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Short-Term Benefits for Age 75 and Older

Persons age 75 and older with an address in Japan become “insured persons of the Medical System for the Old Elderly” (hereafter referred to as “Old Elderly”) and are exempted from Short-Term Benefits provided by PMAC.

Dependents supported by members age 75 or older are also exempted from Short-Term Benefits when the supporting members’ exemption occurs.
Therefore they individually need to participate in the National Health Insurance, etc.

When a dependent reaches age 75 and becomes an Old Elderly, PMAC provides the dependent’s address information to the Medical System for the Old Elderly in the prefecture where he/she resides. If a member and their dependent live separately and have different addresses, the address as indicated on the certificate of residence must be submitted using “the address form for Medical System for the Old Elderly” through the member’s school.

Note 1: A person becomes an Old Elderly on their 75th birthday. Therefore, after the birthday, the Membership Card or Membership Card for a Dependent (insurance card) of PMAC cannot be used to receive medical treatment.

Note 2: When a member or their dependent has been recognized as having a disability between the ages of 65 and 74, and become an Old Elderly, he/she is exempted from Short-Term Benefits. In this case, “a notification of insured person qualification/disqualification for Medical System for the Old Elderly” along with a copy of the insured person certificate of Medical System for the Old Elderly must be submitted to PMAC through the member’s school.

<Case 1>
A member reaching age 75 on May 10, 2017
Category Birthdate Disqualification date Dependency cancellation date Applicable medical care system
Member May 10, 1942 May 10, 2017 - Medical System for the Old Elderly
Dependent A November 20, 1946 - May 10, 2017 National Health Insurance, etc.
Dependent B June 15, 1968 - May 10, 2017 National Health Insurance, etc.

PMAC implements the exemption process of Short-Term Benefits in the beginning of April and notifies it to the corresponding school in advance. Dependent A and B may join National Health Insurance, etc.

<Case 2>
A dependent reaching age 75 on May 10,2017
Category Birthdate Disqualification date Dependency cancellation date Applicable medical care system
Member November 20, 1946 - - PMAC
Dependent A May 10, 1942 - May 10, 2017 Medical System for the Old Elderly
Dependent B June 15, 1968 - - PMAC

Dependent A becomes an insured person of the Medical System for the Old Elderly. The member and dependent B who are under age 75 continuously receive the Short-Term Benefits of PMAC.

In this case, PMAC notifies the member’s school in advance at the beginning of April that the dependency of dependent A will be cancelled.