Measures for reducing cost burdens for persons aged 70-74
The copayment rates and cost-sharing maximum amounts for medical care for persons aged 70–74 are lower than for persons less than 70 years of age.
- *When you reach age 75, you will become an insured person under the Medical Care System for the Advanced Elderly.See herefor more information.
There is no frequently asked questions and answers that have been registered.
Copayment rate for medical care costs
The copayment rate for medical care costs for elderly persons aged 70-74 is lower than for younger persons. Persons aged 70-74 must present their elderly benefits cards when undergoing examinations.
The copayment rate for individuals aged 70–74
Cost-sharing maximum amounts for high-cost medical care
Cost-sharing maximum amounts for elderly persons aged 70–74 are lower than for persons less than 70 years of age.
A per-person cost-sharing maximum amount for outpatient care and a combined cost-sharing maximum amount for total outpatient and inpatient cost-sharing amounts per household apply in cases in which more than one member is covered under the same medical insurance plan within one household.
For high-cost medical care for which the total amount paid per household exceeds the cost-sharing maximum amount, you will be refunded the excess amount at a later date.
Caution:
Those falling in the category of the same income level as active workers II or active workers I must submit a Certificate of Application of Maximum Copayment Amount to avoid paying more than the cost-sharing maximum amount at a hospital.
If you expect to incur high medical care costs, apply to the Society to obtain a certificate in advance.
(Outpatient)
(Outpatient and inpatient)
(Elderly benefits card copayment rate: 30%)
(Standard monthly remuneration830,000 yen or more)
(medical care costs-842,000 yen)×1%
[Frequent qualification of expenditures 140,100 yen]
(Standard monthly remuneration 530,000 yen - 790,000 yen)
(medical care costs-558,000 yen)×1%
[Frequent qualification of expenditures 93,000 yen]
(Standard monthly remuneration280,000 yen - 500,000 yen)
(medical care costs-267,000 yen)×1%
[Frequent qualification of expenditures 44,400 yen]
(Elderly benefits card copayment rate: 20%)
260,000 yen or less
<Annual maximum (August of the previous year to July): 144,000 yen>
[Frequent qualification of expenditures 44,400 yen]
(This benefit is not paid automatically.)
Annual High-Cost Medical Care Benefits for outpatient care (annual total of outpatient costs) for those aged 70 or older
Insured persons and dependents aged 70 or older whose total copayments for outpatient care during the one year period (from August 1 of the previous year to July 31) exceeded 144,000 yen are eligible to be reimbursed for the excess amount as High-Cost Medical Care Benefits.
Column
Persons earning income at the same levels as active workers
Elderly persons earning income at the same levels as active workers are referred to as “persons earning income at the same levels as active workers.” The copayment for such individuals is 30%.
For health-insurance purposes, this refers to persons whose standard monthly remuneration is 280,000 yen or more. However, persons meeting either of the descriptions below may apply to the Health Insurance Society to be treated as persons with normal income levels.
Persons in the earlier stage of old age
Elderly persons aged 65 through 74 are referred to as “persons in the earlier stage of old age.” Since most persons in the earlier stage of old age are covered by National Health Insurance, a system of financial adjustment between health insurance systems has been introduced whereby health insurance associations and other insurers with low percentages of persons in the earlier stage of old age will cover the cost of benefits for persons in the earlier stage of old age.