operation

The system will be administered by "regional associations" established at the prefectural level.
It is operated by the Tokyo Metropolitan Association of Medical Care for the Elderly, which has all cities, wards, towns, and villages in Tokyo (62 municipalities) as members.
The regional association certifies insured persons (qualification), determines insurance premiums (levies), pays medical expenses (benefits), and implements health care projects.
The city hall handles counter services such as the handing over of certificates related to medical care for the elderly, accepting various applications, and collecting insurance premiums.
The system is funded by 50% public funds, 40% subsidies from each insurer (such as National Health Insurance and Social Insurance) to which people up to the age of 74 are enrolled, and 10% of insurance premiums from enrollees.

For more information, please visit the Tokyo Metropolitan Association of Medical Care for the Elderly website.