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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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2026-06-01Health
🩺 2026 Medical Fee Revision — Consultation Fees Effectively Raised
Effective June 1, 2026 — New price-adjustment surcharges increase out-of-pocket costs
+¥20
Initial +
+¥30
Follow-up +
30%
Foreign copay
6/1
Effective
❓ What's changing?
The 2026 medical fee revision introduces new surcharges for price adjustments and wage increases. Initial consultations go up by about ¥20 and follow-ups by about ¥30, increasing patients' out-of-pocket costs at the window.
📋 Specific changes
- ●Initial consultation: ~¥20 effective increase (price adjustment surcharge)
- ●Follow-up: ~¥30 effective increase (incl. wage adjustment)
- ●Inpatient basic fee: nursing ratio-based surcharge revision
- ●Online consultations: gap with in-person narrowed
💳 Impact on out-of-pocket costs
| Copay | Initial | Follow-up | Target |
|---|---|---|---|
| 30% copay | ¥+6 | ¥+9 | Working-age / foreign residents |
| 20% copay | ¥+4 | ¥+6 | Age 70–74 |
| 10% copay | ¥+2 | ¥+3 | Age 75+ |
👥 Who's affected?
- ✓All foreign residents enrolled in Japanese health insurance
- ✓Anyone with regular clinic visits (even 1–2x/month)
- ✓Those visiting multiple medical facilities
- ✓All departments: dental, eye, dermatology, etc.
📈 Background
This revision responds to rising personnel costs, utility bills, and general inflation affecting healthcare providers. It aims to maintain hospital viability and improve healthcare worker compensation.
💡 Key points to know
1At 30% copay: initial +¥6, follow-up +¥9
2Multiple monthly visits = hundreds of yen more per year
3Consider consolidating to one family doctor
4Combine with generic drugs to control overall medical costs
🔗 Related Issues
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2026-04-01
Brand-Name Drug Extra Charge Expanded (775 Items)
From April 2026, 34 more brand-name drugs added to the "selected medical treatment" list (total 775). Patients choosing brand-name over generic pay 1/4 of the price difference out of pocket. Affects foreign residents with chronic conditions.
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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.