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2026-08-01
High-Cost Medical Expenses Cap Raised
Effective August 1, 2026 (Phase 1). Monthly out-of-pocket cap raised 4–38% by income bracket. New annual cap of ¥530,000 for those earning ¥2–7.7M/year. Multiple-occurrence reduction kept as-is.
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2026-04-01Health
💊 Brand-Name Drug Extra Charge Expanded (775 Items)
Effective April 1, 2026 — Choosing brand-name means paying 1/4 of the price gap
775
Items
1/4
Extra charge
+34
Newly added
¥0
If generic
❓ What's changing?
The "selected medical treatment" system for long-listed drugs is expanding with 34 new additions, totaling 775 items. When patients choose a brand-name drug over a generic equivalent, they must pay an extra 25% (1/4) of the price difference out of pocket.
⚙️ How it works
- ●Covers 775 brand-name drugs that have generic equivalents
- ●Choose brand-name → pay 1/4 of the price difference extra
- ●Choose generic → no extra charge (same as before)
- ●If medically necessary, doctor can waive the extra charge
💰 Example
Brand-name: ¥200/tablet, Generic: ¥80/tablet. Difference ¥120 × 1/4 = ¥30 extra. At 30% copay: normal ¥60 + extra ¥30 = ¥90 total.
👥 Who's affected?
- ✓Foreign residents with chronic conditions requiring regular prescriptions
- ✓Those on medications for hypertension, diabetes, high cholesterol, etc.
- ✓Anyone specifically requesting brand-name prescriptions
- ✓All national health insurance / social insurance enrollees
💸 How to reduce your burden
- ✓Ask your doctor about switching to generics
- ✓Tell the pharmacy "generics are OK"
- ✓Check your medication handbook to see if your drugs are covered
- ✓Consult your doctor if there's a medical necessity
💡 Key points to know
1Choosing generic = zero extra charge
2775 items on the list — check your regular medications
3Doctors can waive the extra charge when medically necessary
4Bring your medication handbook to the pharmacy
🔗 Related Issues
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2026-06-01
2026 Medical Fee Revision — Consultation Fees Effectively Raised
From June 2026, new price-adjustment surcharges effectively raise initial consultation by ~¥20 and follow-up by ~¥30. Affects out-of-pocket costs for foreign residents at 30% copay.
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2026-04-01
2026 Drug Price Revision — Prescription Drugs Generally Cheaper
From April 2026, drug prices cut by 0.86% (medical cost basis). Some items reduced by over 40% under market expansion reassessment. Lower out-of-pocket costs for foreign patients using prescription drugs.