About medical expenses (COVID-19)

• After April 1, 2024, we shift to normal medical system, and public expenditure burden ends.
• As with other medical expenses, you will be charged a normal window according to medical expenses's out-of-pocket ratio.

　In medical insurance, the high medical costs system has been established for monthly window charges (including the cost of therapeutic drugs), and there is no self-pay that exceeds the limit according to income. (Please check with each insurer who has joined for procedures related to the high medical costs system.)

(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 the following [Reference] About hospitalization medical expenses (before March 2024).

• From October 5 to March 2006: Part of the drug costs will be borne by public expenses
• Until the end of September 2023: All drug costs are borne by public expenses

　Out-of-pocket expenses are based on the percentage of medical expenses's out-of-pocket expenses.

• 10% out-of-pocket ratio: 3,000 yen
• 20% out-of-pocket ratio: 6,000 yen
• 30% out-of-pocket ratio: 9,000 yen
• "Zebuddy", "Ronaplelib", and "Evacheld", which are purchased by the government and distributed free of charge to the desired medical institutions, etc., will not continue to be charged with drug costs (self-pay).

　Public expenses will be applied to the full amount of drug expenses. (No out-of-pocket expenses)

　Even drugs prescribed for COVID-19 infection, drug costs other than the above therapeutic drugs are not covered by public expenses. In addition, technical 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 a hospital or public health center.

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

　If the medical institution confirms the patient's income classification using the online qualification confirmation system or the limit application certificate, the patient does not need to apply for the public expenditure. Please check with your medical institution to see if it is applied.

(Reference) For the limit application certificate, please contact each insurer (National Health Insurance, Corporate Insurance, Mutual Aid, etc.) that the patient has joined.

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

　Until May 31, 2023, of the expenses required for medical treatment for the infectious disease, excluding the insurance coverage (equivalent to self-pay) will be borne by public expenses. 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 the public expenditure will be covered by insurance for medical expenses after that date, and self-pay will be incurred.
　However, in order to avoid a sudden increase in burdens, payment at the window of the medical institution pertaining to the hospitalization, if the medical institution confirms the patient's income classification, the monthly high medical costs calculation will be reduced by 20,000 yen (excluding non-insurance coverage) from the standard amount (if less than 20,000 yen, the amount)
　For more information about high medical costs, please check with each insurer.
　If the drug is prescribed for the treatment of infectious diseases, the cost of the drug ※For 1st, all public expenses are paid (excluding technical fees) (until the end of September 2023).
　There is no need to apply for public expenses.
　※1 Therapeutic agents are Lagebrio, Pakylovid, Zocova, Becleli, Zebudi, Ronaplelibrib, and Evacheld.

　medical expenses will be charged for those who are hospitalized for the infectious disease after May 8, 2023.
　However, in order to avoid a sudden increase in burdens, payment at the window of the medical institution pertaining to the hospitalization, if the medical institution confirms the patient's income classification, the monthly high medical costs calculation will be reduced by 20,000 yen (excluding non-insurance coverage) from the standard amount (if less than 20,000 yen, the amount)
　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 ※For 1st, all public expenses are paid (excluding technical fees) (until the end of September 2023).
　※1 Therapeutic agents are Lagebrio, Pakylovid, Zocova, Becleli, Zebudi, Ronaplelibrib, and Evacheld.

　We will assist you so that the amount obtained by reducing 10,000 yen in principle from the monthly high medical costs calculation standard amount (self-payment of the high medical costs system) in each medical insurance system becomes the upper limit of self-pay.
　Click here for details of the copayment limit (PDF: 121KB)

　About public expenditure support of therapeutic drugs in the case of hospitalization
　○　Regarding hospitalization, first of all, self-assessment from the perspective of all medical expenses related to COVID-19 infection, including drugs for the treatment of COVID-19 infection.
　　Determines whether the amount equivalent to the burden ratio reaches the amount obtained by reducing 10,000 yen in principle from the co-payment limit of the high medical costs system in each medical insurance system
　　I will do it.
　①　If this is achieved, the patient's burden for COVID-19 infection will be based on the co-payment limit of the high medical costs system in each medical insurance system.
　　In principle, the reduced amount of 10,000 yen (if the medical expenses proportional amount is included, the medical expenses proportion +5,000 yen) will be applied (new coronavirus infection)
　　medical expenses is included in medical expenses for hospitalization for COVID-19 infection).
　　→　Only inpatient public expenses are applicable (excluding public expenditure for therapeutic drugs)
　②　If this is not reached, measures 1 to reduce 10,000 yen in principle from the co-payment limit of the high medical costs system in each medical insurance system will not be applied.
　　Public expenses are applied only to the patient's burden for the treatment of coronavirus infection, and medical expenses's out-of-pocket ratio is 3,000 yen, or 20%.
　　The upper limit of out-of-pocket expenses are 6,000 yen for those and 9,000 yen for 30%. (Inpatient medical expenses for COVID-19 infection excluding therapeutic agents)
　　It does not apply public funding, but claims as medical insurance).
　　→　Only public expenditure for therapeutic drugs (inpatient public expenses are not applied)

　As for the details, please see 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. If you have any questions, such as being unable to print on your own, please contact Health and Welfare Division.

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

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

　If you visit a medical institution and receive a positive definitive diagnosis by an antigen test on the day of the consultation, the first consultation fee, second or subsequent visit (Saishin) fee, in-hospital triage fee, etc. on that day will be the cost performed before the positive confirmation is confirmed. Not eligible for refund. Target examples are also posted on the Kanagawa Prefecture website (outside site), so please check carefully beforehand and complete the procedure.

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