medical expenses (COVID-19)

• After April 1, 2024, we will shift to a normal medical system and the public expenditure will end.
• As with other medical expenses, you will have to pay a regular window according to the medical expenses's out-of-pocket ratio.

　With regard to medical insurance, the high medical costs system has been established for monthly charges (including the cost of therapeutic drugs), and there is no co-payment exceeding the limit according to income. (For procedures related to the high medical costs system, please check with each insurer who has joined.)

(Reference) Ministry of Health, Labour and Welfare website (high medical costs system) (outside site)

　The handling of public expenses varies depending on the time of hospitalization. Please refer to [Reference] Inpatient medical expenses (before March 2024) below.

• October 2015 - March 2016: Part of the drug cost is paid by public funds
• Until the end of September 2023: All drug costs are paid by public expenses

　The co-payment of drug costs is based on the medical expenses's co-payment ratio.

• Out-of-pocket ratio is 10%: 3,000 yen
• Out-of-pocket ratio is 20%: 6,000 yen
• Out-of-pocket ratio is 30% acceptable: 9,000 yen
• "Zevudi", "Ronaprobe", and "Ebasheld", which are purchased by the government and distributed free of charge to the desired medical institutions, etc., will not continue to be charged for drug (self-pay).

　Public expenses will be applied to the full amount of drug costs. (No self-pay)

　Even drugs prescribed for COVID-19 infections are not covered by public expenses for drug costs other than the above treatments. In addition, procedure fees, initial consultation fees, prescription fees, dispensing fees, etc. are not covered by public expenses.

　There is no need for patients or relatives to go to hospitals or public health centers.

　medical expenses related to COVID-19 infection
　Expenses not covered by medical insurance (linen fee, meal fee, etc.) are not eligible.

　There is no need for the patient to proceed with the public expenditure if the medical institution has confirmed the patient's income category using the online qualification confirmation system or the limit application certificate. Please check with the medical institution to see if it is applied.

(Reference) Please refer to each insurer (National Health Insurance, company insurance, mutual aid, etc.) to which the patient has joined for the limit application certificate.

・Those who were hospitalized before May 7, 2023
・Those who were hospitalized after May 8, 2023 (inpatient medical expenses until September)
・Hospitalization from October 2023 to March 2024 medical expenses

　Until May 31, 2023, public expenses will be borne by public expenses for expenses required for medical treatment for the infectious disease, excluding insurance coverage (equivalent to self-pay). Non-insurance medical treatment is not eligible. (In addition, public expenditure decision letter will not be issued for hospitalization after May 1)
　However, if hospitalization continues on or after June 1, 2023, the portion covered by public expenses will be covered by insurance for medical expenses on or after that date, and you will be charged by yourself.
　However, in order to avoid a sudden increase in the burden, if the medical institution confirms the patient's income category, in principle, 20,000 yen will be reduced (excluding non-insurance coverage) from the monthly high medical costs calculation standard amount for each medical insurance system.
　For more information about high medical costs, please check with each insurer.
　If you receive a prescription for the treatment of the infectious disease, the cost of the drug will be reduced. ※For 1, the entire public expenditure (procedures fees are not included) (until the end of September 2023).
　There is no need to apply for public expenses.
　※1 The target therapeutic drugs are "Ragebrio", "Pakilobid", "Zocoba", "Becklery", "Zevudi", "Ronapurve", and "Evacheld".

　If you are hospitalized for the infectious disease after May 8, 2023, you will be charged for medical expenses.
　However, in order to avoid a sudden increase in the burden, if the medical institution confirms the patient's income category, in principle, 20,000 yen will be reduced (excluding non-insurance coverage) from the monthly high medical costs calculation standard amount for each medical insurance system.
　For more information about high medical costs, please check with each insurer.
　In addition, if you receive a prescription for the infectious disease treatment at the time of hospitalization, the drug cost will be reduced. ※For 1, the entire public expenditure (procedures fees are not included) (until the end of September 2023).
　※1 The target therapeutic drugs are "Ragebrio", "Pakilobid", "Zocoba", "Becklery", "Zevudi", "Ronapurve", and "Evacheld".

　In principle, the maximum amount of self-pay will be reduced by 10,000 yen from the monthly high medical costs calculation standard amount (the amount paid by the high medical costs system) for each medical insurance system.
　Click here for details on the copayment limit (PDF: 121KB)

　About public expenditure support of therapeutic drugs in the case of hospitalization
　○　Regarding hospitalization, first of all medical expenses’s views on COVID-19 infections, including drugs for the treatment of COVID-19 infections.
　　Determining whether the amount equivalent to the burden ratio will be reduced by 10,000 yen in principle from the co-payment limit of the high medical costs system in each medical insurance system.
　　I shall do it.
　①　If this is achieved, the patient's burden for COVID-19 infection will be calculated from the co-payment limit of the high medical costs system under each medical insurance system.
　　In principle, the amount reduced by 10,000 yen (if the medical expenses proportional amount is included, the medical expenses proportional amount +5,000 yen) will be applied (COVID-19 infection).
　　medical expenses, a treatment agent, is included in the hospital medical expenses for COVID-19 infection.
　　→　Only inpatient public expenses are applied (therapeutic public expenses are not applied)
　②　If this is not achieved, measures 1 to reduce 10,000 yen in principle from the co-payment limit of the high medical costs system under each medical insurance system will not be applied.
　　medical expenses's out-of-pocket ratio is 3,000 yen or 20%.
　　The maximum amount of co-payment is 6,000 yen per person and 9,000 yen for 30% (inpatients related to COVID-19 infections excluding therapeutic drugs) is medical expenses.
　　It does not apply public funding and claims as medical insurance).
　　→　Only medical expenses are applied (inpatient public expenses are not applied)

　For details, please see the Kanagawa homepage (outside site).

　For those who have visited a hospital due to the infectious disease before May 7, 2023 and wish to receive a refund from Kanagawa Prefecture, please check the contents described in the "Notice" below and send the complete set of required documents to the designated destination. If you are unable to print on your own, please contact Health and Welfare Division in your district.

　・≪Be sure to confirm≫ Notice (PDF: 854KB)…Click here for required documents and the destination.
　・ Application form for refund (style) (PDF: 228KB)…It is necessary to prepare for each person.
　≪Reference≫ Case of medical expenses subject to redemption payment (PDF: 263KB)

　Applicable to those who have visited a hospital before May 7, 2023
　Attention: Those who have visited the hospital after May 8, 2023 are not eligible.

　If you visit a medical institution and receive a positive confirmed diagnosis by an antigen test on the day of the consultation, the initial consultation fee, second or subsequent visit (Saishin) fee, in-hospital triage fee, etc. on that day will be the cost incurred before the positive decision, and will not be refunded. Target cases are also posted on the Kanagawa Prefecture website (outside site), so please check carefully in advance before proceeding.

　Kanagawa Medical Crisis Response Headquarters Office Regional Medical Care Support Group (prefecture representative telephone: 045-210-1111)