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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%.

For members and their dependents aged 70 or older (Elderly Recipients) 

Those between 70 years and 74 years (inclusive) are defined as “Elderly Recipients”.

The self-pay rate is 20% for:

  1. A dependent aged 70 or older who is supported by a member below the age of 70
  2. 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

  1. 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.
  2. A member who does not have any dependent of 70 years or older and whose annual income is less than 3,830,000 yen.
  3. 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.
  4. Note 1:
    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.

    Note 2:
    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.

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