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
- When you face high copayments for medical care or long-term care
- Loans for high-cost medical expenses
When you want to reduce in advance the amount of medical care costs you pay at the medical care institution
Required documents: | |
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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 |
Validity period: | 1 year from the first day of the month we receive the application (if you will lose your eligibility or reach the age of 70/75 prior to the end of the validity period, the expiration date will be the day before that day.) |
Submit documents to: | Rakuten KENPO |
Notes: | You can use this system for both inpatient and outpatient costs. |
When you face high copayments for medical care or long-term care
Required documents: |
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[Documents to attach] |
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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. |