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Persons aged 75 or over to be enrolled in medical service system for persons in the latter stage of old age  |
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 Medical Care System for the Advanced Elderly is an independent medical care system for
those aged 75 or over (referred to as persons in the the advanced elderly).
All individuals aged 75 or over will lose eligibility as inured individuals or dependents under the Health Insurance Society and will be enrolled in the medical service system for persons in the latter stage of old age.
Note: The previous medical care service for the aged was abolished. |
 How the medical service system for persons in the latter stage of old age works
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The medical service system for persons in the latter stage of old age is operated by regional system associations established for each prefecture. Members consist of all local governments in the prefecture. These associations handle operations such as determining premium amounts and paying medical costs.
Premiums are collected by municipal governments, which also serve as system liaisons. |
Persons enrolled in medical service system for persons in the latter stage of old age |
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Persons aged 75 or over and authorized persons aged 65–74 with certain qualifying disabilities will be enrolled in this system.
Since the medical service system for persons in the latter stage of old age insures each persons on an individual basis, persons who were dependents under the coverage of the Health Insurance Society will become insured persons under this system.
Under the system, each persons under the medical service system for persons in the latter stage of old age will be issued one insurance card. |
Insurance premiums |
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Insurance premiums will be collected equitably, in accordance with each insured individual's ability to pay.
The amount of insurance premiums will be the sum of a uniform rate paid by all insured individuals and an income-based rate. Premiums will be paid through account transfer or deducted from pension benefits.
Persons with low income may apply for reductions in the uniform rate.
Individuals who were dependents under their health insurance coverage immediately before adoption of the system need not pay the income-based rate. Additionally, the applicable uniform rate for these individuals will be reduced by one-half. However, the uniform rate will be reduced by 90%
for the present. |
Depending on income, the copay rate will be either 10% or 30% |
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After presenting their health insurance cards, insured individuals will pay 10% or 30% of the cost of medical treatment directly to the administering hospital.
Total co-payments made over the course of a single month are capped. Benefits for onerous medical expenses will be provided for personal payments made beyond this maximum. |
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Persons who are insured persons and dependents, and exempt from paying municipal tax. |
| *2 |
Persons above in households whose insured persons and dependents are all exempt from paying municipal tax and whose incomes meet certain standards (e.g., annual pension income of no more than 800,000 yen) |
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Amount in brackets applies to all subsequent treatments that correspond to high-cost medical care expenses after the household has already borne such expenses three months within the nearest twelve-month period. |
| *4 |
Persons whose taxable income is 280,000 yen or more and whose annual income + other total income is 2 million yen or more for a single-person household or 3.2 million yen or more for a household consisting of multiple persons (not including those earning income at levels comparable to active workers) |
| *5 |
Measures to keep the increase in the cost burden accompanying an increase in the percentage paid over the counter for outpatient treatment to no more than 3,000 yen apply to those whose patient cost-sharing rate has become 20% (General II). These are transitional measures intended to prevent sudden increases in the cost burden for those whose patient cost-sharing rate has become 20% (General II) during the three-year period following the implementation (October 1, 2022). |
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Half of the corresponding amount in the table above will be exceptionally applied, for a new insured person under Medical Care System for the Advanced Elderly, as the cost-sharing maximum amounts (per person) for the month in which he or she will turn 75 and become an insured person under the system (not including cases in which the insured person's 75th birthday will be the first day of that month).
(The cost-sharing maximum amounts under former health insurance society will also be half of the corresponding amount.)
The same measure will also be applied for the case when their dependents shift to be covered under the National Health Insurance or other plans. |
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