High-cost medical care and high-cost long-term care combined system
Update date: December 8, 2023
If there is a recipient of long-term care insurance in a household where medical expenses have become high, the annual co-payment amount (from August to July of the following year) will be added up as shown below after applying the limits of National Health Insurance and long-term care insurance. If the amount exceeds the limit (limited to cases where the amount exceeding the limit exceeds 500 yen), the excess amount will be paid if the application is approved.
Notifications and application forms are sent every year to households that may be eligible.
Self-pay limit for those under 70 (total amount of health insurance and long-term care insurance)
| Income requirements (total income amount, etc. - 430,000 yen) | Division | Out-of-pocket limit |
|---|---|---|
| More than 9,010,000 yen or undeclared income | ah | 2.12 million yen |
| More than 6 million yen but less than 9.01 million yen | stomach | 1.41 million yen |
| More than 2.1 million yen but less than 6 million yen | hare | 670,000 yen |
| 2.1 million yen or less | workman | 600,000 yen |
| Resident tax exempt household | o | 340,000 yen |
- If you are under 70 years of age, you will be eligible for the calculation if you have paid 21,000 yen or more out-of-pocket within the same month per medical institution (hospitalization and outpatient are calculated separately).
- The income classification applies as of the reference date (July 31st of each year).
Maximum co-payment for those aged 70 to 75 (total amount of health insurance and long-term care insurance)
| income category | Out-of-pocket limit |
|---|---|
| Earnings at the same level as active workers 3 | 2.12 million yen |
| Earnings at the same level as active workers 2 | 1.41 million yen |
| Earnings at the same level as active workers 1 | 670,000 yen |
| one General | 560,000 yen |
| low income 2 | 310,000 yen |
| low income 1 | 190,000 yen |
- In the case of low-income1 households with multiple long-term care insurance recipients, the calculation standard amount is applied differently.
- For details on each income category, please refer to " Regarding copayment ratios ."
- The income classification applies as of the reference date (July 31st of each year).
Inquiries about this page
Inagi City Citizens Department Insurance and Pension Division
2111 Higashi Naganuma, Inagi City, Tokyo
Phone: 042-378-2111 Fax: 042-377-4781
