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”.
The expenses combined with any additional sum will be paid automatically to the insured person in four or five months. However, the additional sum to cover a person who has not yet graduated from junior high school will be paid upon application.
- When you want to reduce the amount of medical care costs you pay at the medical care institution
- When your co-payment amount exceeds the maximum amount
- When you face high copayments for medical care or long-term care
- Loans for high-cost medical expenses
When you want to reduce the amount of medical care costs you pay at the medical care institution
We recommend using your My Number Card as your Health Insurance Certificate. By doing so, your cost-sharing maximum amount information will be provided with no need to give your consent and you will no longer need a Certificate of Application of Maximum Copayment Amount.
| Required documents: | Print size | A4 |
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| Applies to: | Insured persons or dependents whose copayment amounts for one month are expected to exceed their individual cost-sharing maximum amounts in the following cases:
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| Submit to: | Submit the form directly to the Health Insurance Society | ||
| Notes: | You can use this system for both inpatient and outpatient costs. | ||
When your co-payment amount exceeds the maximum amount
The additional sum to cover a person who has not yet graduated from junior high school will be “paid upon application."
| Required documents: | Print size | A4 |
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|---|---|---|---|
| Applies to: | Children who are junior high school age or younger, and those eligible for local government medical subsidies | ||
| Submit to: | Submit the form directly to the Health Insurance Society | ||
| Notes: | In the case of those eligible for local government medical subsidies, excluding children who are junior high school age or younger, a copy of their eligible recipient certificate must be submitted to the Health Insurance Society. | ||
When you face high copayments for medical care or long-term care
| Required documents: | Print size | A4 |
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|---|---|---|---|
[Documents to attach] |
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| Deadline: | As soon as possible | ||
| 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 | ||
| Submit to: | Submit the form directly to the Health Insurance Society | ||
| Notes: | For calculation purposes, the one-year period above refers to the period August 1 to July 31 the following year. | ||
Loans for high-cost medical expenses
| Required documents: | Print size | A4 |
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|---|---|---|---|
| Print size | A4 |
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| Applies to: | |||
| Submit to: | Submit the form directly to the Health Insurance Society | ||
| Notes: | |||