I would like to know how to apply Standard Income Amount for elderly healthcare benefit.

In case that the following people have elderly benefits card with 30% copayment rate and their income meet the standard income amount below, they can apply to have their copayment rate reduced from 30% to 20%.

・Insured person aged 70-74

・Dependent aged 70-74 who is supported by insured person aged 70-74

・Insured person aged 70-74 with no dependent aged 70-74 and has former dependent*

 

Standard income amount

・No dependent aged 70-74: Less than 3.83 million yen (insured person only)

・With dependent aged 70-74 or former dependent: Less than 5.2 million yen (total income of the insured person and dependent or former dependent)

 

*Former dependents are those who ceased to be health insurance dependents as a result of becoming insured person under the Medical Care System for the Advanced Elderly and who continue to be insured under the Medical Care System for the Advanced Elderly. Income of former dependent can only be included in the standard income amount for up to 5 years after the person withdrew from health insurance dependent.

 

・Income of last year is applicable if you visit a medical institution during the period from September to December.

・Income of two years ago is applicable if you visit a medical institution during the period from January to August.

 

If you meet above conditions, please submit the following documents to Rakuten KENPO.

・ Application Form for Standard Income Amount for elderly healthcare benefit  (Example)

・ Documents prove the income amount of the relevant year for the subject person

(Tax (non-tax) certificate (original), copy of final income tax return document, etc.)

(Regarding tax (non-tax) certificate, a certificate that clearly states the amount of income is required. If the person covered by the certificate earned no income, please confirm that the space for the income amount on the certificate shows ¥0 (i.e., must not be left blank).)

 

※ Those who have been newly issued an elderly benefit card (30%) must apply within 14 days (be received by Rakuten KENPO) from the date of issue.

※ If the application arrives Rakuten KENPO after 14 days or more, it will be applied from the following month in which the application arrives, except it is deemed unavoidable circumstance.

※ In case that the household income meets the standard income amount by false declaration and category changes from “Persons earning income at levels comparable to active workers” (30%) to “Normal” (20%), insured person will be charged with fraud under the criminal law and health insurance society may collect part of the benefit amount as it caused by a dishonest action.