Elderly Healthcare System (Subsidies/Payments)
The health insurance premiums paid by you and the business operator are allocated for the payment of medical expenses, healthcare business and other healthcare expenses, as well as operation of the Health Insurance Society. In addition, they are also paid as "subsidies/payments" to support the medical expenses of the elderly nationwide.
The aging of society and the advancement of medical technology have resulted in yearly increases of the medical expenses of the elderly. Such expenses currently constitute about 60% of all medical costs nationwide, and the amounts of subsidies and other payments to support those expenses are also increasing each year.
Individuals age 65 to age 74: Early-stage elderly
Individuals age 65 to age 74 are considered to be early-stage elderly, but benefits, etc., remain as they are. The Health Insurance Society contributes the payments for early-stage elderly individuals.
discontinued in FY2014)
When the individual has reached age 70
Insured individuals/dependents age 70 to age 74 are referred to as "elderly beneficiaries." Elderly beneficiaries are issued an "Elderly Beneficiary Health Insurance Card" by the Health Insurance Society, separate from the regular health insurance card. It serves as proof of your out-of-pocket percentage at your healthcare provider, indicating a percentage between 20%～30% based on your income level, etc.
When being examined/treated by a healthcare provider, you must present both your regular insurance card and your Elderly Beneficiary Health Insurance Card to the provider.
Issuance of Elderly Beneficiary Health Insurance Cards
Requirements
- When the insured individual/dependent has reached age 70
- When an individual age 70 or older has been certified as a dependent
- When an individual age 70 or older has been certified as a dependent when acquiring eligibility for this health insurance
- When the out-of-pocket percentage on the Elderly Beneficiary Health Insurance Card has changed
Application month (First day of application)
- The first day of the month after the month in which the individual reaches age 70 (If the individual's birthday is the first day of the month, it will be the birthday.)
- The day on which an individual age 70 or older has been certified as a dependent
- Be sure to present your Elderly Beneficiary Health Insurance Card with your regular insurance card at the hospital, etc. Please store them in a way that they do not become separated.
- If you forget your Elderly Beneficiary Health Insurance Card, you will be considered to be an "earner of income comparable to individuals in active service," and you will be required to pay 30% at that time. Pay careful attention to this, since adjustments cannot be made if you forget to take the card with you or you lose it.
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Promptly return your Elderly Beneficiary Health Insurance Card when it has expired.
In addition, if you retire before the card expires, or the relevant family member is removed from your dependents for health insurance purposes, you will need to return your Elderly Beneficiary Health Insurance Card with the regular insurance card.
When the individual has reached age 75
Individuals lose their eligibility as an insured person (or dependent) in the Health Insurance Society on their 75th birthday, and enroll in the "latter-stage elderly healthcare system" on that same day. Insured individuals to whom this applies will be contacted by the Society in the month before the month of the birthday. Details regarding procedures will be communicated at that time.
| Intended recipients |
All individuals age 75 or older (Age 65 or older in the case of individuals with certain disabilities) * If an insured person age 75 or older has dependents that are under age 75, they will lose eligibility as dependents when the insured individual is switched to the latter-stage elderly healthcare system. Please note that, in such cases, it will be necessary to complete procedures to enroll in NHI. |
|---|---|
| Insurer |
The "regional union" in which your local municipality has enrolled * The municipality will handle all liaison work, such as the various types of application, notification, etc. |
| Insurance premium |
It will be determined in accordance with the individual's income. As a rule, it is withheld from annual pensions. * Under the latter-stage elderly healthcare system, each individual is an insured person. Individuals who were dependents in the Health Insurance Society also become insured persons under the latter-stage elderly healthcare system when they reach age 75, and pay insurance premiums accordingly. (However, there are measures in place to mitigate the burden.) |