Term Care Grade Categories
Korea uses Grades 1 through 5 and a separate Cognitive Support Grade.
| Grade | Recognition score | General meaning | Usual benefit direction |
|---|---|---|---|
| Grade 1 | 95 or higher | Almost completely dependent on another person for daily life | Home care or facility care |
| Grade 2 | 75 to below 95 | Needs substantial assistance with most daily activities | Home care or facility care |
| Grade 3 | 60 to below 75 | Needs significant partial assistance | Mainly home care |
| Grade 4 | 51 to below 60 | Needs assistance with some daily activities | Mainly home care |
| Grade 5 | 45 to below 51 | Has dementia and meets the Grade 5 score range | Dementia-focused home care |
| Cognitive Support Grade | Below 45 | Has dementia but scores below the Grade 5 threshold | Limited dementia-focused services |
These score ranges are published by the NHIS. Grade 5 and the Cognitive Support Grade require qualifying dementia.
Grade 1
Grade 1 generally applies when a person is almost completely dependent on another person for everyday activities.
A Grade 1 recipient may:
- Be unable to change position or get out of bed without assistance
- Need full help with eating, bathing, dressing, and toileting
- Require continuous supervision because of severe cognitive impairment
- Need extensive support to prevent falls, choking, pressure injuries, or other risks
Grade 1 recipients may generally use either home-based care or facility-based care.
Grade 2
Grade 2 usually means that the person retains limited independence but still needs extensive assistance during most of the day.
For example, the person may be able to eat after food is prepared but still require help with:
- Getting in and out of bed
- Walking or wheelchair transfers
- Bathing and dressing
- Using the toilet
- Medication and safety supervision
Grade 2 recipients may also generally use either home care or facility care.
Grade 3
Grade 3 indicates a meaningful need for assistance, although the person may retain more independence than someone in Grades 1 or 2.
A Grade 3 recipient might:
- Walk only with another person’s support
- Require help with bathing or toileting
- Be at high risk of falling
- Need supervision because of confusion
- Be unable to manage meals or household activities alone
The usual benefit direction is home care. Facility care may be approved when the assessment process recognizes a separate need for residential care.
Grade 4
Grade 4 often applies when a person can still perform several daily activities but requires regular support or supervision.
For example, the person may be able to move around inside the home but have difficulty:
- Bathing safely
- Preparing meals
- Managing medication
- Going outside alone
- Using stairs
- Getting to the toilet in time
- Remembering essential daily tasks
The normal service direction is home care, although facility care may be specially approved in qualifying circumstances.
Grade 5
Grade 5 is specifically related to dementia.
The person must have qualifying dementia and receive a recognition score from 45 to below 51.
Services often focus on:
- Maintaining daily routines
- Cognitive activities
- Safety monitoring
- Slowing functional decline
- Supporting family caregivers
A dementia diagnosis alone does not guarantee Grade 5. The person must still complete the NHIS assessment.
Cognitive Support Grade
The Cognitive Support Grade is also restricted to people with qualifying dementia.
It applies when dementia is present but the assessment score is below 45. The available services are more limited than those offered under Grades 1 through 5 and are mainly intended to support cognition, safety, and continued community living.
Home Care and Facility Care: What Is the Difference?
The distinction between home care and facility care is important because receiving a grade does not automatically mean that a person can enter a nursing home.
Home Care
Home care is called jaega geubyeo (재가급여) in Korean.
It means that the recipient continues living at home while using approved long-term care services.
Home-Visit Care
A trained care worker visits the person’s home and assists with physical and daily activities.
Support may include:
- Washing and dressing
- Toileting
- Eating
- Changing position
- Walking or transferring
- Basic household tasks directly connected to the recipient’s care
- Emotional support and daily routine assistance
This service is known as bangmun yoyang (방문요양).
Home-Visit Bathing
Home-visit bathing is called bangmun mokyok (방문목욕).
It is more than simply having a caregiver help someone take a shower. Under the formal service, two or more trained care workers generally provide bathing assistance using appropriate equipment.
Depending on the recipient’s condition and home environment, bathing may be provided:
- Inside a specially equipped bathing van
- Inside the home using hot water, a tub, pump, and hoses from a bathing vehicle
- Inside the home using a portable bathtub or the household’s own bathtub
- At an approved facility with suitable bathing equipment
A bathing vehicle is a specially registered van equipped with items such as a bathtub, water heater, water tank, pump, and hose system. This option may be used when the recipient needs specialized bathing equipment or does not have a suitable bathtub or hot water at home.
Home Nursing
Home nursing is called bangmun ganho (방문간호).
A nurse or qualified nursing assistant visits the home and provides services under a physician’s, dentist’s, or Korean medicine doctor’s instructions.
Services may include:
- Checking vital signs
- Medication education
- Wound or tube-related care
- Infection prevention
- Oral hygiene
- Fall-prevention education
- Caregiver education
- Basic rehabilitation exercises
Home nursing is not the same as having a full-time private nurse living in the home.
Day-and-Night Care
Day-and-night care is called ju-yagan boho (주·야간보호).
It is similar to an adult day care center. The recipient visits a care center for several hours and receives:
- Meals
- Supervision
- Physical and cognitive activities
- Personal care
- Social interaction
- Transportation, when provided by the center
Despite the English translation “day-and-night care,” it does not necessarily mean that the person sleeps at the center overnight.
Short-Term Respite Care
Short-term care allows the recipient to stay temporarily at an approved care facility.
It may be useful when:
- A family caregiver needs a break
- The caregiver is hospitalized
- The family must travel
- Temporary intensive support is needed
Usage limits and extension rules can change, so families should confirm the current conditions with the NHIS or the selected provider.
Assistive Equipment
Approved recipients may also be able to purchase or rent designated assistive equipment.
Examples may include:
- Walkers
- Manual wheelchairs
- Adjustable beds
- Bathing chairs
- Portable toilets
- Pressure-injury prevention equipment
- Safety handles and other designated products
The exact covered items, replacement periods, rental conditions, and annual limits depend on current program rules.
The NHIS lists home-visit care, bathing, nursing, day-and-night care, short-term care, and equipment support as major home-based benefits.
Facility Care
Facility care is called siseol geubyeo (시설급여).
It generally refers to long-term residence in a licensed nursing facility, such as:
- A long-term care nursing facility
- A small group home for older adults
Grades 1 and 2 may generally use either home care or facility care.
Grades 3 through 5 normally use home-care benefits. However, facility care may be approved when residential care is separately recognized as necessary, such as when:
- A family caregiver is unavailable or unable to provide adequate care
- The home environment is unsafe or unsuitable
- Severe dementia-related behavior makes home care impractical
- The person cannot reasonably continue living in the community
Current benefit standards state that Grades 1 and 2 may use home or facility benefits, while Grades 3 through 5 generally use home benefits unless an exception is recognized.
The person’s official Long-Term Care Recognition Certificate and Individual Long-Term Care Use Plan should be checked before arranging admission.
Important: A Korean nursing home and a long-term care hospital are not the same. A nursing home mainly provides daily care and supervision. A long-term care hospital is a medical institution that provides inpatient medical treatment.
Who Can Apply for a Long-Term Care Grade?
The applicant must normally be:
- An insured person under Korea’s Long-Term Care Insurance system
- A dependent of an insured person
- An eligible Medical Aid beneficiary
The person must also meet the relevant age and health requirements.
Applicants Aged 65 or Older
A person aged 65 or older may apply when aging, illness, disability, or declining function makes it difficult to manage daily life independently for an extended period.
A particular disease is not always required for an applicant aged 65 or older.
However, age alone is not enough. The NHIS must determine that the person has a recognized need for long-term assistance.
Applicants Under Age 65
A person under age 65 must generally have a disease officially classified as a qualifying geriatric disease, called noseong jilbyeong (노인성 질병).
Common examples include:
- Dementia
- Cerebrovascular disease, including certain stroke-related conditions
- Parkinson’s disease and related disorders
The official list is based on designated diseases and diagnosis codes. A person under 65 should confirm with the NHIS that the medical diagnosis and code are accepted before applying.
Can Foreign Residents Apply?
Foreign nationality does not automatically prevent a person from applying for a Korean long-term care grade.
The important questions are:
- Is the person enrolled in Korea’s Long-Term Care Insurance system or otherwise eligible?
- Does the person meet the age or qualifying-disease requirement?
- Does the person have a recognized long-term need for care?
Some foreign workers are permitted to apply for exclusion from Long-Term Care Insurance enrollment. A foreign worker who previously opted out may not have the same eligibility as someone who remained insured.
Foreign residents should therefore contact the NHIS and confirm:
- Current Long-Term Care Insurance enrollment
- Contribution status
- Eligibility as an insured person or dependent
- Whether any previous exclusion application is on record
Can Foreigners Apply Online?
Current NHIS instructions state that foreign nationals cannot use the standard online long-term care recognition application.
Foreign applicants may generally need to apply through:
- An NHIS branch with a long-term care operating center
- Fax
Telephone applications are generally restricted to certain renewal cases.
NHIS Foreign-Language Assistance
The NHIS lists the following contact numbers:
- NHIS main call center: 1577-1000
- English consultant: 033-811-2000
Availability, language options, and routing procedures may change, so check the current NHIS contact information before calling.
How to Apply for a Long-Term Care Grade
The application process can be understood in six stages:
- Check basic eligibility
- Submit the application
- Prepare the required documents
- Complete the NHIS home assessment
- Submit the physician’s opinion
- Receive the committee’s decision
Step 1: Check Basic Eligibility
Before applying, confirm:
- The applicant’s age
- Long-Term Care Insurance or Medical Aid eligibility
- Whether an applicant under 65 has a qualifying geriatric disease
- Whether the person’s difficulty with daily activities is expected to continue for at least six months
- Whether a foreign applicant has remained enrolled in Long-Term Care Insurance
A short-term problem following a minor injury may not fit the purpose of the system.
However, a person recovering from a major stroke, neurological disease, severe fracture, or another condition may still qualify when substantial assistance is expected to be needed for an extended period.
Step 2: Submit the Application
The applicant may apply personally, or an authorized representative may apply.
A representative may include:
- A family member
- A relative
- Another person with a legitimate relationship to the applicant
- A public social welfare official
- The head of a dementia safety center when the applicant has dementia
- A person designated by the relevant local government
Applications may be submitted by visiting an NHIS long-term care operating center, by mail, or by fax. Online applications are available only in certain cases and are not currently available to foreign nationals.
Not every NHIS branch provides full long-term care consultation services. Confirm that the branch has a long-term care operating center before visiting.
Step 3: Prepare the Required Documents
Documents commonly include:
- Long-Term Care Recognition Application Form
- The applicant’s identification
- A copy of the identification when applying by mail or fax
- The representative’s identification and authorization documents, when applicable
- A physician’s opinion
- Medical evidence of a qualifying geriatric disease for an applicant under 65
For an applicant aged 65 or older, the physician’s opinion may generally be submitted after the initial application but before the Grade Assessment Committee reviews the case.
The exact documents may differ according to:
- Age
- Nationality
- Insurance status
- Medical condition
- Type of representative
- Whether the application is new, renewed, or requesting a grade change
Foreign residents should confirm whether a Residence Card, passport, proof of relationship, translated document, or additional authorization form is required.
Step 4: Complete the NHIS Home Assessment
After the application is accepted, a trained NHIS employee normally visits the applicant’s residence.
The appointment is arranged in advance, and the time and location may be coordinated with the assessor.
The assessor uses a long-term care assessment form containing 90 items. Sixty-five items in five main areas are used to calculate the recognition score:
- Physical function
- Cognitive function
- Behavioral changes
- Nursing care needs
- Rehabilitation needs
The full assessment also considers general information, social functioning, assistive equipment, support arrangements, vision, hearing, diseases, personal needs, and the living environment.
What the Assessor May Ask
The assessor may ask whether the applicant can:
- Eat without help
- Wash their face and brush their teeth
- Dress and undress
- Use the toilet
- Control urination and bowel movements
- Stand up from a bed or chair
- Walk indoors
- Change position in bed
- Understand instructions
- Remember recent events
- Stay home alone safely
The assessor may also ask about:
- Falls
- Wandering
- Hallucinations
- Aggressive behavior
- Sleep disruption
- Feeding tubes
- Catheters
- Pressure injuries
- Joint limitations
- Paralysis
- Current rehabilitation needs
How to Prepare for the Home Assessment
The best preparation is not to memorize answers. It is to organize accurate examples of the person’s normal condition.
Prepare:
- A list of current diagnoses
- Hospital discharge summaries
- Recent medical reports
- A medication list
- Dates and details of recent falls
- Information about wandering, choking, incontinence, or nighttime behavior
- A list of daily activities requiring help
- Details of how often family members provide care
- Assistive devices currently used
- Recent changes in physical or cognitive function
A family caregiver who knows the applicant’s usual condition should attend whenever possible.
Describe Safety, Not Only Physical Ability
A common mistake is to give a technically correct but incomplete answer.
For example:
“She can walk.”
This may sound as though the person is independent.
A more useful explanation would be:
“She can walk approximately five meters with a walker, but another person must stay beside her because she has fallen twice this month.”
Another example:
“He can eat by himself, but someone must prepare soft food, place the spoon in his hand, and repeatedly remind him to continue eating.”
The assessor needs to understand whether the person can perform the activity:
- Independently
- Repeatedly
- Safely
- Without verbal prompting
- Without physical assistance
Do not exaggerate the applicant’s condition. However, do not describe only an unusually good day. Explain the person’s typical level of function and what happens when assistance is not available.
Step 5: Submit the Physician’s Opinion
The physician’s opinion provides medical information that may not be fully visible during a short home visit.
It may include:
- Main diagnoses
- Cognitive impairment
- Mobility limitations
- Treatment history
- Nursing procedures
- Rehabilitation needs
- Medical evidence of dementia or another qualifying disease
- The physician’s opinion about the person’s condition
The doctor does not directly decide the long-term care grade.
The final decision is made through the formal NHIS assessment and Grade Assessment Committee review.
Follow the NHIS instructions before obtaining the physician’s opinion. The document should normally be issued using the correct NHIS procedure and form.
Step 6: Receive the Grade Assessment Decision
The Grade Assessment Committee reviews:
- The calculated recognition score
- The home assessment report
- The physician’s opinion
- The applicant’s physical and cognitive condition
- Relevant care and living circumstances
Korean law generally requires the committee to complete the grade decision within 30 days after the application is submitted. The period may be extended when further investigation or another unavoidable reason requires additional time.
The result may be:
- Grade 1
- Grade 2
- Grade 3
- Grade 4
- Grade 5
- Cognitive Support Grade
- A result outside the recognized grades
An approved applicant normally receives:
- A Long-Term Care Recognition Certificate
- An Individual Long-Term Care Use Plan
These documents explain the approved grade, recognition period, benefit direction, and recommended services.
What Happens After Receiving a Grade?
Receiving a grade does not mean that the NHIS automatically sends a caregiver or assigns a nursing home.
The recipient or family generally needs to:
- Review the recognition certificate
- Review the individual care plan
- Decide which services are necessary
- Search for approved providers
- Compare service availability and conditions
- Sign a contract with a provider
- Pay the required user copayment
When comparing providers, consider:
- Whether the provider currently accepts new clients
- Available service times
- Transportation
- Staff qualifications
- Dementia programs
- Bathing or nursing availability
- Communication support
- Experience working with foreign families
- Additional non-covered charges
Services used beyond the approved limit or outside the covered benefit package may need to be paid entirely by the recipient.
Does a Long-Term Care Grade Make Care Free?
No.
Long-Term Care Insurance generally covers part of approved service costs, but recipients normally have a copayment.
The amount can depend on:
- Benefit type
- Grade
- Service used
- Income-related reduction eligibility
- Medical Aid status
- Whether an expense is covered or non-covered
Items such as meals, room upgrades, personal supplies, or services outside the insurance package may be charged separately.
Because fees and limits may change annually, confirm current costs with the NHIS and provider before signing a contract.
Can the Grade Change Later?
Yes.
A person’s grade may change if their physical or cognitive condition improves or worsens.
A grade-change assessment may be considered after:
- A major stroke
- A hip fracture
- Rapid progression of dementia
- Loss of walking ability
- A serious fall
- Increased nursing procedures
- A major improvement after rehabilitation
Long-term care recognition also has a defined validity period. Families should check the expiration date printed on the recognition certificate and begin renewal procedures before it expires.
A Simple Example
Consider a 78-year-old man who had a stroke.
He can eat after food is prepared, but he cannot stand safely without assistance. His wife helps him:
- Move from the bed to a wheelchair
- Use the toilet
- Bathe
- Change clothes
- Take medication
He has fallen several times and cannot remain alone for long.
His stroke diagnosis is relevant, but the diagnosis alone does not determine his grade.
The NHIS will also consider:
- How much assistance he needs
- Which activities he cannot perform safely
- How often assistance is required
- Whether he has cognitive or behavioral symptoms
- His nursing and rehabilitation needs
- The physician’s medical opinion
The final grade reflects the combined assessment of these factors.
Common Misunderstandings
“My Parent Has Dementia, So Grade 1 Is Automatic.”
No.
Dementia does not automatically result in Grade 1. The assessment considers how dementia affects:
- Daily functioning
- Safety
- Behavior
- Communication
- Supervision needs
- Dependence on another person
Someone with early dementia may receive a Cognitive Support Grade, while a person with advanced dementia and extensive physical dependence may receive a different grade.
“The Doctor Decides the Grade.”
No.
The physician provides important medical evidence, but the Grade Assessment Committee makes the official decision.
“Anyone Over 65 Can Receive Home Care.”
No.
Age allows a person to apply without proving a specific geriatric disease, but the person must still be assessed as needing long-term assistance.
“Grade 5 Is More Serious Than Grade 1.”
No.
Grade 1 represents the highest assessed level of care need. Grade 5 is a dementia-related category with a lower recognition-score range.
“Receiving a Grade Pays Hospital Bills.”
Not generally.
A long-term care grade mainly supports care services. Hospital treatment, medication, examinations, and inpatient medical expenses are normally handled through National Health Insurance or Medical Aid.
“Grade 3 Automatically Allows Nursing-Home Admission.”
No.
Grades 3 through 5 normally receive home-care benefits. Facility care requires separate recognition when home care is considered impractical or insufficient.
“Receiving a Grade Automatically Assigns a Caregiver.”
No.
The recipient or family must normally choose an approved provider and arrange the service.
Key Takeaways
Korea’s long-term care grade system can be summarized as follows:
- Janggi Yoyang means long-term care.
- A grade measures the person’s need for assistance with daily life.
- The grade is not based on diagnosis alone.
- Grade 1 represents the highest level of care need.
- Grades 1 and 2 generally allow home or facility care.
- Grades 3 through 5 normally focus on home care unless facility care is separately approved.
- Grade 5 and the Cognitive Support Grade require qualifying dementia.
- Applicants aged 65 or older do not necessarily need a specific geriatric diagnosis.
- Applicants under 65 generally need a designated geriatric disease.
- The process includes an application, home assessment, physician’s opinion, and committee decision.
- Foreign residents should confirm their insurance enrollment before applying.
- Foreign nationals cannot currently use the standard online application route.
Frequently Asked Questions
What does Janggi Yoyang mean?
Janggi Yoyang (장기요양) means long-term care.
In Korea, it commonly refers to care services provided through the national Long-Term Care Insurance system for people who have substantial difficulty managing daily life independently.
Is a long-term care grade the same as a disability grade?
No.
A long-term care grade evaluates the need for continuing assistance with everyday activities. Disability registration and other welfare programs use separate standards and procedures.
Can someone under age 65 receive a long-term care grade?
Yes, but the person must generally have a qualifying geriatric disease designated under Korean regulations.
Examples include certain forms of dementia, cerebrovascular disease, and Parkinsonian disorders.
Can a foreign resident apply?
Potentially, yes.
The person must meet the insurance, age or disease, and functional requirements. Foreign residents should confirm their Long-Term Care Insurance enrollment directly with the NHIS.
Can foreigners apply online?
Current NHIS guidance says that foreign nationals cannot use the standard internet application route.
An application may need to be submitted in person, by mail, or by fax.
How long does the decision take?
The grade decision is generally required within 30 days after the application is submitted.
The period may be extended if additional investigation or another unavoidable reason makes extra time necessary.
Does the NHIS visit the applicant’s home?
Yes.
A trained NHIS employee normally visits the applicant’s residence and completes the official assessment.
Should a family member attend the assessment?
It is usually helpful.
A family caregiver can explain how much assistance is provided, how frequently problems occur, and whether there are safety risks that may not be visible during a short visit.
Does Grade 1 mean free nursing-home care?
No.
Grade 1 generally allows facility-care benefits, but the recipient may still have a copayment and may need to pay separately for non-covered expenses.
Can a Grade 3 or Grade 4 recipient enter a nursing home?
Possibly, but not automatically.
Facility care may be approved when the assessment recognizes that continued home care is impractical because of caregiver limitations, an unsuitable living environment, or serious dementia-related behavior.
What happens if the application is rejected?
Review the written decision and the reasons provided.
Depending on the circumstances, the applicant may be able to:
- File an objection within the applicable deadline
- Submit additional medical evidence
- Request a new assessment after a significant change in condition
- Apply again later
Contact the NHIS promptly because the relevant deadline should be stated in the decision notice.
Related Guides
For a broader understanding of Korea’s elder-care system, also read:
- Korea’s Long-Term Care Insurance Explained
- Nursing Home vs. Long-Term Care Hospital in Korea
These guides can help you understand how the insurance system works and how residential care differs from medical hospitalization.
Disclaimer
This article provides general information about Korea’s Long-Term Care Insurance grade and application system. It is not legal, medical, insurance, or individualized eligibility advice.
Eligibility, application methods, required documents, recognition periods, benefit limits, copayments, and service rules may change. Individual results depend on the applicant’s insurance status, age, qualifying disease, physical and cognitive condition, medical evidence, and official assessment outcome.
Foreign residents and families should verify current requirements with the National Health Insurance Service or the relevant NHIS long-term care operating center before applying.