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% co-payment

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 percentage of Medical Expenses that you pay out of pocket will change starting from the month after your birthday (for those born on the 1st, it will change in that month). Since the out-of-pocket percentage is determined based on income, please remember to declare your income.
In the late month of the birthday month for those turning 70 years old (for those born on the 1st, it will be in the late month of the previous month), we will mail a qualification confirmation document or qualification information notice that includes the burden ratio. After December 2, 2024, new Older Adults benefit certificates will not be issued.
The Older Adults benefit 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 a notice of qualification information detailing the burden 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.