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medical expenses, 70 years or older
[People under 74 years old and have subscribed to Yokohama National Health Insurance]
Last Updated December 22, 2022
Contents
From the month following the 70th birthday (if your birthday is 1st, from the current month) Depending on the household income status (January to July is two years before, August to December is the previous year), medical institutions The burden ratio at the counter is 20% and 30%.
Classification | Percentage of burden | Target person |
---|---|---|
Income equal to active duty | 30% | A household with at least one person who is 70 years old or older (hereinafter referred to as the "elderly") who has at least one person who has the same level of income as active duty (the standard amount of residence tax is 1.45 million yen or more) Those who belong. However, those whose income of the elderly is less than a certain amount (for one elderly person: annual income is less than 3.83 million yen, for two or more: total annual income is less than 5.2 million yen), the burden ratio is 30% It will be changed to 20%. (※2) |
General | 20% | Those who fall under any of the following conditions |
※For households that meet all of the primary conditions, the out-of-pocket ratio is "20%". (※2)
- One person in the household who is 70 years old or older who has taken out National Health Insurance, and that person is the same level of income as active duty.
- There are those who have transitioned from the National Health Insurance to the Medical System for Elderly Seniors in same household (limited to those who continue to belong to same household from the date of transition to the medical system for the elderly).
- 1.The total income of all those who are eligible for 2. is less than 5.2 million yen.
※2 This system is originally changed by the application of the insured person, but in Yokohama City, if the applicable conditions of those who are considered eligible can be confirmed, the burden will be changed to 20% without an application in principle.
Issuance of identification of insured person and elderly recipient
At the end of the 70th birthday month (for those born on the 1st, the end of the month before the birthday month), you will be mailed an "Insured Card and Elderly Recipient's Card". From the month following your birthday (if you are born on the 1st, from the month of your birthday), please show your "Insured Card and Elderly Recipient Card" at the window of a medical institution.
medical expenses (payment at hospital counter)
If you are 70 years old or older, present your insured card and senior citizen's card at a hospital or clinics, you will only have to pay 20% or 30% of the medical expenses incurred at that time (limited to medical expenses for insurance medical treatment). In addition, there is an upper limit on the monthly out-of-pocket expenses. However, meals (standard amount) at the time of hospitalization must be paid separately from medical expenses's out-of-pocket expenses.
- As for the meal costGo to the page of dietary treatment at the time of hospitalization and living treatment at the time of hospitalization
- Regarding the copayment limit for those 70 years or olderHigh medical expenses payment system
※For outpatients aged 70 and over (general income and low-income earners), if the total amount of outpatient out-of-pocket expenses for one year (August to July of the following year) exceeds the annual limit (144,000 yen), the excess amount will be paid by employee health insurance as high medical costs. The application method will be notified separately to those who apply.
※Households with those who cannot confirm their income will not be low-income 1.
Application for difference in burden ratio
If a member 70 years or older presents an insured card and an elderly beneficiary card stating that the burden ratio is 30% at the window of the medical institution, 30% of the medical expenses for insurance medical treatment will be paid to the medical institution. It will be. In this case, if the out-of-pocket ratio has become 20% retroactively, you can get a refund of the difference if you apply to the ward office Insurance and Pension Division of your ward. However, it will take 3 to 4 months to get a refund.
<Required for application>
- Certificate of insured person and elderly recipient
- A bank account or bank transfer destination can be confirmed
※After 5 years of payment to the medical institution, the statute of limitations will expire and you will not be able to get a refund. Please be careful.
※private seal (the name of the householder who uses vermilion) is required to transfer to an account other than the head of household.
Inquiries regarding procedures
Please contact your ward office, Insurance and Pension Division National Health Insurance Section.
For inquiries to this page
Health and Social Welfare Bureau Living and Welfare Department Insurance and Pension Division
Phone: 045-671-2424
Phone: 045-671-2424
Fax: 045-664-0403 (For inquiries regarding procedures, please contact the above ward office.)
Email address: kf-hokennenkin@city.yokohama.jp
Page ID: 234-921-879