* Persons with low income refer to insured persons and dependents exempted from municipal tax or to insured persons and dependents who do not require public assistance if they are approved as eligible for measures for reducing cost burdens for persons with low income.
* Those whose standard monthly remuneration is 530,000 yen or more do not fall in the category of persons with low income, even if they are exempt from paying municipal tax.
* To be placed in one of the low-income categories, you must apply in advance for a maximum copayment/reduced standard copayment certificate for health insurance, even when using a Myna health insurance card.
Cost-Sharing Maximum Amounts for High-Cost Medical Care Benefits
Category
Cost-Sharing Maximum Amounts
Frequent qualification of expenditures
Persons with low income
35,400 yen
24,600 yen
*When an eligible person qualifies for high-cost medical care benefits for at least three months of a 12-month period, starting with the fourth month, the cost-sharing maximum amount is reduced to the amount for cases of frequent qualification of expenditures
Cost-Sharing Maximum Amounts for High Aggregate Cost for Long-term Care Service
** Low income II: Persons aged 70 or above who are insured persons and
dependents etc., and exempt from paying municipal tax
** Low income I: Persons aged 70 or above in households whose insured persons and
dependents are all exempt from paying municipal tax and whose incomes
meet certain standards (e.g., pension income not exceeding 800,000 yen), etc.
** Those in the category of persons with the same income level as active workers do not fall in the category of persons with low income, even if they are exempt from paying municipal tax.
** To be placed in the low income I or II category, you must apply in advance for a maximum copayment/reduced standard copayment certificate for health insurance, even when using a Myna health insurance card.
Cost-Sharing Maximum Amounts for High-Cost Medical Care Benefits
Category
Cost-Sharing Maximum Amounts (outpatient)
Cost-Sharing Maximum Amounts (per household)
Low income II
8,000 yen
24,600 yen
Low income I
8,000 yen
15,000 yen
*No frequent qualification of expenditures applies.
Cost-Sharing Maximum Amounts for High Aggregate Cost for Long-term Care Service