Frequently Asked Questions (National Health Insurance)

QuestionI will turn 70 this month, will my out-of-pocket expenses at medical institutions decrease?

Response

From the month following the month of your 70th birthday (if your birthday is on the 1st, it will be the birthday month), the percentage of the co-payment you will need to pay at medical institutions will be either 20% or 30%, depending on your income from the previous year and your date of birth.
For those turning 70, a notification of qualification information or a qualification confirmation document indicating the co-payment burden ratio will be issued. Therefore, from the month following the 70th birthday month (or the month after the month before the birthday month if the birthday is on the 1st), please present your My Number Health Insurance Card or qualification confirmation document at the medical institution's reception.
In addition, for households exempt from resident tax, if you present your My Number Health Insurance Card or the Certificate of Application of the Maximum Amount and Reduction of Standard Burden at the medical institution’s reception, your payments to each medical institution per month will be limited to the respective out-of-pocket maximum amounts. Please note that if there are unpaid insurance taxes, the Certificate of Application of the Maximum Amount and Reduction of Standard Burden may not be issued.

Burden Ratio for Those Aged 70 and Over

Resident Taxable Income for Those Aged 70 and Over (National Health Insurance Members) Less than 1.45 million yen	Resident Taxable Income for Those Aged 70 and Over (National Health Insurance Members) 1.45 million yen or more
20%	30%

Note: Even for those who fall under the 30% burden, if the total income of National Health Insurance members aged 70 and over is less than 5.2 million yen for two or more people, or less than 3.83 million yen for one person, it will become a 20% burden upon application.