A Guide to the

FY2024 Editionhcare System
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for the Elderly
75 and Over
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A
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Stay heaer
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Preventing frailty
starts with your diet!

Okinawa Prefecture Elderly
Healthcare Association

1-1 Ishikawa Ishizaki, Uruma City 904-1192(Uruma City Hall Ishikawa Bldg. 3F)

General Affairs Division ……… ☎098-963-8011
Administration Division ……… ☎098-963-8012
Business Division ……………… ☎098-963-8013

Introduction
The Healthcare System for the Elderly Aged 75 and Over was
made to clarify the obligations of the elderly and of theworking generation, and for society as a whole to support
healthcare expenses of the elderly. It is operated by the local
elderly healthcare association to which all municipalities fromeach prefecture belong to.

Table of contents
3
4
Health Insurance Card ………………………………………………… 5
Insurance Premiums …………………………………………………… 6
Those who must pay insurance premiums /How insurance premiums are determined ……………………………… 6
When you can receive a reduced insurance premium …………………… 7
How to pay your insurance premium ……………………………………… 8Consequences of not paying your insurance premium /Insurance premium reduction and exemption system ………………… 10
When visiting the doctor …………………………………………… 12
When you have high medical expenses ………………………… 14
High-cost medical care/long-term care combined system …………… 16
Meal expenses, etc. when hospitalized ………………………… 17
You can also receive benefits in these cases …………………… 18
When in a traffic accident …………………………………………… 19
Reimbursable costs …………………………………………………… 20
Massage and acupuncture treatment …………………………… 21
Judo therapy (orthopedic clinic/osteopathic clinic) treatment …………… 22
About the insurance business (longevity health checkups) …………… 24
Use generic medicine! ………………………………………………… 25
About the organ donation column ……………………………… 25
The Healthcare System for the Elderly Aged 75 or …………… 26
Roles of municipalities and local associations …………………
Those covered by the system ………………………………………

Older – Supported by Everyone
Be sure to report the following situations ……………………… 27

List of municipalities。

……………………………………

Back cover*Contents may change due to the revisions of the system.

Preventing frailty starts with your diet!

2

What is frailty, which may lead to nursing care?

Roles of municipalities
and local associations
The healthcare system for the elderly
aged 75 and over is operated by a local
association established in each prefecture.
Municipalities carr y out reception
operations.

Roles of municipalities
The contact point for applications and other notifications● Health insurance card transfer● Health insurance premium collection● Applications and notification processing
Etc.

Roles of local associations
Operate the system● Health insurance card issuance● Health insurance premium determination● Benefit provision when receiving medical care

Etc.

Where should I submit
Q notifications
to?
submit notifications to your local
A Pleasemunicipality’s’’s reception desk.
The local association is the main operator, and themunicipality is the reception desk. For more information,please contact your local municipality (see the list ofmunicipalities on the back cover).
“Frailty” is the condition that lies between a healthy state and a state that would
require nursing care. As we get older, muscle strength as well as mental and physicalvitality decline, making us more likely to become frail. One of the important measuresagainst frailty is our diet. Let’s review our daily eating habits and stay healthy!

3Those coveredby the system
People over theage of 75

Starting on the dayof your 75th birthday
People between

the ages of 65 and 75

with certain disabilities(*Must apply and receive approval from your local association.)

To receive coverage, you must transfer from yourcurrently-enrolled healthcare provider such as National
Health Insurance, Health Insurance Association, Mutual Aid
Association, etc., to the healthcare system for the elderly.

Q

My husband is insured by thehealthcare system for theelderly. Which healthcare insurance
system will I (70 years old), a
dependent of my husband's social
insurance, be covered by?

A

Please enroll in a medical insurance,such as National Health Insurance, fromthe social insurance you are currently
enrolled in.

* If you have other family members who have healthcare
insurance other than National Health Insurance, you
can also become their dependents. Please contact theapplicable healthcare insurance company.

Health Insurance Card
The insured will be issued a newhealth insurance card. The healthinsurance card shows the percentage
of eligible coverage (10% to 30%).

Keep your health insurance card ina safe place◆ When your card is issued, please check that all information on it

is correct. If there are any mistakes, inform the reception staff.

◆ Please present it at the counter when seeing a doctor.
◆ Always keep it handy.
◆ Your “My Number Card” can be used as▼Mynaportal

your insurance card.

※Application for using the health insurance card on My
Number Card may be done on Mynaportal site, etc.

Attention!
◆ Your card can be reissued if it is lost or damaged and cannot be

used. Please apply for reissuance at your local municipal office.

◆ If you no longer qualify for coverage or your percentage ofcoverage changes, please return your card to the municipal
office immediately.
◆ Unauthorized tampering of your health insurance card will
make it invalid.
w?
borro◆ You cannot use a copy of your health
Can I
insurance card.
◆ Never lend or allow others to borrow
your card. Such an act is punishable
by law.

New issuance of insurance cards will besuspended from December 2, 2024.

Preventing frailty starts with your diet!

4

Make sure to eat three meals a day, including breakfast.

Some people seem to assume that it is alright to eat a plain or simple diet inold age, but it is during old age that it is necessary to take proper nutrition.

5

Insurance Premiums
Those who must pay insurance premiums

All persons insured by the healthcare system for the elderly aged 75
and over must pay for their health insurance card. After turning 75
years old (65 for those with certain disabilities), even those who weredependents of employee insurance (medical insurance such as thatof health insurance associations and mutual aid associations) who
previously had not paid insurance premiums must also pay them.

How insurance premiums are determined

An insurance premium is determined by the elderly healthcare
association based on the total amount of the insured's per capita
rate paid equally by the insured and the amount of their income
paid according to their previous year's income.

taxable income

per capita
Insurance
Total income after
rate
premium
basic deduction
per person ＝ 56,400 yen ＋ (430,000 yen) ×
11.60%* Carryover deductions for miscellaneous losses do not apply.
* Survivor's pension and disability pension are not included.
●There are mitigation measures in accordance with the review of the
Health Care System for the Elderly.
Note 1) For those whose gross income after basic deduction does not exceed
580,000 yen, the income percentage rate for FY2024 will be 10.18%.
Note 2) Insurance premiums have a levy limit (maximum amount of
insurance premiums). The levy limit for those newly reaching theage of 75 in FY2020 is 800,000 yen.
Note 3) Those who are 75 years of age or older as of March 31, 2024, andthose who have been certified as disabled before March 31, 2025
(excluding those who no longer have an address within the area ofthe Medical Association for the Elderly Wide Area Union who
received the certification) will have the applicable levy limit raisedin stages. (730,000 yen in FY2024, and 800,000 yen in FY2025)
Note 4) The premium amount determined is valid from April 1 of the same
year to March 31 of the following year.
Note 5) Various deductions such as healthcare expense deductions andsocial insurance deductions, life insurance deductions, spouse andchild deductions are not applied like taxable income tax andmunicipal tax (resident tax).
Note 6) The criteria for determining the amount of your insurance premium(per capita rate, income rate) are set every two years.

When you can receive a reduced
insurance premium

1 Reduction measures for those with a low income
Reduced per capita rate
The per capita rate of your insurance premium (56,400 yen) is
reduced as follows according to the income level of the household(head of household and the insured).

Criteria for reducing the per capita rate burdenof insurance premiums
Total income of the household(head of household and the insured)Households that do not exceed the basic
deduction amount (430,000 yen)★
Basic deduction amount (430,000 yen) ★ ＋ 295,000 yen
×A household that does not exceed the numberof insured persons belonging to the household
Basic deduction amount (430,000 yen) ★ ＋ 545,000 yen
×A household that does not exceed the numberof insured persons belonging to the household

Reduced rate

70%

reduction50%

reduction

20%

reduction★ For households with two or more people receiving income, the following
amount is added to the basic deduction amount (430,000 yen).

(Number of people receiving income − 1) × 100,000 yen

Who qualifies as a person receiving income?
Certain salary earners (with a salaried income exceeding 550,000 yen)
Persons with income related to public pensions (whose income frompublic pensions is over 600,000 yen for those under 65 years old, orover 1.1 million yen for those over 65 years old)

* As of January 1, for public pensioners aged 65 and over, 150,000 yen is
deducted from their pension income in the reduction judgment.
* The head of the household is subject to the reduction judgment even if
they are not insured by the healthcare system for the elderly.
* The reduction judgment will be made based on the situation of thehousehold as of April 1st (or the qualification acquisition date if a new
qualification is acquired after April 2nd).
* Full-time employee salary deductions and special deductions for capitalgains are not applicable.

Preventing frailty starts with your diet!

6

Make staple foods, main dishes, and side dishes thebasis of meals

Basing meals on a staple food, main dish, and side dish, such as a Japanese
set meal, gets the necessary nutrients in a well-balanced manner.

7

Reduction measures for those who were

2 employee insurance dependents

If you were a dependent of an insured person's insurance(health insurance association, mutual aid association, etc.)
medical insurance (municipal national insurance or national
insurance association is not covered) on the Per capita Per income
amountimposedday before joining the Health Care System for 50% Notamountthe Elderly, the per capita amount will be
reduced by 50% (for 2 years after joining theMedical Care System for the Elderly), and no
per income amount will be imposed.
* If you fall under the per capita rate reduction measures for those with a
low income (see page 7), you can receive the per capita rate reduction.

How to pay your insurance premium
As a general rule, your insurance premium is deducted(special collection) from your pension (those with an annual
amount of 180,000 yen or more).
* If you are newly enrolled or change addresses in the middle of the year, yourpremium will be temporarily charged through general collection.

Deducted from your pension Special collection

If you cannot have the amount deducted from your pension,
you will have to pay the insurance premium by payment slip
sent from your local municipality or by account transfer(general collection).

By payment slip/account transfer general collection
Persons who are eligible● Those whose annual amount of long-term care insurance

deducted is less than 180,000 yen● Those whose total amount combined with their long-termcare insurance premium exceeds half of the pension amount● Those whose long-term care insurance premium is notdeducted from their pension● Those who are newly enrolled or who change addresses in

the middle of the year

How to pay your insurance premium
Payment slips must be paid by the due dateset by the municipality.
For those paying by direct transfer, amounts
will be deducted from the account registeredon the date set by the municipality.

Persons who are eligible

Direct transfer isThose with an annual pension of 180,000 yen or more (whenthe total amount combined with your long-term care insurance
premium does not exceed half of the annual amount)

You don't have to worry about forgetting
to pay or carrying cash with you, making it
simple, safe, and convenient.
To apply, fill out the “Direct Transfer
Request Form” at the financial institution
designated by your local municipality.

How to pay your insurance premiumYour insurance premium is deducted from your pension
when the pension is paid.

Provisional collection

Regular collection

April
August October December FebruaryJune(1st term) (2nd term) (3rd term) (4th term) (5th term) (6th term)
The provisionally calculated premium
will be deducted until the previous
y e a r ' s i n c o m e i s c o n fi r m e d ( i nprinciple, the same amount deductedin February will be deducted).

After your previous year's income isconfirmed, the amount obtained bysubtracting the provisional collection
amount from the annual insurance premium
will be deducted across three terms.

You can request to have the amount transferred directlyfrom your bank account. If you wish to do so, please
inform the local office in your municipality.
Preventing frailty starts with your diet!

8

Eating the following 10 foods introduced from ❶ to ❿ every day, offers a good nutritionalbalance. Aim for at least 7 types of food a day and use it to plan your menu.

convenient!
Definitely
worth a try!

About social insurance deductions
Those who have paid the premium for the healthcare
system for the elderly aged 75 and over qualify for thesocial insurance deduction for income tax and personal
residence tax. For more information, please contact the tax
office or the reception counter at your municipality.
1 FishRich in animal protein, calcium, and vitamins.

2 Fat

Appropriate amounts of fats and oils are necessary ingredientsfor cells, etc.

9Consequences of not paying yourinsurance premiumQ◆ If you fail to pay your insurance

premium on time, you may be
issued a health insurance cardwith a shor t expiration date(short-term health insurance card)
upon payment consultation.

short-termhinsuraenaclthe card*Scheduled to be abolished in
December 2024
◆ If you fail to pay your insurance premium for noA

I paid for my national
health insurance by directtransfer, so I shouldn't haveto set it up again, right?

They are different systems, so yournational health insurance accountinformation does not transfer overautomatically.

To set up direct transfer, you must apply for it again.

particular reason, you may be penalized.

Insurance premium reduction andexemption system
In Okinawa Prefecture, those who meet the following
conditions may be eligible for an insurance premium
reduction or exemption if they meet certain criteria.

★A dramatic reduction in income as a resultof damage to housing and other property
due to disasters such as earthquakes, fires,storms and floods, poor crops due to adrought, unemployment, suspended
business operations, etc.

A

The person enrolled is obliged to pay,
not the head of the household.

For national health insurance, the person who isobliged to pay the insurance premium is the head of
the household or the one insured by a company, but
for the healthcare system for the elderly aged 75 andover, the person enrolled is responsible for payment.

For inquiries◉About payment of insurance premiums
Please contact the municipality where you currently
live (see the list of municipalities on the back cover).

Feel free to
ask for advice!

* If you cannot pay your insurance premium due
to unavoidable circumstances, please contact
the office in charge of your municipality as soon
as possible.

10Q

I think my son (head ofhousehold)) is the one
paying...

◉About the contents of yourinsurance premium

Please contact your local elderly
healthcare association.

3

Meat

Main animal protein that is the building block of the body.

5 Vegetables

Rich in vitamins, minerals and dietary fiber.

4

Milk

Rich in protein and calcium.

6 Seaweeds

Low in energy and rich in minerals and dietary fiber.

11

When visiting the doctor
The out-of-pocket rate depends on your income category.
Income category is determined by factors such as yourresidential taxable income* (income after various deductions)for the year (April to July counts as the previous fiscal year).
● If you make an income revision, your income category may change from August 1st (base date).
● If you visit a large hospital without a letter of referral, you will be charged a separate fee.

● Patients may be able to receive combined medical treatment not covered by insurance(patient-requested medical treatment) if they request it.

Out-of-pocket
expense ratio

Income category
Category (comparable to current workforce)Ⅲ30%

Insured persons with resident taxable income of 6.9 million yen or
more and insured persons in the same household as the insured.

Category (comparable to current workforce)Ⅱ
Insured persons with resident taxable income of 3.8 million yen or
more and insured persons in the same household as the insured.

Category (comparable to current workforce)Ⅰ★ Those who have a copayment ratio of 30% whose total income during the previous

year is less than the following standard amount, should submit a "Standard income
amount application form" to the person in charge of the local municipality, and if
approved by the local association, the co-payment ratio will be 10% or 20%.
・There is one insured person in the same household and your income is less than
3.83 million yen
・There are multiple insured persons in the same household and your income is lessthan 5.2 million yen
・There is one insured person in the same household and your income is 3.83 million
yen or more, but there is a person between the ages of 70 and 75, and your total
income combined is less than 5.2 million yen.
★ For those who pay 20% copayment, measures are in place to limit the monthly
outpatient medical burden increase up to 3,000 yen compared to 10% (medical expenses
for hospitalization are not covered) from October 1, 2022 until September 30, 2025.

Determining your out-of-pocket ratio

Start

Which item from ❶ to ❸ applies to the taxable
income amount for residence tax, etc., of thesubject individual and the insured person in thesame household❶ 1,450,000 yen or more
❷ 280,000 yen or more and less than 1,450,000 yen❸ Less than 280,000 yen

❸

20
%

GeneralⅠ

10%

Persons other than those with income comparable to current workforce,
General Ⅱ, Category (low income) Ⅱ, Category (low income) Ⅰ.
Those born on or after January 2, 1945 whose residential taxable
income is 1.45 million yen or more and whose total old proviso
income combined with that of an insured person of the household
to which they belong is 2.1 million yen or less.

Is the total amountof your "pension
income and othertotal income"2 million yen? ”

NOHow many insured persons
are in the same household?

1 person2 or moreIs the income of
the insured person
3,830,000 yen
or more?

Is the total incomeof all insured
persons 5,200,000
yen or more?

NO
YES

NO

YES

Is the total amount of"gross income, etc., after
basic deduction" of theinsured person in the same
household including yourself
2.1 million yen or less?

NO

Is the total amountof "pension income
and other total
income" of all
insured persons
3.2 million yen or
more?

Category (low income)ⅡYESNOIs there anyone in thesame household aged
70 but younger than 75?

YES
NO

YES
NO

Category (low income)Ⅰ* If the head of the household is the insured as of December 31 of the previous year(including those to be insured after December 31 of the previous year) and there are people
under the age of 19 who have a total income (for salaried workers, 100,000 yen is deductedfrom salary income) of 380,000 yen or less in the same household, a certain amount(amount multiplied by 330,000 yen for those under 16 years old, 120,000 yen for those 16
years old or older and under 19 years old) will be deducted from the insured's income.

YES

2 or moreNO

Those whose household members are all exempt from residence
tax [Persons not from category (low income)Ⅰ ]Those whose household members are all exempt from residence tax, andwhose income after deducting necessary expenses and deductions fromeach income of the household is 0 yen (The amount deducted for pension
is calculated as 800,000 yen. 100,000 yen is deducted from salary income)12

1 person

General Ⅱ

Do you have any insured
person born after January 2,1945 in the same household
including yourself?

YES❷

How many insured persons
are in the same household?

Insured persons with resident taxable income of 1.45 million yen or
more and insured persons in the same household as the insured.
An insured person in the same household with a taxable income of
280,000 yen or more, who falls under ① or ② below.
① There is only one insured person in the same household, and the total
amount of pension income + other total income is 2 million yen or more
② There are 2 or more insured persons in the same household andthe total amount of pension income + other total income is 3.2
million yen or more❶Is the total income of theperson aged 70 but younger
than 75 and the insured person
5.2 million yen or more?

YES

10%

copayment

20%

copayment

30%

copayment

Note 1) An insured person refers to someone who is insured for healthcare for the elderly.
Note 2) Income refers to the amount written in the payment amount column of withholding
slips for public pensions, the sales column for business, the total income column forrent and other real estate, and the sales price column for the transfer of shares.

13

When you havehigh medical expenses
If out-of-pocket medical expenses for one month (fromthe 1st to the end of the month) exceed the specified limit,with an approved application, the excess amount will be
paid as a high-cost medical care expense.
◎ If you turn 75 in the middle of the month and switch to the healthcare system
for the elderly aged 75 and over, the maximum amount of both your previous
medical insurance and the healthcare system for the elderly will be halved.

Procedure flow

1
2
3

If the medical expenses for one month (from the 1st to theend of the month) become high, the portion exceeding acer tain amount (out-of-pocket limit) will be paid as ahigh-cost medical care expense.
On your first time, we will send you a recommendation notice(postcard) so that you can complete the procedure at theoffice in charge of your municipality.
Once you complete the procedure, you will be automatically paid
(via bank transfer) every time you incur a high-cost medical expense.
● The total is calculated regardless of hospital, clinic, or clinicaldepartment.
● Meals during hospitalization and differential bed charges that are
not covered by insurance are not covered by such payments.

Important points
Before you are hospitalized or go to an expensive outpatient clinic,
obtain one of the following certificates at the municipal office andpresent it with your health insurance card at the medical institution.
(There is no need to apply for issuance of certificate if checking
qualifications online)◆ For people in category (low income)Ⅰand Ⅱ:

Certificate of limit application / standard cost reduction◆ For people in category (comparable to current workforce)ⅠandⅡ:

14

Out-of-pocket limit amount (monthly)
Income category(refer to P12)

Outpatient(calculated for each individual)

Outpatient+
hospitalization(by household)Category

252,600 yen + [(total medical expenses – 842,000 yen) x 1%](comparable to current workforce)(140,100 yen) *1
Ⅲ
Category
Active167,400 yen + [(total medical expenses – 558,000 yen) x 1%]
income (comparable to current workforce)(93,000 yen) *1
Ⅱearners
Category(comparable to current workforce)Ⅰ80,100 yen + [(total medical expenses – 267,000 yen) x 1%](44,400 yen) *1

GeneralⅡ

18,000 yen *2 or[6,000 yen + (medical expenses – 30,000 yen) x 10%],whichever is lower is applied *3

GeneralⅠ

18,000 yen *2

Category (low income)Ⅱ

8,000 yen *2

24,600 yen

Category (low income)Ⅰ

8,000 yen *2

15,000 yen

57,600 yen(44,400 yen) *4*1 The maximum amount from the 4th month when the same household has 3 or moremonths to pay high-cost medical expenses within 12 months.
*2 The annual limit (August to July) is 144,000 yen.
*3 If the medical cost is less than 30,000 yen, it will be calculated as 30,000 yen. If thetotal copayment for outpatient care for one month exceeds 6,000 yen, the increase in
copayment will be limited to 3,000 yen. If applicable, it will be reimbursed at a later
date as High-Cost Medical Expense. The transitional measure covers medical
treatment from October 2022 up to September 2025.
*4 The maximum amount from the 4th month when the same household has 3 or moremonths of high-cost medical expenses that exceed the outpatient + hospitalization(by household) limit within 12 months.

When receiving high-cost treatment for a prolonged period of time
If a specific illness designated by the Minister of Health, Labor and Welfare
requires continuous and expensive treatment for a prolonged period of time,
apply to receive a certificate of medical treatment for specific diseases atyour local municipal office and present it to the medical institution. By
presenting the certificate of medical treatment for specific diseases, themonthly* out-of-pocket cost is up to 10,000 yen for each medical institution(inpatient/outpatient) or for each pharmacy.

[Specific diseases designated by the Minister of Health, Labor and Welfare]

Certificate of limit application◆ Those in category (comparable to current workforce) Ⅲ, General
Ⅰand Ⅱ will be able to pay up to the copayment limit or ceilingby presenting the health insurance card.

① Some congenital coagulation disorders caused by a blood factor deficiency② Chronic renal failure with artificial kidney③ HIV infection caused by administration of blood coagulation factor preparation

By using the My Number Health Insurance Card, you will be exempted frompaying more than the maximum amount under the High-Cost Medical Care
System. There is no need to apply for a Limit Application Certificate inadvance, so please make use of the My Number Health Insurance Card.

Items needed ● Individual number card or notification card and identity
verification documents, etc.
to apply

7

Potatoes

8

Eggs

Rich in carbohydrates and dietary fiber, which are a source ofenergy. It is also good for vitamin and mineral supplementation.
It is a main source of high-quality protein and can becooked or prepared in a variety of ways.

● Health insurance card ● Certificate of applicable disease● A seal is required when application is done by a family member, etc.

*Monthly refers to the period from the 1st to the end of the month.

9 Soybeans

Rich in amino acids, which are the building blocks ofprotein. And calcium as well.

10 Fruits

Full of vitamins, minerals and dietary fiber.

15

High-cost medical care /long-term care combined system
The high-cost medical care/long-term care combined
system provides payments when the annual limit isexceeded by adding up the out-of-pocket costs of boththe healthcare system for the elderly and long-term careinsurance.

Maximum amount when added up (annual amount/
per household)(Applicable every year from August to July of the following year.)

Income category (refer to P12)
Activeincomeearners

Limit

Category (comparable to current workforce) Ⅲ 2,120,000 yen
Category (comparable to current workforce) Ⅱ 1,410,000 yen
Category (comparable to current workforce) Ⅰ

670,000 yen

GeneralⅠ・Ⅱ

560,000 yen

Category (low income)Ⅱ

310,000 yen

Category (low income)Ⅰ

190,000 yen● Out-of-pocket payments do not include meals, extra beds, andother non-insurance payments. In addition, if a large amount of
medical expenses is paid, the amount will be deducted.

Caregiving
Medical care

Preventing frailty starts with your diet!

16

Use commercially available products, cut vegetables, etc.,
when wanting to increase the “number of foods” to eat.

Meal expenses, etc.
when hospitalized

You are responsible for paying the standard cost of meals(per meal) out of pocket.
Per meal
expenseIncome category (refer to P12)
Active income earners

460 yen*1

GeneralⅠ・Ⅱ

460 yen*1

Category

Days hospitalized in the last 12 months is within 90(low income)Ⅱ Days hospitalized in the last 12 months is 91 or more*2

Category (low income)Ⅰ

210 yen
160 yen
100 yen*1 Some may be 260 yen*2 The number of days of hospitalization during the period in which you arepart of the limit application/standard cost reduction certification category(low income) Ⅱ is included in the calculation. If your hospitalization term isconsidered long-term, you will need to present documents that show thelength of hospitalization and apply at your municipal office.

Meal and living expenses when
admitted to a long-term care bed

You are responsible for paying standard meal and living
expenses out of pocket.
Income category

Per meal
expenseLiving expenses
per day

Active income earners

460 yen*3

370 yenGeneralⅠ・Ⅱ

460 yen*3

370 yenCategory (low income)Ⅱ

210 yen370 yenCategory (low income)Ⅰ

130 yen370 yen(refer to P12)

Old-age welfare pension recipient 100 yen
0 yen*3 May be 420 yen at some medical institutions (according to facility standards, etc.)● Costs may be reduced depending on income and illness.

Those in category (low income) Ⅰ and Ⅱ are required topresent a certificate of limit application/standard cost
reduction in advance at the medical institution reception desk
(There is no need to apply for issuance of certificate if checking
qualifications online). If necessary, please apply in advance atyour municipal office.
Using commercially available products (canned, retort, frozen foods), cut
vegetables, and frozen vegetables reduces the burden of cooking andmakes it easy to increase the number of items.

17You can also receive
benefits in these cases
When using a home-visit nursing
station, etc.
If you use a home-visit nursing station according to yourdoctor's instructions, presenting your health insurance
card will count as if you had a medical examination at a
medical institution.
* No municipal procedures are required.

When in a traffic accident
If you become ill or injured by the actions of a third party
due to a traffic accident or an accident at a facility, etc.,
you can receive medical treatment under the healthcare
system for the elderly aged 75 and over by notification. In
such a case, the healthcare
system for the elderly aged 75
and over will reimburse themedical expenses and latercharge the perpetrators for the
expenses.

Make sure to notify the office incharge of your municipality.

Combined medical treatment notcovered by insurance
When receiving advanced medical care, the parts that arecommon to general medical care are covered by insurance,
and treatment may be received using the insurance card.

When an insured dies
If the insured dies, the person who
arranges the funeral can apply toreceive a funeral expense paymentof 20,000 yen.

Preventing frailty starts with your diet!

18

Get your protein from the main dishBring your health insurance card, seal,
and accident certificate (this can be done
at a later date. Please report it to thepolice and get it issued) and go to theoffice in charge of your municipality tocomplete the procedure for “Report of
injury or illness caused by a third party”.

Proceed with settlements carefully
If you receive medical treatment expense paymentsfrom the perpetrator or complete a settlement, you may
not be able to receive medical treatment under thehealthcare system for the elderly aged 75 and over.
Please be sure to consult with the office in charge ofyour municipality before making a settlement.
A lack of protein can lead to frailty. Protein is found in large amounts in main
dishes like meat, fish, eggs, and soybean products. Let's make an effort toeat them. The recommended amount of protein is 20-30g per meal.

19

Reimbursable costs
Medical expenses
In the following cases, you will first need to pay the fullamount out of pocket, but if you apply for reimbursement
at your municipal office and the local association approves,
you will be reimbursed for the amount excluding theout-of-pocket portion you are responsible for.
◆ When forced to receive medical treatment without having
the insurance card or My Number Card
due to an accident or sudden illness, orwhen receiving medical treatment due
to sudden illness while traveling overseas.
* Not applicable if your purpose of travelingabroad is to receive treatment.
◆ When you incur costs for transfused

blood or prosthetics that the doctor
deems necessary for treatment such as
corsets

Transportation costs
If the local association deems thatcosts were incurred for an urgent andunavoidable transfer of a seriously ill
person at the direction of a doctor,
such costs will be reimbursed.
* Voluntary transfer due to a personal reason is
not acknowledged.

Please contact us in advance so that we
can tell you what documents you needfor your application.
Preventing frailty starts with your diet!

20

Use commercially available products, when wanting toincrease protein intake!

Massage and acupuncture
treatment
In order to receive treatment using health insurance, a writtenconsent or medical certificate issued by a doctor in advance isrequired. To continue receiving treatment, it is necessary to
see your doctor regularly and get a consent again.

Massages
Cases that can be covered by health insurance
Cases requiring medical massages due to muscle
paralysis or joint contracture

Acupuncture
Cases that can be covered by health insurance
Diseases that are accompanied by chronic pain such asneuralgia, rheumatism, cervicobrachial syndrome, frozen
shoulder, lower back pain, and sequelae of
cervical spinal cord contusion

Attention
Cases that cannot be covered by health insurance● Those for diseases which you are being treated for at aninsurance medical institution (hospital, clinic, etc.)● Those which are simply for recovery from fatigue and for comfort● Those which are for disease prevention◆ Home-visit fees are covered by insurance only if you

cannot go out due to injury or illness. This does not
apply for reasons such as when it is troublesome to go to
the practitioner, you have no means of transportation, or itis difficult for you to walk.
◆ Please keep your receipt in a safe place as you will need it
when you receive a medical expense deduction. In
addition, your partial collection status may be checked.
Your cooperation is appreciated.
When thinking about the daily menu and wanting to increase the amount ofprotein in the main dish, try using commercially available products that areeasy to store and keep on hand, such as canned, retort, frozen foods, etc.,
processed foods made with soybeans, meat, and fish, dairy products, etc.

21

clinic/
Judo therapy（orthopedic
osteopathic clinic ）treatment
Judo therapy (osteopathic/orthopedic/bone-setting)treatment is for addressing traumatic injuries (thosecaused by slips, falls, or hits).

When health insurance
can be used
◆ When the cause of injury is clearly due to a bone, muscle,or joint injury.

◆ When you receive treatment for a fracture, dislocation,bruise or sprain (including so-called muscle strain)
diagnosed by a doctor or a judo therapist. (For fracturesand dislocations, the consent of a doctor is required inadvance, except in cases requiring first aid treatment.)

Attention
Examples of when health insurance cannot be used
● Treatment for mere stiff shoulders and muscle fatigue(caused by fatigue and chronic factors).
● Long-term treatment that does not improve

chronic diseases such as sequelae of brain
diseases and symptoms.

To optimize medical expenses
The medical expenses incurred for acupuncture,
massage, and judo therapy are paid from yourinsurance premiums, etc.
Please do the following to ensure proper medical
expenses.
● Explain exactly what caused the injury (when,

where, what you did, what symptoms you have).

● Carefully check the contents ofthe medical treatment fee
payment application (cause of
injury, name of injury, numberof days, amount of money), andsign.

● Be sure to receive and keep thereceipt, and check the amountand number of days in your
medical expense notification.

check!

● If a procedure is long-term, it

may be due to medical factors,
so consult your doctor.

● When receiving treatment for the same

injury at an insurance medical institution(hospital, clinic, etc.).

◆ Discounts

on partial coverage are not permitted, andreceipts are assumed to be issued free of charge. Be sure
to receive and keep the receipt, and check the amount inyour medical expense notification.

You may be asked about your treatment
date and treatment details.
If treated by a Judo therapist, please note theinjured body part, treatment details, record of
the treatment date, receipt, etc., so that you cancooperate in answering any questions asked.

Preventing frailty starts with your diet!

22

Measures to take for blood pressure in old age(cutting down on salt)

Too much salt can lead to various diseases. Try to reduce the amount of salt
intake by changing the way you eat (see Points ❶ to ❹ for reducing salt).

23

About the insurance business(longevity health checkups)

Use generic medicine!

Local elderly healthcare associations conduct health checkups
for the early detection and treatment of lifestyle-relateddiseases. Even if you don't have any subjective symptoms,
you should receive an annual longevity checkup. You canchoose between a mass screening or an individual screening.

What is generic medicine?

1 Those eligible

Persons insured by the healthcare system for the elderly aged
75 and over (people aged 75 and over and those aged 65 andunder 75 who have certain disabilities)* Those who have been hospitalized for more than 6 months or who
have been admitted to a facility are not eligible for a checkup.

It is medicine that has been recognized to have the same
effect as the original version of certain medicine.

Medicine that is easier on both medical expenses
and household budgets
Since they are made based on original medicine whose
patent period has expired, their prices are lower, reducing
the burden of medicine expenses.

2 Date and place of checkups

Of course, their safety is guaranteed

3 Checkup expenses

Please consult your doctor or pharmacist and receive
sufficient explanation before use.

The date and place of group checkups differ depending on
the municipality, so please contact the office in charge ofcheckups in your municipality for details. You can also receive
an individual checkup at a medical institution (please ask yourmunicipality or local association for the medical institution).
Examination is done free of charge once a year. However,from the second time onwards, self-payment of full amount
may be required.

4 Application/consultation tickets

A medical consultation ticket and a health insurance card are
required to undergo a checkup. For information on how toapply and receive a consultation ticket, please contact theoffice in charge of municipal health examinations in your area.

Health checkup items● Body measurement (height, weight,

BMI, abdominal circumference)● Medical examination by a doctor● Blood pressure measurement● Blood test (including uric acid and serum creatinine)● Urinalysis (urine sugar, urine protein, urine occult blood)● Anemia test, electrocardiogram test, fundus test

(Detailed items at the discretion of the doctor)

Preventing frailty starts with your diet!

24

Cheaper medicine with the same ingredients andefficacy as the original kind

Key points for
reducing salt intake ❶Use fresh ingredients

Salt is added to processed products to increase
their shelf life. By using fresh ingredients, you
can enjoy the flavor of ingredients as well as
cutting down on salt.

They are safe because they are made from the ingredients of
the original medicine that has been used for a long time. In
addition, their quality and safety are thoroughly inspected.

When using generic medicine
About theorgan donation column

There is a column on the back of health insurance cards inwhich you can declare your willingness to donate yourorgans. Both your willingness and your family's willingness
is important when it comes to organ donation. Please takethe opportunity to discuss this with your family and fill out
the column according to your views.
* If you do not wish to express your intention, you may choose to leave it blank.

For questions and inquiries regarding organ donation
Japan Organ Transplant Network
Toll-free

Website0120-78-1069

https://www.jotnw.or.jp/

Preventing frailty starts with your diet!

Key points for
reducing salt intake ❷Reduce the amount broth in soups

Soup contains a lot of salt.
Reducing the broth will
reduce the salt content.

25

The Healthcare System
for the Elderly Aged 75 orOlder - Supported by Everyone
Under the current system, as a general rule, all insureds pay about
10% of medical expenses as insurance premiums, and theremaining 90% is funded by financial resources from public
expenses of the national, prefectural, and municipal governments
and insurance premiums of the working generation.
Measures are being taken to reduce the per capita rate of
insurance premiums by 70%, 50%, and 20% for low-income
earners, and to reduce the per capita rate by 50% for dependents.
The future of the healthcare
About%system for the elderly aged
Insurance premiums
75 and over is currently
under discussion by the About%government.
Public expenses
About
%

10

50

National
4/12
Prefectural 1/12
Municipal 1/12

40

Support fund forthe elderly aged 75
and overInsurance premiums of
the working generation

fraud
Beware of refund
There have been many reported cases of financial fraud
Be careful, as cases of refund fraud have beenreported all over the country.
Refund fraud refers to fraudulent acts in which
someone pretends to be an employee of apublic organization such as a government office or local
association, calls or visits a victim to try to skillfully convince
them that they have been overpaying for their taxes andpensions or that they can receive a refund on medical expenses,
and deceive the victim into disclosing their bank accountinformation or instruct them to transfer money via ATM at abank, etc.
To avoid being deceived by such tricks, avoid judging the situation
on you own, and rather, consult with your family, or contact yourlocal municipality, police, or elderly healthcare association.
Preventing frailty starts with your diet!

26

Key points for
reducing salt intake ❸Season just before it is done

Seasoning food just before it is done,
can give the full flavor even with asmall amount of seasoning.

Be sure to report thefollowing situations● Your individual number (My Number) is required to make a report.

Please bring your individual number card or notification card andany identity verification documents.

Situation

Required items

When

You are between
the ages of 65 and75 with a certain
disability and wish
to enroll

Health Insurance card,
national pension certificate,disability certificate, or any
other document that shows
the degree of disability, seal

When trying
to get adisability
certification

You can no longer
receive welfare

Suspension of publicwelfare notice, seal

You moved fromanother prefecture

Health Insurance card, cost
category certificate, seal

You are an insured with acertain disability
between the ages of 65
Health Insurance card, seal
and 75 and intend towithdraw fromhealthcare for the elderly
You start to receive
welfareHealth Insurance card,
start of welfare notice, seal

You are moving toanother prefecture

Health Insurance card, seal

Within14 days
When youwant towithdraw
yourdisability
certification

You have passed away Health Insurance card of the Within
deceased, seal of the reporter 14 days
Your address has changed
Health Insurance card, seal
within the prefectureYour name has changed Health Insurance card, sealYour health insurance
card is lost or damaged
and unusable

Health Insurance card, seal

Immediately* Items other than the above may also be needed. Please contact the officein charge of your municipality.
* If signing by hand, a seal may not be needed.

Preventing frailty starts with your diet!

Key points for
reducing salt intake ❹Eat enough plant foods

Vegetables, potatoes, soybean products, andfruits contain a component called potassium,
which helps eliminate excess salt (sodium).

27

List of municipalities
Municipality

Contact ☎Municipality

Contact ☎Naha-shi

098-917-0410

Kadena-cho

098-956-1111 (Main)

Ginowan-shi 098-893-4411(Main)

Chatan-cho 098-936-1234 (Main)

Ishigaki-shi 0980-87-9040
Urasoe-shi

098-876-1717

Kitanakagusuku098-935-2267
son
Nakagusuku098-895-2171
sonNago-shi

0980-53-1212(Main)

Nishihara-cho 098-911-9163

Itoman-shi

098-840-8127

Yonabaru-cho 098-945-2204

Okinawa-shi 098-939-1212(Main)

Haebaru-cho 098-889-1798

Tomigusuku098-850-0160
shi

Tokashiki-son 098-987-2322

098-973-3177

Zamami-son 098-896-4045

Uruma-shi

Miyakojima0980-72-3751(Main)shi

Aguni-son

098-988-2017

098-917-5327

Tonaki-son 098-989-2317

Kunigami-son 0980-41-2765

Minamidaito- 09802-2-2036
son0980-44-3003

Kitadaito-son 09802-3-4055

Higashi-son 0980-43-2202

Iheya-son 0980-46-2142

Nakijin-son 0980-56-4189

Izena-sonMotobu-cho 0980-47-2701

Kumejima-cho 098-985-7124

Nanjo-shi

Ogimi-son

0980-45-2819

098-966-1217

Yaese-cho098-998-2210

Ginoza-son 098-968-3253

Tarama-son

0980-79-2623

Onna-sonKin-cho098-968-2116

Taketomi-cho 0980-82-6191 (Main)

Ie-son0980-49-2002

Yonaguni-cho 0980-87-3575

Yomitan-son 098-982-9213
This pamphlet was published in March, 2024. Its contents are subject to change inthe future.

KITC0970−1757992