Measures for reducing cost burdens for persons aged 70-74

The copayment rate for medical care costs for elderly persons aged 70-74 is lower than for younger persons.

*When you reach age 75, you will become an insured person under the Medical Care System for the Advanced Elderly. See here for more information.

Applying to the Recruit Health Insurance Society for High-Cost Medical Care Benefits (Outpatient Annual Total)
When applying for High-Cost Medical Care Benefits (Outpatient Annual Total) to another health insurer

Applying to the Recruit Health Insurance Society for High-Cost Medical Care Benefits (Outpatient Annual Total)

When applying for High-Cost Medical Care Benefits (Outpatient Annual Total), check the following information and apply to the Recruit Health Insurance Society directly. (You do not need to apply for ordinary High-Cost Medical Care Benefits. They are calculated automatically.)

Claimants	Insured persons of the Recruit Health Insurance Society as of the basis date Basis date: The last day of the calculation period (July 31); or the day before the date of loss of eligibility if the person (subject to settlement) is no longer covered by health or long-term care insurance due to death during the calculation period (August 1 – July 31)
Subject persons:	Insured persons or dependents (those in the general or low-income category as of July 31) aged 70 or older who received outpatient treatment and for whom the total copayment amount during the period in the general or low-income category during the calculation period (August 1 of the previous year – July 31) exceeded the 144,000 yen maximum * Applies to examinations and treatment received August 1, 2017 and later. * The copayment is the amount after subtracting High-Cost Medical Care Benefits, patient cost-sharing reimbursement, subsidies from public funds, and the like.
Required documents:	①If not a member of any other health insurance during the one-year period prior to the basis date Application Form for Payment of High-Cost Medical Care Benefits (Outpatient Annual Total)/Issue of Copayment Certificate(A4) Example ②If a member of any other health insurance during the one-year period prior to the basis date Application Form for Payment of High-Cost Medical Care Benefits (Outpatient Annual Total)/Issue of Copayment Certificate(A4) Example ・Copayment Certificate of High-Cost Medical Care (Outpatient Annual Total) issued by the other medical insurer
Deadline:	Within two years from the day after the basis date
Submit to:	See here for where to submit.
Address inquiries to:	Operations Group, Health Insurance Society 0120-501-042 (Choose voice guidance option 1.)
Notes:	If you apply by notifying your Individual Number instead of your health insurance card code/number, you must submit separate documents to verify your Individual Number and your identification. See here for more information on the documents that need to be submitted for Individual Numbers.

When applying for High-Cost Medical Care Benefits (Outpatient Annual Total) to another health insurer

Claimants	Those who are not insured by the Recruit Health Insurance Society on the basis date but were insured persons of the Recruit Health Insurance Society during the period from August 1 of the previous year through July 31 Basis date: The end date of the calculation period (July 31). However, in the event that the member of health or long-term care insurance (person subject to settlement) no longer is a member due to having died during the calculation period (August 1 of the previous year – July 31), the basis date will be the day before loss of eligibility.
Subject persons:	Insured persons or dependents (those in the general or low-income category as of July 31) aged 70 or older who received outpatient treatment and for whom the total copayment amount during the period in the general or low-income category during the calculation period (August 1 of the previous year – July 31) exceeded the 144,000 yen maximum * Applies to examinations and treatment received August 1, 2017 and later. * The copayment is the amount after subtracting High-Cost Medical Care Benefits, patient cost-sharing reimbursement, subsidies from public funds, and the like.
Required documents:	Application Form for Payment of High-Cost Medical Care Benefits (Outpatient Annual Total)/Issue of Copayment Certificate(A4) Example The Health Insurance Society will issue a Copayment Certificate of High-Cost Medical Care (Outpatient Annual Total) after receiving the application. Attach this certificate to the Application Form for Payment of High-Cost Medical Care Benefits (Outpatient Annual Total) and submit it to the current health insurer as of the basis date.
Deadline:	Within two years from the day after the basis date
Submit to:	See here for where to submit.
Address inquiries to:	Operations Group, Health Insurance Society 0120-501-042 (Choose voice guidance option 1.)
Notes:	If you apply by notifying your Individual Number instead of your health insurance card code/number, you must submit separate documents to verify your Individual Number and your identification. See here for more information on the documents that need to be submitted for Individual Numbers.

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