When going to a medical institution

When you visit a medical institution, please show either a minor insurance card, a certificate of insured medical care for the elderly, or a certificate of qualification.
At the counter, 10%, 20% or 30% of medical expenses will be borne.
The out-of-pocket ratio when going to a medical institution (the "partial contribution ratio" stated on the insurance card) varies depending on the income category. The income category is determined by the taxable income (income after various deductions) of the municipal tax for the current fiscal year (from April to July is the previous year).
Of the 10% from October 2022, those who have a certain level of income will be charged 20%.

[Change in window burden ratio]
Kanagawa Prefecture Senior Citizens' Medical Wide Area Alliance Homepage (outside site)

Insured persons with municipal taxable income of 1.45 million yen or more and other insured persons in same household.
It is divided into three more stages depending on your income.

• Income equal to active duty 3: Municipal taxable income of 6.9 million yen or more
• Income equal to active duty 2: Municipal tax taxable income is more than 3.8 million yen and less than 6.9 million yen
• Income equal to active duty 1: Municipal tax taxable income is more than 1.45 million yen and less than 3.8 million yen

However, if the total income of the insured person etc. satisfies the conditions in [Table] below, it will be classified as "General 1" or "General 2". For those who cannot confirm the total income amount, an application is required. In that case, we will inform you of the application in advance.

Those who have a self-pay ratio of 20%.
If both of the following (1) and (2) apply:
（1） Some insured persons in the same household have resident taxable income of 280,000 yen or more and less than 1.45 million yen.
（2） The sum of “pension income (Note 1)” + “Other total income (Note 2)” for insured persons in the same household is as follows:
　・One insured person ... 2,000,000 yen or more　　　
　・Two or more insured persons: a total of 3.2 million yen or more

(Note 1) “pension income” is the amount before deducting public pension deductions. It does not include survivors' pensions or disability pension.
(Note 2) "Other total income amount" is the amount after deducting necessary expenses and employment income deductions from business income and salary income.

Insured persons other than active earners, general 2, low-income 2 and low-income 1.

All same household people are exempt from municipal tax (other than low-income 1).

All same household employees are exempt from municipal tax and their household members earn 0 yen (pension income is calculated with a deduction of 800,000 yen).

Grant of limit application certificate and limit application, standard burden reduction certificate (reduction certificate) were finished on December 1, 2024. Valid "Certificate of application of limit and reduction of standard burden (reduction certificate)" and "Certificate of application of limit" at hand as of December 1, 2024 are valid even after December 2 (Up to July 31, 2025). However, if there are any changes to the information, such as Address or applicable categories, it will not be usable.

If you are a low-income person 1 or 2, use a minor insurance card (Note 1), along with a "qualification confirmation" (Note 2) with the classification of the limit and an insurance card If you present the “Certificate of application of the limit / standard burden reduction certificate (reduction certificate)” to a medical institution, the payment at each window will be up to the co-payment limit of the income category of low-income person 1 or 1 or 2.

If you are an active earner 1 or 2, use a minor insurance card (Note 1), along with a "qualification confirmation" (Note 2) with the classification of the limit and an insurance card If you present the “Certificate of Limit Application” to a medical institution, the payment at each window will be up to the limit of the income category.

Note 1 If you use a minor insurance card, you agree to the information provided by the person, and you will need to apply the “Certificate of application of the limit and reduction of the standard burden (reduction certificate)” and “Certificate of application of the limit”. No need to show ".

Note 2 The classification of the limit is described by application, but after August 1, 2024, "Certificate of application of limit and reduction of standard burden (reduction certificate)" and "Certificate of application of limit" will be issued. For those who have received the grant, we will issue a qualification confirmation stating the category of the limit without applying.

For more information, please contact your ward office, Insurance and Pension Division National Health Insurance Section.