Reduce Your Medical Costs in Japan: What You Need to Know

Foreign residents in Japan should be aware of a Japanese social security system that caps monthly medical expenses at 100,000 yen. If you incur medical costs exceeding this amount due to a serious injury or illness, your health insurance will reimburse the excess. This system is available to those who pay monthly health insurance premiums in Japan.

Unfortunately, there isn't much information about it available online in English. However, I did manage to find [this explanation] on the Keio University Hospital website.

In Summary:

If you are enrolled in Japanese health insurance and your monthly medical expenses exceed a certain threshold, the amount over that limit will be reimbursed.

Example:

If your medical care costs 1,000,000 yen, and you are responsible for paying 300,000 yen (30%) at the hospital, you may be eligible for reimbursement of the amount over the monthly out-of-pocket maximum.

Eligibility Certificate for Ceiling-Amount Application:

By presenting an Eligibility Certificate for Ceiling-Amount Application along with your health insurance card at the hospital, you will only need to pay your out-of-pocket maximum for that month.

Important Notes:

• Medical care costs, out-of-pocket maximums, and reimbursements are calculated separately for each department within the hospital.
• Calculations vary based on the type of service (medical or dental) and the patient's status (inpatient or outpatient).
• Non-insurance-covered fees, such as hospital bed charges or meal costs, are not included in these calculations.
• All necessary certificates must be presented during the same month as the treatment.
• Be sure to present your health insurance card and the certificate every month, ensuring they are valid and not expired.