Frequently Asked Questions (National Health Insurance)

QuestionI will turn 70 this month, will my out-of-pocket expenses at medical institutions decrease?

Response

From the month following the month of your 70th birthday (if your birthday is on the 1st, it will be the birthday month), the percentage of the co-payment you will need to pay at medical institutions will be either 20% or 30%, depending on your income from the previous year and your date of birth.
For those turning 70, a "Older Adults Health Recipient Certificate" indicating the co-payment ratio will be issued. Therefore, from the month following your 70th birthday (if your birthday is on the 1st, it will be the month before your birthday), please present both your Health Insurance Card and the Older Adults Health Recipient Certificate at the medical institution's reception.
Additionally, for households exempt from resident tax, you can apply for a "Limit Application and Standard Burden Reduction Certification". By presenting this at the medical institution's reception, your payments to each medical institution will be limited to the "Self-Burden Limit" per month. Please note that if there are any unpaid insurance taxes, the "Limit Application and Standard Burden Reduction Certification" may not be issued.

Burden Ratio for Those Aged 70 and Over

Resident tax taxable income for those aged 70 and over (National Health Insurance members) Less than 1.45 million yen	Residents aged 70 and over (National Health Insurance members) with taxable income for resident tax 1.45 million yen or more
20%	30%

Note: Even for those who fall under the 30% burden, if the total income of National Health Insurance members aged 70 and over is less than 5.2 million yen for two or more people, or less than 3.83 million yen for one person, it will become a 20% burden upon application.