High-priced medical care and high-cost nursing care combined medical expenses system

　If the total amount of “National Health Insurance Out-of-pocket (*1)” and “The Long-term Care Insurance User’s Out-of-pocket (*2)” in same household for one year (from August to July of the following year) exceeds the co-payment limit, the excess amount will be paid as “summary nursing care expenses” upon application.

　※1 In the case of high medical costs, high medical costs's maximum co-payment limit is applicable. In addition, those under the age of 70 are eligible for a partial contribution of 21,000 yen or more per medical institution per month.
　※2 In the case of high-cost nursing care service costs, up to the amount of the copayment limit of high-cost nursing care service costs is eligible. It does not include food expenses, accommodation expenses, housing renovation expenses, welfare equipment purchase expenses, etc.

• Apply for medical insurance (national health insurance, medical care for the elderly, employee insurance, etc.) that you have enrolled as of the base date (July 31).
• If all insured persons in the household exceed the standard amount, the total amount of “medical insurance” and “The Long-term Care Insurance” paid for one year (from August to the end of July every year) Will be paid.
• For those aged 75 or older To the Medical System for Elderly Seniors
• If you are an employee insurance such as a health insurance union, please apply to your employee health insurance.

Example: If you pay 200,000 yen for medical insurance and 150,000 yen for The Long-term Care Insurance in one year (annual co-payment (*) 350,000 yen), you can apply for the standard amount: The amount (40,000 yen) exceeding 310,000 yen (when all households are exempt from municipal tax) will be paid.

※Out-of-pocket expenses exclude food expenses, living expenses, and differential bed charges. In addition, the cost of long-term care services is deducted from high medical costs.

※The income amount is the total income amount minus the basic deduction and the net loss carryforward.
In addition, the amount used for classification judgment is the total amount of income of all National Health Insurance members in the household.
For more information about basic deductions, please refer to the terms related to insurance premiums.
※Households with those who cannot confirm their income are classified as Category A.

From August to July of the following year, households who continue to live in Yokohama City and have taken out National Health Insurance and are likely to be eligible for the high-priced medical care and high-cost nursing care combined medical expenses system We will send you a notice of application recommendation.
However, recommendation notices may not be sent for the following households.

• Every year between August and the end of July of the following year
  • Those who have been transferred to Yokohama City from other municipalities
  • Those who have been transferred from other medical insurance to National Health Insurance

• For those who have taken out Yokohama City National Health Insurance, applications can be accepted at each ward office Insurance and Pension Division National Health Insurance Section.
• If you are a household applying for employee insurance and need a certificate of co-payment, it will be issued at each ward office Insurance and Pension Division National Health Insurance Section. Attach the “self-pay certificate” and apply for employee insurance.

Health insurance card, long-term care insurance card, passbook, etc., which shows the transfer account number, and if the insurer has changed during the calculation period, the co-payment certificate issued by the insurer who had joined before.
※If you want to transfer money to an account other than the head of household, you need private seal (the name of the head of household using vermilion).
※You do not need a receipt for medical or nursing care when applying.

Please contact Insurance and Pension Division National Health Insurance Section in your ward office.