Copayment rate for medical care costs

The copayment rate for medical care costs for elderly persons aged 70-74 is lower than for persons under 70 years of age. Note that those not using a Myna health insurance card must present an elderly benefits card to receive examinations and treatment.

• * We recommend using a Myna health insurance card. Doing so eliminates the need to present an elderly benefits card.
• * From December 2, 2024, elderly benefits cards will in principle be issued to those who have an Eligibility Verification Certificate. (Up until December 1, 2025, they can be issued to those who have a valid health insurance card.)

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.

• * The maximum annual limit is calculated for the period through August of each calendar year.
• ◇Those falling in the category of the same income level as active workers will be treated as such, even if they are exempt from paying municipal tax.

参考リンク

• When you incur high medical care costs

When a person aged 70 or older encounters a high copayment amount for outpatient treatment (annual outpatient total for high-cost medical care)

When the total copayment amount (*2) during the period of belonging to the general or low-income category during the calculation period (August 1 of the previous year ? July 31) (*1) for an insured person or dependent aged 70 or older who underwent outpatient treatment (only those in categories other than persons with income comparable to income earned by active workers as of July 31) exceeds the annual maximum of 144,000 yen, the amount beyond the maximum will be paid as insurance benefits.

• *1   If the patient was a member of another health insurance society or other insurer during the calculation period, the copayment amounts are aggregated together.
• *2  ·Amounts that contribute to the sum include copayment amounts paid by each insured person or dependent (must belong to the general or low-income category) aged 70 or older who received outpatient treatment.
  ·Copayments for outpatient treatment are determined after subtracting refunds from medical insurance (such as High-Cost Medical Care Benefits and additional benefits) and public assistance.