You pay at most ¥121,720 for 2027-09; about ¥328,280 of your ¥450,000 copay comes back.

Cap applies: money back · 2027-09 · from Aug 2027

You pay at most ¥121,720 for 2027-09; about ¥328,280 of your ¥450,000 copay comes back.

What to do

1. Show your My Number insurance card (マイナ保険証) or a 限度額適用認定証 at the hospital, and the counter charges only up to the cap, so you don't have to pay first and wait.
2. If you already paid more, claim the refund from your insurer: 協会けんぽ or your company's health insurance society (健康保険組合), or the city office for National Health Insurance (国民健康保険) or late-stage elderly insurance (後期高齢者医療). Many send you the form automatically about 3–4 months later.
3. Claim deadline for 2027-09: 2029-09-30 (2 years from the 1st of the following month).
4. Under 70: add bills of ¥21,000 or more per hospital per month (inpatient, outpatient and dental counted separately; pharmacy bills join the prescribing clinic) for you and family on the same insurance, then the cap applies to the total.
5. Hospital meals, private-room fees (差額ベッド), advanced medical care (先進医療) and uninsured treatment don't count.
6. Ask your insurer about extra benefits (付加給付): many company health insurance societies cap costs lower, often around ¥20,000–25,000 a month.
7. From Aug 2026 there is also a yearly cap (Aug–Jul): ¥530,000 for your band. Keep your receipts.

Band: Income about ¥6.5M–7.7M (年収約650〜770万円). MHLW high-cost medical expense call center 0120-617-111 (Japanese).