Burden ratio at window of medical institution becomes 20%, 30% depending on the income situation (as for year, from August to December as for from January to July before last last year) of household (birthday in the one of the day from this month) from the next month of 70-year-old birthday.
Judgment of burden on person ratio 70 years or older
|Division||Burden ratio||Target person|
|Income earner at the same level as active play||30%||Regular which belongs to household where one is alone with income (taxable income of residence tax 1.45 million yen or more) active for National Health Insurance person insured (called "elderly person" as follows) 70 years or older.|
But case that included application of income of elderly person being less than amount of uniformity (with less than 5.2 million yen in yearly income of the total yearly income 3.83 million yen, more than 2 cases in the case of one elderly person) is excluded.
|The public (※ 1)||20% (※ 2)||One that comes under none of "low income 1." "low income 2." "income earner at the same level as active play."|
|Low income 2.||20% (※ 2)||Residence tax tax exemption household|
|Low income 1.||20% (※ 2)||Household (we calculate public pension deduction as 800,000 yen) in residence tax tax exemption household for all the members of household without income|
※When household corresponding to all next conditions from 1 January, 2009 performs application application of income amount of money, self-pay ratio becomes "20%".
- Person taking out National Health Insurance 70 years or older is alone in household, and the is active play regular income earner.
- There is one (we limit to one that continues from day when it shifted to medical system for elder senior citizens, and belongs to same household.) transferred to medical system for elder senior citizens in same household by National Health Insurance.
- 1.Total amount of income of all the to be for of this is within 5.2 million yen one and 2 of this.
※In the one born in 2 before April 1, 1944, burden ratio is left unredeemed to 10% by special measures. (but burden ratio about the treatment becomes 20% only when we are damaged from third party (assailant) including traffic accident and case of bodily injury.)
Grant of identification of old recipient
We mail "identification of old recipient" for the end (in the one born in 1st the previous month end of month of birthday) of month of 70-year-old birthday. Please show (in the one born in 1st from month of birthday) from the next month of birthday, health insurance card and "identification of old recipient" at windows such as medical institutions.
Medical expenses (payment at window of hospital)
When member 70 years or older shows two of health insurance card and identification of old recipient in windows such as hospital, clinics , we only pay our own 20%, 30% of medical expenses which we suffered from then and finish (limited to medical expenses for medical service under health insurance). Furthermore, the upper limit is established in self-burden for a month. But it is necessary for meal charges (standard burden) at admission to pay sum determined separately from self-burden of medical expenses .
※After that we are provided with thing that exceeded from employee health insurance as "high medical costs" for August, 2017 medical treatment when the totals of foreign self-burden of one year (from August next year July) exceed the ceiling (144,000 yen) a year newly about outpatient department of 70 years or older (general income earner and low-income person). We notify person who corresponded of application methods separately.
※Household where there is person who cannot confirm income does not become low income 1.
※In the one born in before April 1, 1944, burden ratio is left unredeemed to 10% by special measures. (but burden ratio about the treatment becomes 20% only when we are damaged from third party (assailant) including traffic accident and case of bodily injury.)
The balance application of burden ratio
When member 70 years or older shows only health insurance card in window of medical institution and we put identifications of old recipient together and do not show, regardless of original self-pay ratio, we will pay 30% of medical expenses for medical service under health insurance to medical institution. In this case we can receive refund of the balance when one corresponding to 20% burden is originally applied to ward office Insurance and Pension Division of ward to live for. (※) but take 3-4 months before receive refund. When medical institution is consulted, please show both health insurance card and identification of old recipient by all means.
※It is statute of limitations after paying to medical institution when it is past five years and cannot receive refund. Please be careful.
<thing necessary for application>
- Health insurance card
- Identification of old recipient
- Private seal (by family nurturer name thing using vermilion)
- We can confirm bank book or transfer
Window burden on 74-year-old person became 20% from 70 years old legally, but was done with 10% burden by special measures until now. These special measures will be reviewed to assume fairer structure from 2014.
In review, it will be carried out progressively by old one to invite 70-year-old birthday to not to make any big influence occurring for life on after April 2, 2014.
Person who was born after April 2, 1944
From medical treatment of the next month (month but for each one a month day in the one of birthday) of the 70-year-old birth moon, window burden becomes 20%.
※One with constant income is 30% burden according to to this.