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Medical expenses of people 70 years or older

Last update date July 17, 2019

Contents

Burden ratio at window of medical institution becomes 20%, 30% depending on the income situation (as for year, from August to December as for from January to July before last last year) of household (birthday as for the person of the day from this month) from the next month of 70-year-old birthday.

Judgment of burden on people ratio 70 years or older
DivisionBurden ratioEligible people

Income earner at the same level as active play
(※ 1)

30%Regular which belongs to household where person is alone with income (taxable income of residence tax 1.45 million yen or more) active for National Health Insurance people insured (called "elderly person" as follows) 70 years or older.
But case that included application of income of elderly person being less than certain amount (with less than 5.2 million yen in yearly income of the total yearly income 3.83 million yen, more than two cases in the case of one elderly person) is excluded.

The public
Low income II
Low income I


20% (※ 2)

The next condition which corresponds to either
①Person who does not correspond to "income earner at the same level as active play"
②Household which belongs to household where net totals of standard gross income amount of money of all the members of elderly person are 2.1 million yen or less where elderly person is born in after January 2, 1945

※When household corresponding to all next conditions from 1 January, 2009 performs application application of income amount of money, self-pay ratio becomes "20%".

  1. People taking out National Health Insurance 70 years or older are alone in household, and the person is active regular income earner.
  2. There is person (we limit to that continues from day when it shifted to medical system for elder senior citizens, and belongs to same household.) transferred to medical system for elder senior citizens in same household by National Health Insurance.
  3. 1.Total amount of income of all the to be for of this is within 5.2 million yen and 2 of this.

※As for the person born in 2 before April 1, 1944, burden ratio was left unredeemed to 10% by special measures. (but burden ratio about the treatment becomes 20% only when we are damaged from third party (assailant) including traffic accident and case of bodily injury.)

Grant of identification of identification of person insured and old recipient

We mail "identification of identification of person insured and old recipient" for the end (as for the person born in 1st the previous month end of month of birthday) of month of 70-year-old birthday. Please show (as for the person born in 1st from month of birthday) from the next month of birthday, "identification of identification of person insured and old recipient" at windows such as medical institutions.

Medical expenses (payment at window of hospital)

When members 70 years or older shows identification of identification of person insured and old recipient to windows such as hospital, clinics , we will just pay our own 20%, 30% of medical expenses which we suffered from then and finish (limited to medical expenses for medical service under health insurance). Furthermore, the upper limit is established in self-burden for a month. But it is necessary for meal charges (standard burden) at admission to pay sum set separately from self-burden of medical expenses .

※After that we are provided with thing that exceeded from employee health insurance as "high medical costs" for August, 2017 medical treatment when the totals of foreign self-burden of one year (from August next year July) exceed limit (144,000 yen) a year newly about outpatient department of 70 years or older (general income earner and low-income person). We notify person who corresponded of application methods separately.
※Household which we cannot confirm income, and there is does not become low income 1.
※As for the person born in before April 1, 1944, burden ratio was left unredeemed to 10% by special measures. (but burden ratio about the treatment becomes 20% only when we are damaged from third party (assailant) including traffic accident and case of bodily injury.)
※When medical institution is consulted, person having identification of old recipient of postcard size puts health insurance cards together, and, not identification of identification of person insured and old recipient, please show.

The balance application of burden ratio

When burden ratio shows 30% and identification of identification of listed person insured and old recipient to window of medical institution, members 70 years or older will pay 30% of medical expenses for medical service under health insurance to medical institution. In this case when people that we sail up, and self-pay ratio became 20% are applied to ward office Insurance and Pension Division of ward to live for, we can receive refund of the balance. But it takes 3-4 months before we receive refund.
※It is statute of limitations after paying to medical institution when it is past five years and cannot receive refund. Please be careful.
※When medical institution is consulted, person having identification of old recipient of postcard size puts health insurance cards together, and, not identification of identification of person insured and old recipient, please show.
<thing necessary for application>

  • Identification of identification of person insured and old recipient
  • Private seal (by family nurturer name thing using vermilion)
  • We can confirm bank book or transfer

※Not identification of identification of person insured and old recipient, person having identification of old recipient of postcard size, please apply for health insurance card and old recipient after bringing.

Purpose of review

Window burden on 74-year-old person became 20% from 70 years old legally, but was done with 10% burden by special measures until now. These special measures will be reviewed to assume fairer structure from 2014.
In review, it will be carried out progressively by old person to invite 70 years old birthday to not to make any big influence occurring for life on after April 2, 2014.

Contents of review

 Person who was born after April 2, 1944

From medical treatment of the next month (month but for each one a month day as for the person of birthday) of the 70-year-old birth moon, window burden becomes 20%.
※Person with constant income is koremadedori 30% burden.

Inquiry about procedure

Please refer to ward office Insurance and Pension Division National Health Insurance Section of ward to live.

List of references of each ward office Insurance and Pension Division National Health Insurance Section
Inquiry by emailPhone number
Tsurumi Ward Insurance and Pension Division National Health Insurance Section045-510-1810
Kanagawa Ward Insurance and Pension Division National Health Insurance Section045-411-7126
Nishi Ward Insurance and Pension Division National Health Insurance Section045-320-8427, 045-320-8428
Naka Ward Insurance and Pension Division National Health Insurance Section045-224-8317, 045-224-8318
Minami Ward Insurance and Pension Division National Health Insurance Section045-341-1128
Konan Ward Insurance and Pension Division National Health Insurance Section045-847-8423
Hodogaya Ward Insurance and Pension Division National Health Insurance Section045-334-6338
Asahi Ward Insurance and Pension Division National Health Insurance Section045-954-6138
Isogo Ward Insurance and Pension Division National Health Insurance Section045-750-2428
Kanazawa Ward Insurance and Pension Division National Health Insurance Section045-788-7838, 045-788-7839
Kohoku Ward Insurance and Pension Division National Health Insurance Section045-540-2351
Midori Ward Insurance and Pension Division National Health Insurance Section045-930-2344
Aoba Ward Insurance and Pension Division National Health Insurance Section045-978-2337
Tsuzuki Ward   Insurance and Pension Division National Health Insurance Section045-948-2336, 045-948-2337
Totsuka Ward Insurance and Pension Division National Health Insurance Section045-866-8450
Sakae Ward Insurance and Pension Division National Health Insurance Section045-894-8426
Izumi Ward Insurance and Pension Division National Health Insurance Section045-800-2425, 045-800-2426, 045-800-2427
Seya Ward Insurance and Pension Division National Health Insurance Section045-367-5727, 045-367-5728

Inquiry to this page

Health and Social Welfare Bureau life Welfare Division Insurance and Pension Division

Telephone: 045-671-2424

Telephone: 045-671-2424

Fax: 045-664-0403 (to ward office as for the inquiry about procedure mentioned above please contact)

E-Mail address [email protected]

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