Enrolling in Medical Insurance for the Elderly


Page Number 2000107  Updated on April 1, 2024

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The health care system for older senior citizens was created as a way to address Japan's rapid aging and declining birth rate and support the elderly and their families by making it easier for the elderly to continue receiving medical care.

  • Contact
    Medical Welfare Division (Gifu City Hall, 1F / Tel. 058-214-2128)
  • Details

Those Eligible

Foreign nationals that have stayed in Japan for three months or longer (excluding those with a special residence status) and those to whom all the following apply to.

  • Those aged 75 or older (starting from your 75th birthday)
  • Those aged 65-74 with a disability
    • Starting from the day that the Koiki Union has determined your eligibility
    • You can choose not to enroll in Medical Insurance for the Elderly
  • Those not receiving public assistance

How to Pay Insurance Premiums

Special collections

Those receiving a monthly pension of ¥180,000 or more will have the premium deducted from their pension.
However, those to whom the following conditions apply to cannot have premiums deducted from their pension.

  • Those whose Medical Insurance for the Elderly and long-term care insurance premiums are over 50% of their public pension
  • Those who do not have their long-term care insurance deducted from their public pension
  • First year enrolled in insurance

*The insurance premium is usually deducted from the amount you receive from the national pension plan, but you can also choose to have it automatically deducted from your bank account.

Normal collections

Those who are ineligible to have premiums be deducted from the amount they receive from the national pension program can use the following method to pay them once every month from July until March (nine months total). 

  • Payment slips issued by your municipality
    (these can be paid at financial institutions and convenience stores.)
  • Bank payments

Reduced or Waived Insurance Premiums

Those who have special cirumstances and fulfill certain conditions can have part of their insurance premiums reduced or waived.

Examples of special circumstances

  • The insured person and the head of the household suffered considerable losses from a natural disaster.
  • Those whose income has considerably decreased due to becoming unemployed, etc.

Medical Expense Coverage

If become ill or injured

If you bring your Medical Insurance for the Elderly Card to a hospital or clinic that accepts Medical Insurance for the Elderly and receive treatment there, you will only be responsible for only 10%, 20%, or 30% of all costs incurred.
You will have to pay 10% of 20% of all costs incurred, but if you live in a household with anyone earning ¥1.45m or more that is subject to residence tax, you will have to pay 30%.

*In this context, someone earning income is defined as:
Someone enrolled in Medical Insurance for the Elderly and has ¥1,450,000 or more a year subject to residence tax.
Despite this, however, there are cases in which you still only have to pay 10% or 20%.

If you receive treatment and do not bring your health insurance card due to an emergency or other such reasons beyond your control.

  • If you receive treatment at a medical institution, a portion of your medical expenses will be covered.
  • Documents necessary to apply
    • Itemized medical expense receipt
    • Receipt(s)
    • Applicant ID (driver's license, residence card, etc.)
    • Health insurance card
    • A document containing the account number for the account you would like to receive the payment in.

Partial reimbursement for corsets and other support goods

The cost of support goods such as corsets that a medical institution has deemed necessary for your treatment can be partially reimbursed to you.

Documents necessary to apply

  • Written statement or certificate from a doctor stating the necessity of a support good, etc.
  • Receipt(s) (including itemized list(s))
  • Applicant ID (driver's license, residence card, etc.)
  • Health insurance card
  • A document containing the account number for the account you would like to receive the payment in.

Funeral expense allowance

Those who conduct a funeral for an insured person will receive an allowance to help cover funeral expenses.



Documents necessary to apply

  • The health insurance card of the person that passed away
  • Thank you card to those that attended the funeral or receipt(s) for funeral expenses
    (Full name of the person that had the funeral conducted)
  • Applicant ID (driver's license, residence card, etc.)
  • A document containing the account number for the account the person who had the funeral conducted would like to receive the payment in.

High-cost medical expense reimbursement

If you have exceeded the maximum amount of medical fees that you are liable to pay for in a month (during the same month), you can apply (for the first time only) to have all excess fees to be paid by your insurance as high-cost medical expenses.

The maximum medical expense limits for individuals (outpatient visits) will be applied first, and then the household's maximum limit (outpatient visits and hospitalizations) will be applied afterwards (in which case fees exceeding this limit will also be reimbursed to your household).

If being admitted to a hospital, your household income will be used in determining the maximum amount of expenses you have to pay.

You will still need to pay for meals, room fees, or any other such fees that are not subject to being covered by insurance.