Copayment for using Medical Institutions
For members and their dependents under 70 years
The self-pay rate is 30% except for children under 6 years (before entering elementary school) whose rate is 20%.
Those between 70 years and 74 years (inclusive) are defined as “Elderly Recipients”.
The self-pay rate is 20% for:
- A dependent aged 70 or older who is supported by a member below the age of 70
- A member aged 70 or older whose Monthly Standard Salary is less than 280,000 yen and a dependent aged 70 or older who is supported by the member
The self-pay rate is 30% for:
A member age 70 or older with a monthly standard salary of more than 280,000 yen, and a dependent of that member age 70 or older.
The self-pay rate of 30% is altered to 20% upon request for:
If the annual income of a person whose self-pay rate is 30% falls below one of the following base income amounts for elderly recipients, the self-pay rate is reduced to 20%.
Base income amounts for elderly recipients
- A member who has a dependent(s) of 70 years or older and whose annual income and that of the member’s dependent(s) are less than 5,200,000 yen in total.
- A member who does not have any dependent of 70 years or older and whose annual income is less than 3,830,000 yen.
- A member whose annual income and that of a family member(s) aged 70 or older who is/are no longer the member’s dependent(s) by having been insured under the “Medical System for the Old Elderly” are less than 5,200,000 yen.
The “annual income” here means the annual income before tax or other deductions. Retirement pension benefit or non-taxable incomes such as disability pension benefit and survivors’ pension benefit are not regarded as part of the annual income.
The self-pay rate for a period of January to August is determined based on the income of the year before the previous year and that for a period of September to December is determined based on the income of the previous year.