Proportion of Medical Expenses

The percentage of medical expenses that you pay out of pocket at the hospital varies by age.

Age-specific Self-burden Ratio

Before compulsory education (until the first March 31 after reaching the age of 6)

20% burden

Under 70 years old after entering elementary school

30% burden

Aged 70 and over but under 75

20% or 30% copayment
Note: Those who turned 70 years old by April 1, 2014, are subject to special measures allowing for a 10% or 30% copayment.

Income Category	Burden Ratio	Applicable Standards
Active Income Earners 3 (Taxable Income of 6.9 million yen or more) Active Income Earners 2 (Taxable Income of 3.8 million yen or more) Active Income Earners 1 (Taxable Income of 1.45 million yen or more)	30%	Those who have a National Health Insurance beneficiary aged 70 to under 75 in the same household with taxable income of 1.45 million yen or more. However, if the total income of the applicable individuals is less than 5.2 million yen for two or more people, or less than 3.83 million yen for one person, the burden ratio will be the same as the "General" category when applying.
General (Taxable Income under 1.45 million yen)	20%	Individuals who do not fall under the categories of high-income earners, low-income earners 2, or low-income earners 1.
Low Income Group 2	20%	Household heads and National Health Insurance beneficiaries who are exempt from resident tax.
Low Income Person 1	20%	Household heads and National Health Insurance insured persons who are exempt from resident tax, and whose income after deducting necessary expenses and deductions for each income category is 0 yen. (The public pension deduction amount is calculated at 800,000 yen.)

A qualification confirmation document or qualification information notice will be issued to those who turn 70 years old.

For those who turn 70 years old, the self-payment ratio for Medical Expenses paid at hospitals will change starting from the month after their birthday (for those born on the 1st, it will be that month). Since the self-payment ratio is determined based on income, please remember to declare your income.
In late the month of your 70th birthday (for those born on the 1st, it will be late the previous month), we will mail a qualification confirmation document or notification of qualification information that includes the payment ratio. After December 2, 2024, the Older Adults Recipient Certificate will not be issued anew.
The Older Adults Recipient Certificates issued by December 1, 2024, can be used until their expiration date. Around July 2025, we plan to mail a qualification confirmation document or notification of qualification information that includes the payment ratio after August 1, 2025.

About Reduction and Exemption of Partial Payment

In cases where life becomes significantly difficult due to disasters or special circumstances, a portion of the burden fee may be reduced or exempted depending on the situation.