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High-cost medical care and high-cost long-term 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)

Annual amount
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)

Annual amount
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

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2111 Higashi Naganuma, Inagi City, Tokyo 206-8601
Open agency hours: 8:30 a.m. to 5:00 p.m. Main phone number: 042-378-2111 Fax: 042-377-4781
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