When you incur high medical care costs

The copayment for medical care costs you can be required to pay is capped. If your copayment calculated based on a certain standards exceeds this maximum, the excess amount will be paid as “High-Cost Medical Care Benefits”.

When you want to reduce the amount of medical care costs you pay at the medical care institution
When you face high copayments for medical care or long-term care
If you are aged 70 or older and incurred high annual costs for outpatient care (annual total of outpatient costs)

When you want to reduce the amount of medical care costs you pay at the medical care institution

Required documents:	Request for issuance of Maximum Co-payment Certificate for Health Insurance Example
Applies to:	Insured persons or dependents who expect to pay more than their Cost-Sharing Maximum Amounts for medical care costs incurred at the medical care institution over one month
Address inquiries to:	Health Insurance Society
Notes:	You can use this system for both inpatient and outpatient costs.

When you face high copayments for medical care or long-term care

Required documents:	Application for Payment of High Aggregate Cost for Long-Term Care Service
Required documents:	Copayment certificate for long-term care insurance
Deadline:	As soon as possible
Applies to:	Insured persons paying copayments for both medical care and long-term care for all individuals in the same household, for whom the total copayment amount paid under both systems over a one-year period exceeds the maximum amount
Address inquiries to:	Health Insurance Society
Notes:	For calculation purposes, the one-year period above refers to the period August 1 to July 31 the following year.

If you are aged 70 or older and incurred high annual costs for outpatient care (annual total of outpatient costs)

Required documents:	Application for High-Cost Medical Care Benefits (Annual Total of Outpatient Costs)/Application for Issue of a Copayment Certificate
Deadline:	As soon as possible
Applies to:	Insured persons and dependents aged 70 or older whose total copayments for outpatient care during the one year period (from August 1 of the previous year to July 31) exceeded 144,000 yen * This benefit is available only to those whose income category is "general" or "low income" as of the basis date (July 31, or the day before the date of death in the event of the death of the insured person). * Calculations of High-Cost Medical Care Benefits exclude copayments paid during a period in which the insured person belonged to the "same income level as active workers" category.
Address inquiries to:	Health Insurance Society
Notes:	Apply to the health insurance society of which you are a member as of the basis date. Link Measures for reducing cost burdens for persons aged 70-74 “Cost-sharing maximum amounts for high-cost medical care”