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Measures for reducing cost burdens for persons with low income

Measures are available to reduce financial burdens for persons who find it difficult to pay medical care costs due to low income.

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Less than 70 years of age

  • * Persons with low income refer to insured persons and dependents exempted from municipal tax or to insured persons and dependents who do not require public assistance if they are approved as eligible for measures for reducing cost burdens for persons with low income.
  • * Those whose standard monthly remuneration is 530,000 yen or more do not fall in the category of persons with low income, even if they are exempt from paying municipal tax.

Cost-Sharing Maximum Amounts for High-Cost Medical Care Benefits

Category Cost-Sharing Maximum Amounts Frequent qualification of expenditures
Persons with low income 35,400 yen 24,600 yen
  • ** If you qualified for High-Cost Medical Care Benefits for three months or longer during the most recent 12-month period, the amount will be reduced to the amount for frequent qualification of expenditures starting with the fourth month.

Cost-Sharing Maximum Amounts for High Aggregate Cost for Long-term Care Service

Category Cost-Sharing Maximum Amounts
Persons with low income 340,000 yen

Inpatient meal standard expenses during hospitalization (per meal, up to three meals/day)

Category   Cost-Sharing Maximum Amounts
Persons with low income Through the 90th day hospitalized over the past 12 months prior to the month of application 210 yen
Beginning with the 91st day hospitalized over the past 12 months prior to the month of application 160 yen

Standard copayment when hospitalized at a convalescent facility

Category Cost-Sharing Maximum Amounts
Persons with low income Those with low degrees of medical necessity (Medical Care Category I) Meal expenses: 210 yen/meal
Accommodation expenses: 370 yen/day
Those with high degrees of medical necessity (Medical Care Categories II or III) Meal expenses: 210 yen/meal
Accommodation expenses: 370 yen/day (0 yen for patients with designated intractable diseases)

Ages 70-74

  • ** Low income II: Persons aged 70 or above who are insured persons and dependents etc., and exempt from paying municipal tax
  • ** Low income I: Persons aged 70 or above in households whose insured persons and dependents are all exempt from paying municipal tax and whose incomes meet certain standards (e.g., pension income not exceeding 800,000 yen), etc.
  • ** Those in the category of persons with the same income level as active workers do not fall in the category of persons with low income, even if they are exempt from paying municipal tax.

Cost-Sharing Maximum Amounts for High-Cost Medical Care Benefits

Category Cost-Sharing Maximum Amounts (outpatient) Cost-Sharing Maximum Amounts (per household)
Low income II
(Elderly benefits card copayment rate: 20%)
8,000 yen 24,600 yen
Low income I
(Elderly benefits card copayment rate: 20%)
8,000 yen 15,000 yen
  • *No frequent qualification of expenditures applies.

Cost-Sharing Maximum Amounts for High Aggregate Cost for Long-term Care Service

Category Cost-Sharing Maximum Amounts
Low income II 310,000 yen
Low income I 190,000 yen

Inpatient meal standard expenses during hospitalization (per meal, up to three meals/day)

Category   Cost-Sharing Maximum Amounts
Low income II Through the 90th day hospitalized over the past 12 months prior to the month of application 210 yen
Beginning with the 91st day hospitalized over the past 12 months prior to the month of application 160 yen
Low income I 100 yen

Standard copayment when hospitalized at a convalescent facility

Category Cost-Sharing Maximum Amounts
Low income II Those with low degrees of medical necessity (Medical Care Category I) Meal expenses: 210 yen/meal
Accommodation expenses: 370 yen/day
Those with high degrees of medical necessity (Medical Care Categories II or III) Meal expenses: 210 yen/meal
Accommodation expenses: 370 yen/day (0 yen for patients with designated intractable diseases)
Low income I Those with low degrees of medical necessity (Medical Care Category I) Meal expenses: 130 yen/meal
Accommodation expenses: 370 yen/day
Those with high degrees of medical necessity (Medical Care Categories II or III) Meal expenses: 100 yen/meal
Accommodation expenses: 370 yen/day (0 yen for patients with designated intractable diseases)

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