Healthcare System for Seniors Aged 75 and Over

Medical Care System for Older Senior Citizens is new healthcare system launched in April 2008 to meet the needs of Japan’s aging society. Individuals aged 75 and older were moved to this new system from the medical insurance that they had previously subscribed to.

Medical Care System for Older Senior Citizens is managed by the Tokyo Metropolitan Association of Medical Care Services for Older Senior Citizens, which is composed of all the municipal governments in Tokyo. Minato City works with the Metropolitan Association in providing customer service and collecting premiums. Procedures regarding Medical Care System for Senior Citizens are handled by the Counter Services Subsection, Residents Support Section of each Regional City Office.

Who Must Subscribe?

Individuals aged 75 and older with an address in Minato City must subscribe to this system. Foreigners with a length of stay of three months or longer are included.・Individuals aged 65 to 74 who are certified as having certain disabilities should make application at the Tokyo Metropolitan Association of Medical Care Services for Older Senior Citizens.

*Recipients of public welfare assistance do not subscribe to this system.
* Individuals who have moved to prefectures other than Tokyo must withdraw from Medical Care System for Senior Citizens. However, if his/her new address is a nursing home or other Facility Subject to Domicile Exception, the individual continues to be an insured person.

Percentage of Payment

The out-of-pocket percentage paid by the insured at medical institutions is 10%, 20% or 30%. This out-of-pocket percentage is reviewed on August 1 each year, when the individual's income in the previous year is determined.

Premiums

The premiums of Medical Care System for Senior Citizens consist of two parts: one part is an amount divided up equally among all insured persons (per-capita amount), and the other is a percentage of income based on the subscriber’s income (income percentage).

Insurance Premium Payment Methods

Premiums are typically automatically withheld from the insured’s pension. This method is referred to as special collection. Those with pensions of less than ¥180,000 per year or whose premiums, including longterm care insurance premiums, exceed more than half of their pension benefits, pay upon receipt of a payment slip or via bank transfer.

High Medical Expenses

There is a monthly limit on the out-of-pocket amount of medical treatment costs. Patients may request reimbursement if the limit is exceeded. The exceeded amount will be paid back later.

Reimbursement of Medical Treatment Costs (Medical Expenses)

If you are unable to present your health insurance card when receiving examination or if a medical corset or other item is made for you as prescribed by your doctor, you will have to pay the full amount of your medical expenses at the time of payment. However, you can later request reimbursement for the difference between the paid amount and the out-of-pocket amount.

High medical and nursing care joint expenses

If the combined total of (1) the out-of-pocket portion of Medical Care System for Senior Citizens and (2) the out-of-pocket costs of long-term care insurance, paid over the course of one year (August 1 to July 31 of the following year), exceeds the annual maximum out-of-pocket amount for a household, reimbursement for the amount over and above that limit will be issued later from each of those respective systems. Eligible individuals should apply for it to get reimbursed.

Funeral Allowances

When a person insured by the Medical Care System for Senior Citizens dies, ¥70,000 will be paid to the person responsible for funeral expenses.

Inquiries: Senior Citizens’ Medical Benefits Subsection, National Health Insurance and Pension Section

Tel: 03-3578-2654 to 2659

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Welfare for Senior Citizens