Rakuten KENPO

Rakuten KENPO

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When you incur high medical care costs

The copayment for medical care costs you can be required to pay is capped. If your copayment calculated based on a certain standards exceeds this maximum, the excess amount will be paid as “High-Cost Medical Care Benefits”.
Since the Health Insurance Society automatically calculates these benefits together with its additional benefits (Patient Cost-Sharing Reimbursements and Additional Benefits), no special application is required.
Payment of High-Cost Medical Care Benefits and additional benefits is remitted through your employer.

When you want to reduce in advance the amount of medical care costs you pay at the medical care institution

Required documents:
Applies to: Insured persons or dependents who expect to pay more than their Cost-Sharing Maximum Amounts for medical care costs incurred at the medical care institution over one month
Submit documents to: Rakuten KENPO
Notes: You can use this system for both inpatient and outpatient costs.
Reference link

When you face high copayments for medical care or long-term care

Required documents:
  • “Application for Payment of High Aggregate Cost for Long-Term Care Service”

[Documents to attach]
Copayment certificate for long-term care insurance

Applies to: Insured persons paying copayments for both medical care and long-term care for all individuals in the same household, for whom the total copayment amount paid under both systems over a one-year period exceeds the maximum amount
Deadline: As soon as possible
Submit documents to: Rakuten KENPO
Notes: For calculation purposes, the one-year period above refers to the period August 1 to July 31 the following year.