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Measures for reducing cost burdens for persons aged 70-74

The copayment rates and cost-sharing maximum amounts for medical care for persons aged 70–74 are lower than for persons less than 70 years of age.

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Copayment rate for medical care costs

The copayment rate for medical care costs for elderly persons aged 70-74 is lower than for younger persons. Persons aged 70-74 must present their elderly benefits cards when undergoing examinations.

The copayment rate for individuals aged 70–74

  • ** Copayments for persons aged 70-74 (excluding persons earning income at the same levels as active workers) remained at 10% from April 2008 through March 2014.
    For persons turning 70 on or after April 1, 2014 (i.e., those born on or after April 2, 1944), the copayment will be 20%, starting with examinations or treatments in the month following the month in which they turn 70.
  • ** Copayments will remain at 10% for persons turning 70 on or before March 31, 2014 (i.e., for those born April 2, 1939, through April 1, 1944).

Cost-sharing maximum amounts for high-cost medical care

Cost-sharing maximum amounts for elderly persons aged 70–74 are lower than for persons less than 70 years of age.
A per-person cost-sharing maximum amount for outpatient care and a combined cost-sharing maximum amount for total outpatient and inpatient cost-sharing amounts per household apply in cases in which more than one member is covered under the same medical insurance plan within one household.
For high-cost medical care for which the total amount paid per household exceeds the cost-sharing maximum amount, you will be refunded the excess amount at a later date.

(August 2017 - July 2018)
Category Cost-sharing maximum amount
Per person
(Outpatient)
Per household
(Outpatient and inpatient)
Frequent qualification
of expenditures
Persons earning
income at levels
comparable to
active workers
57,600 yen 80,100 yen+
(medical care costs - 267,000 yen) × 1%
44,400 yen
Normal 14,000 yen
( Annual maximum: 144,000 yen )
57,600 yen 44,400 yen
  • *When an eligible person qualifies for high-cost medical care benefits for at least three months of a 12-month period, starting with the fourth month, the cost-sharing maximum amount is reduced to the amount for cases of frequent qualification of expenditures.
  • *During the month of an individual’s 75th birthday, he or she will be an insured person under both health insurance and the Medical Care System for the Advanced Elderly. For this reason, the cost-sharing maximum amount for that month will be halved on an exceptional basis. (This exception does not apply to individuals whose birthday falls on the first of the month.)
  • *See here for information on the cost-sharing maximum amount for persons with low income.

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Persons earning income at the same levels as active workers

Elderly persons earning income at the same levels as active workers are referred to as “persons earning income at the same levels as active workers.” The copayment for such individuals is 30%.
For health-insurance purposes, this refers to persons whose standard monthly remuneration is 280,000 yen or more. However, persons meeting either of the descriptions below may apply to the Health Insurance Association to be treated as persons with normal income levels.

  • Those in a household consisting of two or more elderly persons with a combined annual income of less than 5.2 million yen (or elderly persons living alone whose annual income is less than 3.83 million yen)
  • Those for which the judgment criteria for annual income have changed from those for a multi-person household to those for a single-person household because a dependent becomes an insured person under the Medical Care System for the Advanced Elderly and who are therefore judged to qualify as persons earning income at the same levels as active workers

Persons in the earlier stage of old age

Elderly persons aged 65 through 74 are referred to as “persons in the earlier stage of old age.” Since most persons in the earlier stage of old age are covered by National Health Insurance, a system of financial adjustment between health insurance systems has been introduced whereby health insurance associations and other insurers with low percentages of persons in the earlier stage of old age will cover the cost of benefits for persons in the earlier stage of old age.

There is no frequently asked questions and answers that have been registered.

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