Medical Care Service System for the Aged (Subsidies/Payments)
The Mercari Health Insurance Association allocates health insurance premiums paid by employers and insured persons to the payment of medical expenses, the healthcare business and other healthcare expenses, as well as its operations as a health insurance society. In addition, these premiums are also used as subsidies and payments to support the medical expenses of elderly throughout Japan.
The aging of society and the advancement of medical technology have resulted in annual increases in the elderly medical expenses. These medical care costs currently constitute about 60% of all medical care expenses nationwide, increasing the annual subsidies and other payments to support those costs as well.
Individuals age 65 to 74: Early-stage elderly
Individuals age 65 to 74 are considered early-stage elderly, but benefits and other aspects of the health insurance coverage remain the same. The Mercari Health Insurance Association contributes to the payments for early-stage elderly individuals.
Individual Age 70
An “elderly recipient” refers to an insured person or dependent age 70 to 74. The Mercari Health Insurance Association issues an Elderly Beneficiary Health Insurance Card separate from the Eligibility Confirmation Document, etc. to elderly beneficiaries. This card acts as a certificate to verify the percentage of out-of-pocket costs at the billing counter of the healthcare provider. It indicates a percentage between 20% and 30% based on income.
Insured persons must present both the health insurance card, the Eligibility Confirmation Document, etc. and the Elderly Beneficiary Individual Number Card to the healthcare provider when undergoing an examination or treatment by the healthcare provider.
Issuance of Elderly Beneficiary Health Insurance Card
Requirements
- The insured person or dependent has turned 70 years old
- The individual age 70 or older has been certified as a dependent
- The individual age 70 or older has been certified as a dependent when acquiring eligibility for this health insurance
- The out-of-pocket percentage on the Elderly Beneficiary Health Insurance Card has changed
Applicable Month (Date to Start Use)
- The first day of the month after the month in which the individual turns 70 (the birthday of the individual if the birthday falls on the first day of the month)
- The day on which an individual age 70 or older has been certified as a dependent
Notes
- Insured persons need to present an Elderly Beneficiary Individual Number Card, an Eligibility Confirmation Document, etc. at hospitals and other healthcare providers. Please do not store these cards separately.
- An insured person is considered an income earner comparable to individuals in active service and will pay 30% of the medical costs at the billing counter if he/she has forgotten the Elderly Beneficiary Health Insurance Card. Please make sure not to lose or forget to bring this card to the healthcare provider because adjustments cannot be made without it.
- Promptly return the Elderly Beneficiary Individual Number Card when it expires.
The insured person must return the Elderly Beneficiary Individual Number Card, the Eligibility Confirmation Document, etc. if the individual retires before the card expires, or if a family member who is an elderly recipient is removed as a dependent for health insurance purposes.*There is no need to return your Individual Number Insurance Card.
Individual Age 75
Individuals lose eligibility as an insured person (dependent) of the Mercari Health Insurance Association on their 75th birthday and need to enroll in the medical care system for the advanced elderly on that same day. The Mercari Health Insurance Association contacts applicable insured persons in the month before their birthday. Details regarding the filing procedures will be provided at that time.
| Eligible Persons |
All individuals age 75 or older (age 65 or older in the case of individuals with certain disabilities) *If an insured person age 75 or older has dependents that are under age 75, they will lose eligibility as dependents when the insured person switches to the medical care system for the advanced elderly. Please note that the individual must complete procedures to enroll in National Health Insurance in such cases. |
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| Insurer |
The regional union in which your local municipality has enrolled *The municipality will handle all liaison work, such as the various types of application, notifications. |
| Insurance Premiums |
Insurance premiums are determined in accordance with the income of each individual. As a general rule, insurance premiums are withheld from annual pensions. *Each individual is an insured person under the medical care system for the advanced elderly. Individuals who were dependents in the Mercari Health Insurance Association also become insured persons under the medical care system for the advanced elderly when turning 75 and will pay those insurance premiums (however, there are measures in place to mitigate these costs). |