Unlike health insurance, the benefit of the LTCI will not automatically be granted just by showing the insurance card. To be eligible for the benefit, the beneficiary must apply to the municipal government for need assessment. Only after the person is assessed as disabled, he or she will be entitled to the benefit.

A beneficiary must apply to the municipal government and the municipal government send a surveyor to the applicant. The surveyors must be qualified care managers and on-site survey will be conducted using the uniform assessment tool, which consists of 73 survey items to measure ADLs, IADLs and behaviors. The surveyors may record any particular findings to be considered for final assessment but they have no authority to make any judgment.

The recorded assessment tools will be evaluated by computer to give preliminary assessment [dismiss, borderline, level1,2,3,4,5]. The municipal governments will also ask attending doctors who are designated in the application forms to submit their professional opinion.

The need assessment review committees [NARC] consisting of around five health and welfare professionals will review the surveyors' findings and doctors' professional opinion to decide whether the preliminary assessment should be altered.