Finance of Yokohama City National Health Insurance

• Composition of Financial Resources

• How to determine insurance rates

• medical expenses

• Financial Results

medical expenses, excluding co-payments paid at the counter when a member of the National Health Insurance goes to a medical institution, is paid by the National Health Insurance (= benefit expenses). As a general rule, the remaining 50% of this benefit, excluding the subsidy for the younger elderly (* 1), is subsidized by the national and prefectural governments, and the remaining 50% is covered by the insurance premium of the member .
From 2018 onwards, Kanagawa Prefecture expects benefits and presents "National Health Insurance operating expenses payment (= payment)" to Yokohama City after deducting subsidies from countries and prefectures. In order to cover the amount necessary to pay this "payment" to the prefecture, Yokohama City is working to reduce the burden of insurance premiums through the insurer support system (* 2).

※1 Grants for the younger elderly (ages 65 to 74) are allocated to balance the burden on the medical expenses.
※2 The insurer support system is a system that reduces the burden of insurance premiums by paying the country, prefecture, and city and transferring a certain amount.
※3 20% of pre-primary school children and 20% of insured persons aged 70 and over (30% for income equivalent to active duty).

Each medical insurer pays late-elderly support money for the latter-stage elderly medical care system.
The financial resources are covered by national and prefectural subsidies and premiums for members of the National Health Insurance.
In addition, in the same way as medical expenses's financial resources, Yokohama City is working to reduce the burden of insurance premiums through insurer support systems.

※2 The insurer support system is a system that reduces the burden of insurance premiums by paying the country, prefecture, and city and transferring a certain amount.

Each medical insurer pays nursing care payments to the long-term care insurance system, but the financial resources are subsidies from the national and prefectural governments and premiums for the second insured (40 to under 65 years old). It is covered by

※2 The insurer support system is a system that reduces the burden of insurance premiums by paying the country, prefecture, and city and transferring a certain amount.

We calculate from the number of insured persons and the amount of income based on "total insurance premiums" necessary to cover a part of the payments indicated by the prefecture.
※The insurance rate (per capita rate, income rate) changes every year.

The insurance premium rate is increasing year by year due to an increase in “medical expenses per capita” due to the aging of society and the advancement of medical care. In addition to these, recently, due to the shift of the so-called “baby boomers” to the medical system for the elderly (at the age of 75) and the expansion of the application of employee insurance (social insurance) due to the revision of the national system, the number of insured persons has decreased significantly, and as a result, insurance premiums per person have also increased.

In Yokohama City, when deciding the insurance rate, in addition to public expenses from the national and prefectural governments, we also transfer funds from the general account of the city to reduce the burden of insurance premiums.

If medical expenses goes up, insurance premiums will rise. That does not mean that it is necessary to suppress going to a medical institution, but what is important is that each and every one should pay attention to their health on a daily basis, and when treatment is needed, go to a "family doctor" and go to a "ladder consultation" Is to refrain from.
Yokohama City National Health Insurance member medical expenses (FY2023)
Total amount: approx. 209.8 billion yen (approximately 405,000 yen per person)
※The sum of general insured persons and Retirement insured persons.

・FY2023 (PDF: 84KB)