Certificate of eligibility for ceiling-amount application, High-Cost Medical Care Benefit System
Certificate of eligibility for ceiling-amount application, Certificate of reduction of the standard amount of patient liability (70 years old or younger)
Application to your medical insurance is required before hospitalization. Payment of hospitalization charges for a month can be limited to a certain amount.
If you did not present a certificate, you will be charged the standard insurance rate.
Maximum copayment
| Application classification | Maximum copayment (monthly amount) |
|---|---|
| a. Standard monthly remuneration 830,000 yen or more | 252,600 yen＋(Total medical expenses－842,000 yen)×1％ ＊Corresponding number of installments 140,100 yen |
| b. Standard monthly remuneration 530,000 - 790,000 yen | 167,400 yen＋(Total medical expenses－558,000 yen )×1％ ＊Corresponding number of installments 93,000 yen |
| c. Standard monthly remuneration 280,000 yen to 500,000 yen | 80,100 yen＋(Total medical expenses－267,000 yen)×1％ ＊Corresponding number of installments 44,000 yen |
| d. Standard monthly remuneration Less than 260,000 yen | 57,600 yen ＊Corresponding number of installments 44,000 yen |
| e. Low income Non-taxable income tax | 35,400 yen ＊Corresponding number of installments 24,600 yen |
1. Documents needed for application
- Application form (available at each application agency)
- Seal
- Health insurance certificate
- Certificate of reduction of the standard amount of patient liability (if eligible)
- Receipts, etc. showing period of hospitalization
(Patients hospitalized for 91 days or more over the past year and whose household is exempt from resident tax)
2. Application agency / counter
- National health insurance municipal office
- Health insurance Japan Health Insurance Association
- Mutual aid insurance Local office or place of employment
- Union‐managed health insurance Union office or place of employment
High-Cost Medical Care Benefit System
Under this system, medical expenses paid in a month exceeding a certain amount are reimbursed.
1. Documents needed for application
- Application form (available at each application agency)
- Seal
- Health insurance certificate
- Hospital receipts (invoices)
- Bankbook (money transfer destination bank account number)
2. Application agency / counter
- National health insurance municipal office
- Health insurance Japan Health Insurance Association
- Mutual aid insurance Local office or place of employment
- Union‐managed health insurance Union office or place of employment
Loan system for high medical costs For patients charged for high medical costs
Required documents for application and application agency are the same as the above “High-Cost Medical Care Benefit System”.
Measure to reduce copayment of meals during hospitalization
Low income earner II
- For hospitalization up to 90 days
1 meal 210 yen - Hospitalization for more than 90 days within the past year
1 meal 160 yen
Low income earner I
- Persons receiving elderly welfare pensions
1 meal 100 yen