The top of page

Link for movement in page
We move to global navigation
We move to the text
We move to footer menu
It is jumped to the text - Top menu|Search
It is global navigation from here
It is the text from here

Medical system for elder senior citizens

Important news

Update information

Topics

Adobe Reader is necessary to see PDF file. This software is available from link to Adobe company.

Topics (latest information, news)

With 1 medical system for elder senior citizens

We move to medical system for elder senior citizens from medical insurance that we joined till then when we reach 75-year-old birthday in medical system that person 75 years or older takes out.

Current system began in 2008 so that elderly people that conventional Japanese society was supported felt relieved for the future, and medical care was received.

The system is such that active generation and elderly people assist this system together. As for the expense necessary for administration, approximately 40%, elderly people bear approximately 10% for premium for tax (public money) approximately 50%, active generation.
→→Structure (PDF file 345kb) to assist

The municipalities cooperate with elderly aged 75 or over medical care interjurisdictional affiliation (we say "interjurisdictional affiliation" as follows.) established by every metropolis and districts and perform administration. Interjurisdictional affiliation runs system mainly, and the municipalities perform window duties mainly.

For details, please see Kanagawa elderly aged 75 or over medical care interjurisdictional affiliation homepage.

<about participation>

We take out medical system for elder senior citizens automatically when we become 75 years old. There is no procedure necessary to join. On the pre-end of the month of the 75-year-old birth moon, we send identification of elderly aged 75 or over medical care person insured from interjurisdictional affiliation.

In addition, people who are on welfare do not become with person insured.

<when family comes to one moved to by employee health insurance of company>

When the person moves to medical system for elder senior citizens when the person joins employee health insurance and health insurance union of company, and family becomes the dependent, family will withdraw from the medical insurance, too.

In this case family will take out other medical insurance such as National Health Insurance of Yokohama-shi. Participation to National Health Insurance needs procedure in ward office Insurance and Pension Division National Health Insurance Section.

→→Thing (page of National Health Insurance) necessary for report of National Health Insurance participation

<about participation of impaired person>

When constant impaired person applies to interjurisdictional affiliation in 65 years old or more, and authorization (note) is considered to be when there is in state of obstacle, we can move to medical system for elder senior citizens from medical insurance joining now such as National Health Insurance.

Window burden with medical institution may become 10% when we move to medical system for elder senior citizens. In addition, premium is different from premium of medical insurance taking out now. For more details, please refer to ward office Insurance and Pension Division National Health Insurance Section.

You hope for participation to medical system for elder senior citizens in 65 years old or more, and please file for one that is going to receive authorization in ward office Insurance and Pension Division National Health Insurance Section.

(note) "authorization" means authorization of interjurisdictional affiliation. It is different from authorization to receive grants such as certificates of the physically disabled.

◆Thing necessary for report
  • Documents (medical certificates of notebook (nursing notebook) of certificate of the physically disabled, love, mental patient health welfare notebook, rente, doctor) which can confirm constant obstacle
  • Health insurance card to have now
  • Documents about personal number (my number)
  • Seal kan ※In the case of signature, we omit seal.

<about the severeness person with a disability medical expenses furtherance>

To impaired person corresponding to either from 1 to 4 next, there is severeness person with a disability medical expenses furtherance business. Report to ward office Insurance and Pension Division National Health Insurance Section is necessary, and sum equivalent to co-payment is supported (in the one issued mental patient notebook to, only going to hospital is targeted for the furtherance).

Person who receives grant of certificate of the physically disabled of 1 first grade, second grade

One that is judged to be less than 35 in 2 intelligence quotients

Certificate of the physically disabled which receives grant and is judged to be less than 50 in intelligence quotient of 3 third grade

Person who receives grant of mental patient notebook of 4 first grade

↑To the top of page

When 2 medical institutions cost (about medical care benefits)

(1)Co-payment

When you consult medical institution, please show identification of elderly aged 75 or over medical care person insured. At window, we bear 10% of medical expenses or 30%.


(2)High medical costs

When self-pay of medical expenses of one month (the same during the month) became large, thing beyond the self-pay ceiling returns as high medical costs. After applying personal unit, the self-pay ceiling applies household unit. In addition, payment with medical institution is to the self-pay ceiling every window.

The table 1-1 self-pay ceiling (monthly basis: in August, 2018 from medical treatment) 
Income divisionSelf-pay ratioThe foreign ceiling (personal unit)The ceiling (household unit) that we matched outpatient department, hospitalization with
Income earner at the same level as active play 30% 252,600 yen + (total medical expenses -842,000 yen) *1%
[140,100 yen] (※ 1)
Income earner at the same level as active play 167,400 yen + (total medical expenses -558,000 yen) *1%
[93,000 yen] (※ 1)
Income earner at the same level as active play 80,100 yen + (total medical expenses -267,000 yen) *1%
[44,400 yen] (※ 1)
The public 10% 18,000 yen
<144,000 yen> (※ 2)
57,600 yen
[44,400 yen] (※ 1)
Low-income person 2 10% 8,000 yen 24,600 yen
Low-income person 1 10% 8,000 yen 15,000 yen
The table 1-2 self-pay ceiling (monthly basis: in July, 2018 to medical treatment)
Income divisionSelf-pay ratioThe foreign ceiling (personal unit)The ceiling (household unit) that we matched outpatient department, hospitalization with
Income earner at the same level as active play 30% 57,600 yen 80,100 yen + (total medical expenses -267,000 yen) *1%
[44,400 yen] (※ 1)
The public 10% 14,000 yen
<144,000 yen> (※ 2)
57,600 yen
[44,400 yen] (※ 1)
Low-income person 2 10% 8,000 yen 24,600 yen
Low-income person 1 10% 8,000 yen 15,000 yen

  (※ 1) It is the ceiling from the fourth when we corresponded to high medical costs more than four times for the past 12 months.
  (※ 2) The amount of annual upper limit. (one year until August - next year July)

About exception of 75 years old birth month
Medical insurance system (National Health Insurance, employed insurance) and the self-pay ceiling in medical-care system for the latter-stage elderly after birthday that we joined before birthday originally reduce person reaching 75-year-old birthday in the middle of month to a half of sum about birth month. (excluded toward the daily birthplace)

(3)Hospitalization meal allowance for family medical expenses, life allowance for family medical expenses

When we were hospitalized, there are burdens such as meal charges (the food expenses bear one meal of unit, three times a day). Burden becomes expense of lower table every kind of hospital and bed. In addition, calculation of high medical costs does not contain meal medical treatment standard burden, life medical treatment standard burden.

 

Table 2-1 meal medical treatment standard burden
Person insured bears the food expenses (meal medical treatment standard burden) when admitted to general hospital.
Income divisionThe food expenses per one meal
Income earner at the same level as active play and the public 460 yen
 Designated incurable disease patient who does not correspond to low-income person 1.2 260 yen
Low-income person 2 (hospitalization until 90 days) 210 yen
Low-income person 2 (hospitalized more than 91 days during the past 12 months) 160 yen
Low-income person 1 100 yen
Table 2-2 life medical treatment standard burden
Person insured bears the food expenses and residence costs (life medical treatment standard burden) when admitted to medical treatment bed. Please confirm to medical institution whether you correspond to medical treatment bed.
Income divisionSelf-pay ratioThe food expenses per one mealResidence costs per day
Income earner at the same level as active play  30% 460 yen [420 yen (※ 1)] 370 yen
 The public   10%  460 yen [420 yen (※ 1)] 370 yen
Low-income person 2  10% 210 yen 370 yen
Low-income person 1  10% 130 yen 370 yen
Old-age welfare pension recipient of low-income person 1  10% 100 yen 0 yen
  • We bear the food expenses of sum same as general hospital about need which high state leads to and hospitalization medical care hospitalized in rehabilitation ward for convalescence.
  • Designated incurable disease patient does not have burden of residence costs.

(※ 1) When we are admitted to hospital calculating life allowance for family medical expenses (2) at hospitalization. (please confirm whether you are calculated to medical institution)


 When we receive grant of "burden reduction certificate standard elderly aged 75 or over medical care ceiling application" (reduction certificate) beforehand when we arrive at low-income person 1 and low-income person 2 and show to window of medical institution, it is when window burden on co-payments such as hospitalization is to the ceiling of table 1-1 and table 1-2, and it is each sum of table 2-1, table 2-2 about meal allowance for family medical expenses, life allowance for family medical expenses at hospitalization.
 When we receive grant of "elderly aged 75 or over medical care ceiling application certificate" beforehand when there is toward active play regular income earner 1 and active play regular income earner 2 after August, 2018 and show to window of medical institution, it is when window burden on co-payments such as hospitalization is to the ceiling of table 1-1.
 Please refer to ward Insurance and Pension Division National Health Insurance Section for procedure.

(4) Judgment of income division

Self-pay ratio ("ratio listed in health insurance card of co-payment") when we hang over medical institution varies according to income division. Income division is judged by taxable income (income after various subtraction) of municipal tax of the year (as for from April to July last year).

"Income earner at the same level as active play"

As for person insured with more than 1,450,000 yen of taxable income of municipal tax and other people insured of same household, income division becomes "income earner at the same level as active play".
 In addition, division is divided into three phases by income more.

  • Taxable income of citizen of 3... income earner tax at the same level as active play more than 6,900,000 yen
  • Taxable income of citizen of 2... income earner tax at the same level as active play is less than 6,900,000 yen more than 3,800,000 yen
  • Taxable income of citizen of 1... income earner tax at the same level as active play is less than 3,800,000 yen more than 1,450,000 yen

But it is sorted "the public" by application when total incomes such as people insured meet condition of table 3 below.

Table 3: Household which sorts "the public" by application
The number of people insuredTotal income of the left one
One person insured Less than 3,830,000 yen
More than two people insured Less than 5,200,000 yen
It is people from 70 years old to 74 years old in one person insured and same household Less than 5,200,000 yen
"Low-income person 2"

As for the person insured of municipal tax tax exemption, income division becomes "low-income person 2" all the same household. (person insured except low-income person 1)

"Low-income person 1"

All the same household is municipal tax tax exemption, and, as for the person insured that each income of member of household is 0 yen (we calculate pension income for deduction 800,000 yen), income division becomes "low-income person 1".

(5) Elderly aged 75 or over medical care ceiling application, standard burden reduction certificate (reduction certificate) and elderly aged 75 or over medical care ceiling application certificate

When one corresponding to "low-income person 1.2" shows "elderly aged 75 or over medical care ceiling application, standard burden reduction certificate" (reduction certificate) to medical institution with health insurance card beforehand, payment with medical institution becomes to the ceiling of table 1-1 and table 1-2 every window. Income division becomes "the public" when we do not show and is not reduced. In addition, there is no "elderly aged 75 or over medical care ceiling application, standard burden reduction certificate" in where income division corresponds to "the public".
 
  One corresponding to "income earner 1.2 at the same level as active play" can receive grant of "elderly aged 75 or over medical care ceiling application certificate" depending on income division. Payment with medical institution is to the ceiling of table 1-1 every window by showing "elderly aged 75 or over medical care ceiling application certificate" to medical institution.

 And "elderly aged 75 or over medical care ceiling application certificate", please perform "elderly aged 75 or over medical care ceiling application, standard burden reduction certificate" of application in each ward Insurance and Pension Division National Health Insurance Section (reduction certificate).

(6)Other medical care benefits

The details about medical care benefits, please look at homepage of Kanagawa elderly aged 75 or over medical care interjurisdictional affiliation.

↑To the top of page

About 3 premiums

In medical system for elder senior citizens, interjurisdictional affiliation decides the amount of premium, and municipality to live collects the premium. Premium that municipality collected is paid by interjurisdictional affiliation.

The details about premium, please look at homepage of Kanagawa elderly aged 75 or over medical care interjurisdictional affiliation.

↑To the top of page

About 4 premium reduction measures

(1) Reduction depending on income

  Reduction of the amount of per capita rate

As for the same household that sums that added up gross income amounts of money in the last year of all the person insured and family nurturer become less than standard of the next table, the amount of per capita rate (41,600 yen) is reduced.

Standard of household where the amount of table 4 per capita rate is reduced
Standards (2018) such as gross income amounts of money of householdReduction ratioSum that is reducedThe amount of per capita rate after reduction
330,000 yen or less 8.5 percent  35,360 yen  6,240 yen
Among the households mentioned above, all the people insured are less than pension income 800,000 yen
In the case of (there is no other various income) 
 90% 37,440 yen  4,160 yen
330,000 yen + (the number of people insured belonging to 275,000 yen X household concerned) lower than  50% 20,800 yen  20,800 yen
330,000 yen + (the number of people insured belonging to 500,000 yen X household concerned) lower than  20%  8,320 yen 33,280 yen
  • Because it is unknown whether you correspond to standard, about one where is not reported income to, reduction measures are not applicable. As you may ask for presentation of "petition for income" from elderly aged 75 or over medical care counter in charge of municipality to live, please cooperate.
  • By calculation such as gross income amounts of money targeted for reduction judgment, there is no subtraction of basic deduction (330,000 yen).
    In addition, elderly person judges catching deduction from the pension in the tax law to affect one 65 years or older with amount of money that subtracted deduction 150,000 yen in particular from public pension income.
  • "Standards such as gross income amounts of money of household", please be careful in different one every year.

(2)Reduction of employed insurance which was dependent

On the day before to take out medical system for elder senior citizens, as for the association of national employee health insurance management employee health insurance, seamen's insurance, health insurance union, cooperative association which was dependent, premium is reduced (not for National Health Insurance, National Health Insurance Association which was member).

 There is not burden of the amount of income percent and burdens only the amount of per capita rate from the moon which took out system, and, as for the reduction ratio of amount of per capita rate, it is to 50%.

  • In addition, about after 2019, reduction ratio of amount of per capita rate becomes 50% only for period until month passing after the participation in two years.

↑To the top of page

About change of 5 payment methods

(1)When we hope for change of payment method

Premium should be, and from pension pay, but want, and can choose payment by fund transfer more. Premium to be expected to pay in the year is the same even if we have you choose either payment method.
 In addition, we may not be changed to fund transfer when nonpayment occurs about elderly aged 75 or over medical care premium before payment start from pension though there are not unavoidable special circumstances and did not accept demand of payment.
 In addition, we will change for payment from pension when state that fund transfer is not possible continues after the change of payment method.

※The handling of social insurance deduction about premium
In the case of final income tax return, we can do the amount of premium paid in fund transfer with the amount of social insurance deduction of one of account holder of a title deed from accounts such as relatives except the person. As a result, burden of income tax of whole family and residence tax may fall. (in the case of payment from pension , it becomes subtraction of person insured.)

(2)About procedure

You ask ward office Insurance and Pension Division National Health Insurance Section of ward to live, and please submit the following documents.
  • Elderly aged 75 or over medical care premium payment method change proposal book
    (proposal book to keep payment from pension as)
  • Yokohama-shi elderly aged 75 or over medical care premium fund transfer request book
    (fund transfer request book (three pieces copying) to financial institution)

  Thing necessary for procedure: Identification of elderly aged 75 or over medical care person insured, bankbook, report mark of bankbook
 (note 1) Procedure is necessary for one that had you pay National Health Insurance charges by fund transfer some other time.
 (note 2) Fund transfer finishing procedure offers payment method change with elderly aged 75 or over medical care premium, and please submit only book. But you put together, and please submit fund transfer request book when you want to change withdrawal designation account.

(3)Time when payment from pension is canceled

(it takes time for 2-3 months before payment from pension stops after having proposal. As it becomes payment from pension during then, forgive.
When I cannot switch to fund transfer, I will inform so by mail.

↑To the top of page

About 6 reports

Time such as next table 5 needs report to ward office Insurance and Pension Division National Health Insurance Section of ward to live.

Table 5: When report is necessary
DivisionWhen report is necessaryThing necessary for report
Participation When we moved into from outside the prefecture Certificates such as elderly aged 75 or over medical care burden division,
Documents about personal number (my number) (feel mark)
When we were not on welfare The protection abolition, stop letter of advice,
Documents about personal number (my number) (feel mark)
In 65 years old - 74 years old
When there is defect in uniformity
Documents (medical certificates of notebook (nursing notebook) of certificate of the physically disabled, love, mental patient health welfare notebook, rente, doctor) which can confirm constant obstacle, health insurance card to have now, documents about individual number (my number) (feel mark)
Withdrawal When we are transferred to outside the prefecture Health insurance card, documents about personal number (my number) (feel mark)
When we were on welfare Protection decision letter of advice, health insurance card,
Documents about personal number (my number) (feel mark)
When he died Health insurance card (thing of person who died),
Documents about personal number (my number), seal kan
When it was for obstacle state non-pertinence in one receiving obstacle authorization or when we withdraw application of obstacle authorization Health insurance card (feel mark)
Others When address changed in the city Health insurance card, documents about personal number (my number) (feel mark)
When address changed in the prefecture
(other municipalities)
Documents, (we feel mark) about personal number (my number),
(in the case of transference procedure, please return health insurance card in front.)
When full name changed Health insurance card, documents about personal number (my number) (feel mark)
When or loss polluted health insurance card Health insurance card, documents about personal number (my number) (feel mark)

※In the case of signature, we omit seal.

※"Documents about personal number" (my number)
Please bring documents
of the next one or two.

1.Documents which can identify personal number
<among next one point>
 Notice card, my number card, copying (thing which personal number was listed in) of resident certificate

2.Documents to confirm the person
<be over one point potato> :
 Documents which the date of birth and address can identify as full name with documents with photograph of the face issued by public office
(example) my number card, driver's license, passport, certificate of the physically disabled, mental patient health welfare notebook, nursing notebook, residence card
<thing which two points are necessary for>
 Documents which the date of birth or address can identify as full name with documents without photograph of the face issued by public office
(example) health insurance card, care health insurance card, National Pension Plan (Kokumin Nenkin) notebook

↑To the top of page

7 Yokohama-shi Health Checkups

The details, please look at page of Yokohama-shi Health Checkups about Yokohama-shi Health Checkups.

◆About the self-medication taxation system (exception of medical expenses subtraction)

 When individual performing "constant approach" as approach to maintenance increase of health and the prevention of illness purchased switch OTC pharmaceutical products (pharmaceutical products converted among instruction pharmaceutical products required and OTC drugs by medical use) on after January 1, 2017, the self-medication taxation system (exception of medical expenses subtraction) can receive deductions from income about the purchase expense.

 As for the details, please see homepage of Ministry of Health, Labour and Welfare about self-medication.
 About report of the self-medication taxation system (exception of medical expenses subtraction), please see homepage of the National Tax Agency.

 ※Downloading of proof request book about deductions from income when paid purchase costs such as specific OTC drugs this (PDF361KB)
  (after filling out entry, seal of claimer full name, the large frame, please submit to Insurance and Pension Division National Health Insurance Section of ward to live.)


↑To the top of page

8 public information

↑To the top of page

9 and others

↑To the top of page

It is footer menu from here