High-cost medical care/high-cost nursing care combined system
Updated: October 17, 2024
If there is a recipient of nursing care insurance in a household with high medical expenses, and the combined annual (August to July of the following year) out-of-pocket expenses after applying the respective limits for national health insurance and nursing care insurance exceed the limits below (only if the amount exceeding the limit exceeds 500 yen), the excess amount will be paid if the application is approved.
Potentially eligible households are sent notices and applications each year.
Note: We may not be able to send application forms to those who joined Inagi City's National Health Insurance from another health insurance company during the applicable period.
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) | classification | Out-of-pocket limit |
|---|---|---|
| More than 9,010,000 yen or undeclared income | a | 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 | cormorant | 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 |
| 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 regarding this page
Inagi City Citizens Department Insurance and Pension Division
2111 Higashi-Naganuma, Inagi-shi, Tokyo
Phone: 042-378-2111 Fax: 042-377-4781
