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2026-08-01Health
💊 High-Cost Medical Expenses Cap Raised
Effective Aug 2026; monthly cap up 4–38% + new annual cap of ¥530,000
+38%
Max increase
¥530K
New annual cap
Phase 1
Aug 2026
Same
Low income
❓ What's changing?
The High-Cost Medical Expenses Benefit refunds medical costs that exceed a set monthly limit. In the first-phase revision on August 1, 2026, monthly out-of-pocket caps are raised by 4–38% across income brackets, and a new annual cap of ¥530,000 is introduced for those with ¥2–7.7M annual income.
📊 Monthly Cap Changes by Income Bracket
| Before | After | Δ | |
|---|---|---|---|
| ~¥11.6M annual | ¥252,600+α | ¥348,000+α | +38% |
| ¥7.7M~¥11.6M | ¥167,400+α | ¥232,000+α | +39% |
| ¥3.7M~¥7.7M | ¥80,100+α | ¥113,000+α | +41% |
| ~¥3.7M | ¥57,600 | ¥60,000 | +4% |
| Tax-exempt | ¥35,400 | ¥35,400 | Unchanged |
📅 New Annual Cap
A new ¥530,000 annual cap is introduced for those earning ¥2–7.7M/year, aimed at easing the burden on those needing long-term treatment. The multiple-occurrence reduction (cap reached 3+ times in the past 12 months) remains unchanged.
👥 Who is affected?
- ●All foreign residents enrolled in National Health Insurance, Kyokai Kenpo, or union health insurance
- ●Those undergoing major surgery, hospitalization, or cancer treatment
- ●Those with chronic conditions requiring ongoing treatment and medication
- ●Higher-income brackets (¥3.7M+) see notable increases in burden
📝 How to Apply for the Limit Application Certificate
- ✓① Apply to your health insurer (city/town, Kyokai Kenpo, health insurance union)
- ✓② Bring residence card and insurance card; some insurers accept online applications
- ✓③ Issuance typically within 1–2 weeks
- ✓④ Present with your insurance card at the hospital → pay only up to the cap
- ✓⑤ With a My Number health card, no application needed — applied automatically
💡 Key points to know
1Enforcement August 1, 2026 (Phase 1). Treatment before then uses the old rules
2Apply in advance for a "Limit Application Certificate" to pay only the cap at the counter
3Multiple-occurrence reduction (4+ times in 12 months) stays the same
4Caps for tax-exempt households are unchanged (consideration)
5Public assistance recipients continue to have no out-of-pocket cost