## [2] Health and Medical Services

## (1) Health Care Insurance

## Health Care Insurance System

Outline of Health Care Insurance System

(As of June 2012)

System	Insurer (as of the end of March 2011)	Number of subscribers (March 2011)	Insurance benefits	Financial resources
Medical care benefits	Cash benefits	Premium rate	State subsidy
Co-payment	High-cost medical care benefit, Unitary high-cost medical/long-term care system	Hospital meal expenses	Hospital living expenses
Health Insurance	General employees	JHIA-managed Health Insurance	Japan Health Insurance Association	34,845	(High-cost medical care benefit system)	(Co-payment for meal expenses)	(Co-payment for living expenses)	·Sickness and injury allowance·Lump-sum birth allowance, etc.	10.00% (national average)	16.4% of benefit expenses (16.4% for Support coverage for the late-stage elderly)
15,265	·Maximum co-payment (Persons younger than 70) (High income) ¥150,000 + (medical fee - ¥500,000) × 1% (General) ¥80,100 + (medical fee - ¥267,000) × 1% (Low income) ¥35,400 (Persons 70 or older but younger than 75) (More than a certain level of income) ¥80,100 + (medical fee - ¥267,000) × 1%, outpatient (per person) ¥44,400 (General (1)) ¥62,100, outpatient (per person) ¥24,600 (Low income) ¥24,600, outpatient (per person) ¥8,000 (Extremely low income) ¥15,000, outpatient (per person) ¥8,000 ·Per-household standard amount If more than one person younger than 70 pay ¥21,000 or more in a single month, per-household standard amount is added to the benefits paid ·Reduced payment for multiple high-cost medical care For persons who have received high-cost care three times within a twelve-month period, the maximum co-payment of the fourth time and up will be reduced to: (Persons younger than 70) (High income) ¥83,400 (General) ¥44,400 (Low income) ¥24,600 (Persons aged 70 or older with general or more than a certain level of income (1)) ¥44,400	(General) ¥24,600, outpatient (per person) ¥8,000 (Extremely low income) ¥150,000, outpatient (per person) ¥8,000 ·Per-household standard amount If more than one person younger than 70 pay ¥21,000 or more in a single month, per-household standard amount is added to the benefits paid ·Reduced payment for multiple high-cost medical care For persons who have received high-cost care three times within a twelve-month period, the maximum co-payment of the fourth time and up will be reduced to: (Persons younger than 70) (High income) ¥83,400 (General) ¥44,400 (Low income) ¥24,600 (Persons aged

(Note) 1. Insured persons of the late-stage medical care system for the elderly includes those aged 75 or older or 65-75 certified as having a specific disability by a wide area union.

2. Persons with a certain amount of income include those with a taxable income of ¥1.45 million (monthly income of ¥280,000) or more, those in households of two or more elderly with a taxable income of ¥5.20 million, and those of a single elderly household with a taxable income of ¥3.83 million. Persons with a higher income are considered to be those with a monthly income of ¥530,000 or more (annual income of more than ¥6 million for NHI). Persons with a low income are considered to be those who belong to a municipal-tax exempt household. Persons with an extremely low income are considered to be those with a pension income of ¥800,000 or less, etc.

3. Fixed-rate national subsidy for National Health Insurance shall be at the same level as that for the Japan Health Insurance Association-managed Health Insurance for those exempt from application of Health Insurance and that newly subscribed to the National Health Insurance on and after September 1, 1997 and their families.

4. The numbers of Health Insurance subscribers are preliminary figures. The sums in the breakdown may not equal the total due to rounding.

5. National subsidy rate for the Japan Health Insurance Association (general insured persons and insured persons under item 2, Article 3 of the National Health Insurance Act) is 16.4% for the period between July 2010 and FY 2012.

6. The premium rate of Seamen's Insurance is the rate after the deduction resulting from the measure to reduce the burden of insurance premiums for insured persons (0.35%).