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English Website > 01.Latest News > City Newspaper 2021 > City Newspaper July 5, 2021 > For Those with Excessive Medical Expenses

For Those with Excessive Medical Expenses

Update : 2021-12-8

Application Received for the Certificate of Applying the Individual Limit
For the Fiscal Year 2021

In case the medical expenses are going to be a large amount, you can limit the amount to be paid at the counter of the medical institution within your individual limit by showing in advance "Gendogaku Tekiyo Ninteishou (Certificate of Applying the Individual Limit)," both as an outpatient and as an inpatient.
If you fall under the category "E" or "Low income I or II" in the table below, show the "Gendogaku Tekiyo Hyojun Futangaku Gengaku Ninteishou (Certificate of Applying the Individual Limit and Partial Exemption of Standard Amount Borne)." If you are of age 70 or older and under 75 and fall under the category of "General families" or "Those with income comparable to current workforce III" in the table below, show the "Hokenshou Ken Korei Jukyushashou (Health Insurance Card and Aged Recipient Proof)."

Application period

July 19 (Monday) ~ August 31 (Tuesday) * except Saturdays and holidays

Application procedure

Application will be received for "Gendogaku Tekiyo Ninteishou (Certificate of Applying the Individual Limit)" to be valid from August 1 (Sunday).
Make an inquiry at Hoken Nenkin-ka (Health Insurance and Pension Section) about the category of income and about other questions.
Application cannot be received at service centers.

What to bring

Your health insurance card, a document to certify the Individual Number (nicknamed "My Number") of the householder and of the person who needs Gendogaku Tekiyo Ninteishou (Certificate of Applying the Individual Limit), such as Individual Number (nicknamed "My Number") Card or the notification of that number.

NOTES

  • Gendogaku Tekiyo Ninteishou (Certificate of Applying the Individual Limit) cannot be issued for the family who is failing to pay insurance tax. Pay the tax before application.
  • In case you paid the tax during the last month, using the payment statement, bring the receipt to verify your payment status.
  • In case any of the family has not yet filed the income tax return, your family will be judged under the category "A" in the table below. File the income tax return, whether you have income or not, before application.
  • In case you make an application in September or later, Gendogaku Tekiyo Ninteishou (Certificate of Applying the Individual Limit) will be issued which is to be valid from the 1st of the month of application.

Individual Limit of Those of Age under 70

Category Individual Limit
A Standard gross income *1
9.01 million yen or more or families who did not file the income tax return
252,600 yen + (Total medical expenses - 842,000 yen) x 1%
(140,100 yen *3)
B Standard gross income
6 million yen or more and less than 9.01 million yen
167,400 yen + (Total medical expenses - 558,000 yen) x 1%
(93,000 yen *3)
C Standard gross income
2.1 million yen or more and less than 6 million yen
80,100 yen + (Total medical expenses - 267,000 yen) x 1%
(44,400 yen *3)
D Standard gross income
Less than 2.1 million yen
57,600 yen
(44,400 yen *3
E Families exempted from the per capita rate of city and prefecture tax *2 35,400 yen
(24,600 yen *3)

Individual Limit of Those of Age 70 or over and under 75

Category Outpatient
(By individual)
Outpatient + Inpatient
(By family)
Those with income comparable to current workforce III Taxable income: 6.9 million yen or more 252,600 yen + (Total medical expenses - 842,000 yen) x 1%(140,100 yen *3)
II Taxable income: 3.8 million yen or more and less than 6.9 million yen 167,400 yen + (Total medical expenses - 558,000 yen) x 1%(93,000 yen *3)
I Taxable income: 1.45 million yen or more and less than 3.8 million yen 80,100 yen + (Total medical expenses - 267,000 yen) x 1%(44,400 yen *3)
General families or families who did not file the income tax return 18,000 yen *4 57,600 yen(44,400 yen *3)
Families exempted from the per capita rate of city and prefecture tax Low income II *5 8,000 yen 24,600 yen
Low income I 8,000 yen 15,000 yen

* 1 The amount after the deduction of basic deduction (430 thousand yen) from the gross income (total of earned income, business income, etc.), the income from transfer of land, etc.
* 2 If a member of a family exempted from the per capita rate of city and prefecture tax was hospitalized for 91 days or more during the past one year, the meal charge during the hospitalization will be reduced. Bring a receipt to verify the hospitalization of 91 days or more, and make an application at Hoken Nenkin-ka (Health Insurance and Pension Section).
* 3 This is the upper limit from the 4th time on in case the high medical care cost was paid four times or more within the past 12 months. In case of those of age 70 or over and less than 75, the number of times excludes months relevant only as an outpatient.
* 4 The upper limit of 144 thousand yen per year is set on the total amount paid as an outpatient in one year (from August to July of the following year).
* 5 If a person falling under the category of "Low income II" was hospitalized for 91 days or more during the past one year, the meal charge will be reduced. Bring a receipt to verify the hospitalization, and make an application at Hoken Nenkin-ka (Health Insurance and Pension Section).

Inquiry

Hoken Nenkin-ka (Health Insurance and Pension Section)
Tel.(048) 922-1593
FAX(048) 922-3178