{
  "formula": "monthly cap = base + max(0, 10割 total medical cost − threshold) × 1%, rounded to the yen; flat caps for lower bands",
  "schedules": {
    "pre": {
      "id": "pre",
      "label": "Before the 2026 review (treatment up to July 2026)",
      "from": null,
      "to": "2026-07"
    },
    "r8": {
      "id": "r8",
      "label": "Stage 1 (treatment Aug 2026 – Jul 2027): higher caps, new annual cap",
      "from": "2026-08",
      "to": "2027-07"
    },
    "r9": {
      "id": "r9",
      "label": "Stage 2 (treatment from Aug 2027): 12 income bands",
      "from": "2027-08",
      "to": null
    }
  },
  "manyTimes": "多数回該当: from the 4th month with a benefit in the last 12 months, a lower flat cap applies (none for 70+ 低所得I). 70+ outpatient-only months don't count.",
  "annualCap": "From treatment in Aug 2026: yearly cap per Aug–Jul period on what you paid after monthly refunds (and the 70+ outpatient yearly cap).",
  "claim": "Claim within 2 years from the 1st of the month after treatment.",
  "under70Combine": "Under 70: only bills of ¥21,000+ per facility per month (inpatient / outpatient / dental separate) can be combined within the household.",
  "bands": {
    "y1650": {
      "id": "y1650",
      "label": "Income about ¥16.5M+",
      "labelJa": "年収約1,650万円〜",
      "annualIncome": "about ¥16.5M+",
      "smr": "¥1.27M+",
      "nhiIncome": "over ¥13.56M",
      "taxable70": "¥11.07M+",
      "legacy": "ア"
    },
    "y1410": {
      "id": "y1410",
      "label": "Income about ¥14.1M–16.5M",
      "labelJa": "年収約1,410〜1,650万円",
      "annualIncome": "about ¥14.1M–16.5M",
      "smr": "¥1.03M–1.21M",
      "nhiIncome": "¥11.1M–13.56M",
      "taxable70": "¥9.0M–11.07M",
      "legacy": "ア"
    },
    "y1160": {
      "id": "y1160",
      "label": "Income about ¥11.6M–14.1M",
      "labelJa": "年収約1,160〜1,410万円",
      "annualIncome": "about ¥11.6M–14.1M",
      "smr": "¥830k–980k",
      "nhiIncome": "¥9.01M–11.1M",
      "taxable70": "¥6.9M–9.0M",
      "legacy": "ア"
    },
    "y1040": {
      "id": "y1040",
      "label": "Income about ¥10.4M–11.6M",
      "labelJa": "年収約1,040〜1,160万円",
      "annualIncome": "about ¥10.4M–11.6M",
      "smr": "¥710k–790k",
      "nhiIncome": "¥8.09M–9.01M",
      "taxable70": "¥6.14M–6.9M",
      "legacy": "イ"
    },
    "y950": {
      "id": "y950",
      "label": "Income about ¥9.5M–10.4M",
      "labelJa": "年収約950〜1,040万円",
      "annualIncome": "about ¥9.5M–10.4M",
      "smr": "¥620k–680k",
      "nhiIncome": "¥6.79M–8.09M",
      "taxable70": "¥5.04M–6.14M",
      "legacy": "イ"
    },
    "y770": {
      "id": "y770",
      "label": "Income about ¥7.7M–9.5M",
      "labelJa": "年収約770〜950万円",
      "annualIncome": "about ¥7.7M–9.5M",
      "smr": "¥530k–590k",
      "nhiIncome": "¥6.0M–6.79M",
      "taxable70": "¥3.8M–5.04M",
      "legacy": "イ"
    },
    "y650": {
      "id": "y650",
      "label": "Income about ¥6.5M–7.7M",
      "labelJa": "年収約650〜770万円",
      "annualIncome": "about ¥6.5M–7.7M",
      "smr": "¥440k–500k",
      "nhiIncome": "¥4.1M–6.0M",
      "taxable70": "¥2.8M–3.8M",
      "legacy": "ウ"
    },
    "y510": {
      "id": "y510",
      "label": "Income about ¥5.1M–6.5M",
      "labelJa": "年収約510〜650万円",
      "annualIncome": "about ¥5.1M–6.5M",
      "smr": "¥360k–410k",
      "nhiIncome": "¥3.13M–4.1M",
      "taxable70": "¥2.03M–2.8M",
      "legacy": "ウ"
    },
    "y370": {
      "id": "y370",
      "label": "Income about ¥3.7M–5.1M",
      "labelJa": "年収約370〜510万円",
      "annualIncome": "about ¥3.7M–5.1M",
      "smr": "¥280k–340k",
      "nhiIncome": "¥2.1M–3.13M",
      "taxable70": "¥1.45M–2.03M",
      "legacy": "ウ"
    },
    "y260": {
      "id": "y260",
      "label": "Income about ¥2.6M–3.7M",
      "labelJa": "年収約260〜370万円",
      "annualIncome": "about ¥2.6M–3.7M",
      "smr": "¥200k–260k",
      "nhiIncome": "¥1.27M–2.1M",
      "taxable70": "¥570k–1.45M",
      "legacy": "エ"
    },
    "y200": {
      "id": "y200",
      "label": "Income about ¥2.0M–2.6M",
      "labelJa": "年収約200〜260万円",
      "annualIncome": "about ¥2.0M–2.6M",
      "smr": "¥160k–190k",
      "nhiIncome": "¥860k–1.27M",
      "taxable70": "¥280k–570k",
      "legacy": "エ"
    },
    "y0": {
      "id": "y0",
      "label": "Income up to about ¥2.0M",
      "labelJa": "年収約200万円以下",
      "annualIncome": "up to about ¥2.0M",
      "smr": "¥150k or less",
      "nhiIncome": "¥860k or less",
      "taxable70": "under ¥280k",
      "legacy": "エ"
    },
    "nontaxable": {
      "id": "nontaxable",
      "label": "Resident-tax exempt (住民税非課税)",
      "labelJa": "住民税非課税（低所得者・低所得II）",
      "annualIncome": "resident-tax exempt",
      "smr": "—",
      "nhiIncome": "—",
      "taxable70": "—",
      "legacy": "オ / 低所得II"
    },
    "nontaxable_low": {
      "id": "nontaxable_low",
      "label": "70+, tax exempt with very low income (低所得I)",
      "labelJa": "70歳以上・低所得I（一定所得以下）",
      "annualIncome": "70+ tax exempt, pension ≤ about ¥826,500",
      "smr": "—",
      "nhiIncome": "—",
      "taxable70": "—",
      "legacy": "低所得I"
    }
  },
  "table": {
    "pre": {
      "under70": {
        "y1650": {
          "base": 252600,
          "threshold": 842000,
          "many": 140100,
          "annual": null
        },
        "y1410": {
          "base": 252600,
          "threshold": 842000,
          "many": 140100,
          "annual": null
        },
        "y1160": {
          "base": 252600,
          "threshold": 842000,
          "many": 140100,
          "annual": null
        },
        "y1040": {
          "base": 167400,
          "threshold": 558000,
          "many": 93000,
          "annual": null
        },
        "y950": {
          "base": 167400,
          "threshold": 558000,
          "many": 93000,
          "annual": null
        },
        "y770": {
          "base": 167400,
          "threshold": 558000,
          "many": 93000,
          "annual": null
        },
        "y650": {
          "base": 80100,
          "threshold": 267000,
          "many": 44400,
          "annual": null
        },
        "y510": {
          "base": 80100,
          "threshold": 267000,
          "many": 44400,
          "annual": null
        },
        "y370": {
          "base": 80100,
          "threshold": 267000,
          "many": 44400,
          "annual": null
        },
        "y260": {
          "base": 57600,
          "threshold": null,
          "many": 44400,
          "annual": null
        },
        "y200": {
          "base": 57600,
          "threshold": null,
          "many": 44400,
          "annual": null
        },
        "y0": {
          "base": 57600,
          "threshold": null,
          "many": 44400,
          "annual": null
        },
        "nontaxable": {
          "base": 35400,
          "threshold": null,
          "many": 24600,
          "annual": null
        }
      },
      "70plus": {
        "y1650": {
          "base": 252600,
          "threshold": 842000,
          "many": 140100,
          "annual": null
        },
        "y1410": {
          "base": 252600,
          "threshold": 842000,
          "many": 140100,
          "annual": null
        },
        "y1160": {
          "base": 252600,
          "threshold": 842000,
          "many": 140100,
          "annual": null
        },
        "y1040": {
          "base": 167400,
          "threshold": 558000,
          "many": 93000,
          "annual": null
        },
        "y950": {
          "base": 167400,
          "threshold": 558000,
          "many": 93000,
          "annual": null
        },
        "y770": {
          "base": 167400,
          "threshold": 558000,
          "many": 93000,
          "annual": null
        },
        "y650": {
          "base": 80100,
          "threshold": 267000,
          "many": 44400,
          "annual": null
        },
        "y510": {
          "base": 80100,
          "threshold": 267000,
          "many": 44400,
          "annual": null
        },
        "y370": {
          "base": 80100,
          "threshold": 267000,
          "many": 44400,
          "annual": null
        },
        "y260": {
          "base": 57600,
          "threshold": null,
          "many": 44400,
          "annual": null,
          "outpatient": 18000,
          "outpatientAnnual": 144000
        },
        "y200": {
          "base": 57600,
          "threshold": null,
          "many": 44400,
          "annual": null,
          "outpatient": 18000,
          "outpatientAnnual": 144000
        },
        "y0": {
          "base": 57600,
          "threshold": null,
          "many": 44400,
          "annual": null,
          "outpatient": 18000,
          "outpatientAnnual": 144000
        },
        "nontaxable": {
          "base": 24600,
          "threshold": null,
          "many": null,
          "annual": null,
          "outpatient": 8000,
          "outpatientAnnual": null
        },
        "nontaxable_low": {
          "base": 15000,
          "threshold": null,
          "many": null,
          "annual": null,
          "outpatient": 8000,
          "outpatientAnnual": null
        }
      }
    },
    "r8": {
      "under70": {
        "y1650": {
          "base": 270300,
          "threshold": 901000,
          "many": 140100,
          "annual": 1680000
        },
        "y1410": {
          "base": 270300,
          "threshold": 901000,
          "many": 140100,
          "annual": 1680000
        },
        "y1160": {
          "base": 270300,
          "threshold": 901000,
          "many": 140100,
          "annual": 1680000
        },
        "y1040": {
          "base": 179100,
          "threshold": 597000,
          "many": 93000,
          "annual": 1110000
        },
        "y950": {
          "base": 179100,
          "threshold": 597000,
          "many": 93000,
          "annual": 1110000
        },
        "y770": {
          "base": 179100,
          "threshold": 597000,
          "many": 93000,
          "annual": 1110000
        },
        "y650": {
          "base": 85800,
          "threshold": 286000,
          "many": 44400,
          "annual": 530000
        },
        "y510": {
          "base": 85800,
          "threshold": 286000,
          "many": 44400,
          "annual": 530000
        },
        "y370": {
          "base": 85800,
          "threshold": 286000,
          "many": 44400,
          "annual": 530000
        },
        "y260": {
          "base": 61500,
          "threshold": null,
          "many": 44400,
          "annual": 530000
        },
        "y200": {
          "base": 61500,
          "threshold": null,
          "many": 44400,
          "annual": 530000
        },
        "y0": {
          "base": 61500,
          "threshold": null,
          "many": 44400,
          "annual": 410000
        },
        "nontaxable": {
          "base": 36900,
          "threshold": null,
          "many": 24600,
          "annual": 290000
        }
      },
      "70plus": {
        "y1650": {
          "base": 270300,
          "threshold": 901000,
          "many": 140100,
          "annual": 1680000
        },
        "y1410": {
          "base": 270300,
          "threshold": 901000,
          "many": 140100,
          "annual": 1680000
        },
        "y1160": {
          "base": 270300,
          "threshold": 901000,
          "many": 140100,
          "annual": 1680000
        },
        "y1040": {
          "base": 179100,
          "threshold": 597000,
          "many": 93000,
          "annual": 1110000
        },
        "y950": {
          "base": 179100,
          "threshold": 597000,
          "many": 93000,
          "annual": 1110000
        },
        "y770": {
          "base": 179100,
          "threshold": 597000,
          "many": 93000,
          "annual": 1110000
        },
        "y650": {
          "base": 85800,
          "threshold": 286000,
          "many": 44400,
          "annual": 530000
        },
        "y510": {
          "base": 85800,
          "threshold": 286000,
          "many": 44400,
          "annual": 530000
        },
        "y370": {
          "base": 85800,
          "threshold": 286000,
          "many": 44400,
          "annual": 530000
        },
        "y260": {
          "base": 61500,
          "threshold": null,
          "many": 44400,
          "annual": 530000,
          "outpatient": 22000,
          "outpatientAnnual": 216000
        },
        "y200": {
          "base": 61500,
          "threshold": null,
          "many": 44400,
          "annual": 530000,
          "outpatient": 22000,
          "outpatientAnnual": 216000
        },
        "y0": {
          "base": 61500,
          "threshold": null,
          "many": 44400,
          "annual": 410000,
          "outpatient": 22000,
          "outpatientAnnual": 216000
        },
        "nontaxable": {
          "base": 25700,
          "threshold": null,
          "many": 24600,
          "annual": 290000,
          "outpatient": 11000,
          "outpatientAnnual": 96000
        },
        "nontaxable_low": {
          "base": 15700,
          "threshold": null,
          "many": null,
          "annual": 180000,
          "outpatient": 8000,
          "outpatientAnnual": null
        }
      }
    },
    "r9": {
      "under70": {
        "y1650": {
          "base": 342000,
          "threshold": 1140000,
          "many": 140100,
          "annual": 1680000
        },
        "y1410": {
          "base": 303000,
          "threshold": 1010000,
          "many": 140100,
          "annual": 1680000
        },
        "y1160": {
          "base": 270300,
          "threshold": 901000,
          "many": 140100,
          "annual": 1680000
        },
        "y1040": {
          "base": 209400,
          "threshold": 698000,
          "many": 93000,
          "annual": 1110000
        },
        "y950": {
          "base": 194400,
          "threshold": 648000,
          "many": 93000,
          "annual": 1110000
        },
        "y770": {
          "base": 179100,
          "threshold": 597000,
          "many": 93000,
          "annual": 1110000
        },
        "y650": {
          "base": 110400,
          "threshold": 368000,
          "many": 44400,
          "annual": 530000
        },
        "y510": {
          "base": 98100,
          "threshold": 327000,
          "many": 44400,
          "annual": 530000
        },
        "y370": {
          "base": 85800,
          "threshold": 286000,
          "many": 44400,
          "annual": 530000
        },
        "y260": {
          "base": 69600,
          "threshold": null,
          "many": 44400,
          "annual": 530000
        },
        "y200": {
          "base": 65400,
          "threshold": null,
          "many": 44400,
          "annual": 530000
        },
        "y0": {
          "base": 61500,
          "threshold": null,
          "many": 34500,
          "annual": 410000
        },
        "nontaxable": {
          "base": 36900,
          "threshold": null,
          "many": 24600,
          "annual": 290000
        }
      },
      "70plus": {
        "y1650": {
          "base": 342000,
          "threshold": 1140000,
          "many": 140100,
          "annual": 1680000
        },
        "y1410": {
          "base": 303000,
          "threshold": 1010000,
          "many": 140100,
          "annual": 1680000
        },
        "y1160": {
          "base": 270300,
          "threshold": 901000,
          "many": 140100,
          "annual": 1680000
        },
        "y1040": {
          "base": 209400,
          "threshold": 698000,
          "many": 93000,
          "annual": 1110000
        },
        "y950": {
          "base": 194400,
          "threshold": 648000,
          "many": 93000,
          "annual": 1110000
        },
        "y770": {
          "base": 179100,
          "threshold": 597000,
          "many": 93000,
          "annual": 1110000
        },
        "y650": {
          "base": 110400,
          "threshold": 368000,
          "many": 44400,
          "annual": 530000
        },
        "y510": {
          "base": 98100,
          "threshold": 327000,
          "many": 44400,
          "annual": 530000
        },
        "y370": {
          "base": 85800,
          "threshold": 286000,
          "many": 44400,
          "annual": 530000
        },
        "y260": {
          "base": 69600,
          "threshold": null,
          "many": 44400,
          "annual": 530000,
          "outpatient": 28000,
          "outpatientAnnual": 216000
        },
        "y200": {
          "base": 65400,
          "threshold": null,
          "many": 44400,
          "annual": 530000,
          "outpatient": 28000,
          "outpatientAnnual": 216000
        },
        "y0": {
          "base": 61500,
          "threshold": null,
          "many": 34500,
          "annual": 410000,
          "outpatient": 22000,
          "outpatientAnnual": 216000
        },
        "nontaxable": {
          "base": 25700,
          "threshold": null,
          "many": 24600,
          "annual": 290000,
          "outpatient": 13000,
          "outpatientAnnual": 96000
        },
        "nontaxable_low": {
          "base": 15700,
          "threshold": null,
          "many": null,
          "annual": 180000,
          "outpatient": 8000,
          "outpatientAnnual": null
        }
      }
    }
  },
  "ageGroups": [
    "under70",
    "70plus"
  ],
  "bandIds": [
    "y1650",
    "y1410",
    "y1160",
    "y1040",
    "y950",
    "y770",
    "y650",
    "y510",
    "y370",
    "y260",
    "y200",
    "y0",
    "nontaxable",
    "nontaxable_low"
  ],
  "settings": [
    "inpatient",
    "outpatient"
  ],
  "rulesAsOf": "2026-11-04",
  "sources": [
    "https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/iryouhoken/juuyou/kougakuiryou/index.html",
    "https://www.mhlw.go.jp/content/001726232.pdf",
    "https://www.mhlw.go.jp/content/001729632.pdf",
    "https://www.kyoukaikenpo.or.jp/g3/sb3030/r150/",
    "https://www.city.setagaya.lg.jp/02060/33049.html",
    "https://www.city.machida.tokyo.jp/kurashi/hoken/kokuho/ironnakyuufu/kougaku.html",
    "https://www.city.fukuoka.lg.jp/hofuku/hokennenkin/hp/kokuminkenkouhoken/09-00.html",
    "https://laws.e-gov.go.jp/law/215IO0000000243"
  ],
  "disclaimer": "Educational estimate, not medical, financial or legal advice. Not affiliated with the Ministry of Health, Labour and Welfare (MHLW), Japan Health Insurance Association (協会けんぽ), any health insurance society, city NHI office or hospital. Your insurer decides the actual benefit; extra benefits (付加給付) and local subsidies can lower your cost further. Rules as of 2026-11-04.",
  "docs": "https://japan-medical-cost-cap.vercel.app/openapi.json",
  "checker": "https://japan-medical-cost-cap.vercel.app/api/check"
}