Children’s Medical Expense Subsidy

This system reduces expenses borne at the payment counter of medical institutions when your child receives medical care. If you present your child’s health insurance card and Children’s Medical Expenses Recipient Card at medical institutions in Hiroshima Prefecture, your child can receive medical care for a limited copayment amount.

Beginning January 2025, the age of those able to receive subsidies for doctor visits will be raised from up to year six elementary school students to up to year three junior high school students. Those who meet this criterion will be issued a new Children’s Medical Expenses Recipient Card in late December 2024. Junior high school students who do not currently have a card must apply for one.

Note: the income limit amount, threshold income amounts to determine partial copayment amount, and copayment amounts have not changed.

Eligibility

Parents/guardians (principal earners) whose children fall under all of the conditions below are eligible:

1. Child’s age range is from less than 12 months to year three in junior high school student. Note: for doctor’s visits, children up to year six in elementary school are eligible.
2. Parent/guardian’s income from the previous year (for children born January 1 to June 1, income from two years before) is less than the income limit (there are deductions that also apply to income).
3. Enrolled in health insurance.
4. Are not receiving public welfare, Medical Expense Subsidies for Severely Mentally and Physically Disabled Persons, or Medical Expense Subsidies for Single-Parent Households.

Subsidy Coverage

The City of Hiroshima will subsidize the amount after partial copayment is deducted from the cost to be borne by the patient (20% of the total medical expenses for children not yet in school, 30% of the total medical expenses for elementary school students and older) of the total medical expenses for healthcare services provided by health insurance (excluding fees for meals during hospitalization) when children use their health insurance card to see a doctor. Note that there are items that are not covered by the Children’s Medical Expense Subsidy system (items for which patients must bear the full cost), as the items are not covered by insurance.

Items not covered by the subsidy system:

• Treatments, tests, medicines not covered by insurance
• Health check-ups
• Vaccinations
• Cosmetic surgery
• Orthodontics
• Additional charges for rooms
• Additional amount for first visit fee when visiting a larger hospital without a letter of introduction
• Services needed for day-to-day living, such as diaper costs, etc.

Subsidy Details

When presenting your health insurance card and Children’s Medical Expenses Recipient Card issued by the City of Hiroshima at the payment counter of medical institutions in Hiroshima Prefecture, you will have to pay partial copayments up to the amount limit (see below). If the amount equivalent to the full copayment is less than that cost of the partial copayment, you will have to pay the full copayment.

The partial copayment amount limit differs depending on the age of the child and their parent/guardian’s income. If the parent/guardian’s income exceeds the income limit, they will not be eligible for this subsidy.

If you are using your My Number Card as your insurance card, you still must present your Medical Expenses Recipient Card at the payment counter.

Please note that in regard to healthcare received outside of the prefecture of before applying for your Medical Expenses Recipient Card, you will have to pay the full copayment amount at the payment counter of the medical institution. In these cases, your money will be reimbursed at a later date.

Number of Dependents, etc.	Threshold Income Amount to Determine Partial Copayment (Yen)	Income Limit Amount (Yen)
0	2,952,000	5,320,000
1	3,332,000	5,700,000
2	3,712,000	6,080,000
3	4,092,000	6,460,000
4 or more	An additional 380,000 per dependent	An additional 380,000 per dependent
Spouse in the same household (aged 70 or older) OR elderly dependent	An additional 60,000 per dependent	An additional 60,000 per dependent

　

Partial copayment amount at the payment counter of the medical institution

	Parent/guardian’s income is below the threshold income amount to determine partial copayment	Parent/guardian’s income is above the threshold income amount to determine partial copayment, but below the income limit	Parent/guardian’s income is above the income limit
Doctor Visits	Children up to year six in elementary school First visit fee: up to 500 yen per day (up to four days per month) Note: to be expanded to include children up to year three in junior high school beginning January 2025	Children not yet attending school First visit fee: up to 1,000 yen per day (up to two days per month) Children from year one to year six in elementary school When visiting (regardless of first visit or subsequent visit): up to 1,500 yen per day (up to two days per month) Note: to be expanded to include children up to year three in junior high school beginning January 2025 Third child or younger First visit fee: up to 500 yen per day (up to four days per month)	Not eligible for the subsidy
Hospitalization	Children up to year three in junior high school No partial copayment (excluding fees not covered by insurance, such as meals or room charges)	Children up to year three in junior high school No partial copayment (excluding fees not covered by insurance, such as meals or room charges)	Not eligible for the subsidy
Pharmacies (prescriptions filled outside of the hospital)	Children up to year six in elementary school No partial copayment Note: to be expanded to include children up to year three in junior high school beginning January 2025	Children up to year six in elementary school No partial copayment Note: to be expanded to include children up to year three in junior high school beginning January 2025	Not eligible for the subsidy
Home medical care	Children up to year six in elementary school No partial copayment Note: to be expanded to include children up to year three in junior high school beginning January 2025	Children up to year six in elementary school No partial copayment Note: to be expanded to include children up to year three in junior high school beginning January 2025	Not eligible for the subsidy
Judo therapy, acupuncture, moxibustion, massage	Children up to year six in elementary school No partial copayment Note: to be expanded to include children up to year three in junior high school beginning January 2025	Children up to year six in elementary school No partial copayment Note: to be expanded to include children up to year three in junior high school beginning January 2025	Not eligible for the subsidy
Orthosis for medical treatment	Children up to year six in elementary school No partial copayment Note: to be expanded to include children up to year three in junior high school beginning January 2025	Children up to year six in elementary school No partial copayment Note: to be expanded to include children up to year three in junior high school beginning January 2025	Not eligible for the subsidy

Notes

1. “Number of dependents, etc.” refers to the total number of the following:
   • Spouse and dependents sharing the same livelihood as stipulated in the Income Tax Act based on the parent/guardian’s income of the year used as the standard.
   • Children who are not dependents and whose parent/guardian sustained a living as of December 31 of the year used as the standard.
2. Partial copayments shall be paid for each medical institution, limited to the amount and days listed in the table above.
3. For medical institutions that perform both dental care and non-dental care: the dental care and non-dental care shall be considered to be provided at separate medical institutions.
4. The partial copayment may differ between medical institutions with in-house prescriptions and those with external prescriptions.
5. “Third child or younger” refers to the third child (with the first child being your eldest child in year three of junior high school or younger) and any subsequent children. If you have three or more children who are in year three of junior high school or younger, and, of those children, some who have different Resident Records due to being dependents who live separately from you: you will need to submit a separate application.

Income Amount

Parent/guardian’s income=Income amount* - 80,000 yen (equivalent of social insurance payments) – any deductions

• *If the income comes from employment income, then the income after employment income deductions is made shall be used.
• *For employment income and income from public pension, the amount minus 100,000 yen (if less than 100,000 yen, then that amount).

Deduction	Deduction Amount (Yen)
Exemption for the Disabled	270,000
Exemption for the Severely Disabled	400,000
Exemption for Widows/Working Students	270,000
Exemption for Single Parents	350,000
Exemption for Casualty Losses/Medical Expenses/Small Enterprise Mutual Aid Premiums	Specified deduction amount

• Note 1: Medical fee deductions include those declared under the Self-Medication Tax System (special provision for medical expense deductions).
• Note 2: Regarding income amount, special deductions will be made for long- and short-term transfer income.

How to Apply for the Subsidy

Parents/guardians should submit a Children’s Medical Expense Qualification Application and health insurance card (with their child’s name) to the Welfare Division of their local ward or branch office to apply.

Note: If the parent/guardian or their spouse has moved into Hiroshima City or if your Resident Record is outside of Hiroshima City (e.g., job transfer without family (tanshin-funin), etc.), you will need to provide documentation that confirms your Individual Number, such as your My Number Card (Individual Number Card) or your Resident Record with your Individual Number on it and proof of ID (driver’s license, passport, etc.).

Period of Validity for the Children’s Medical Expenses Recipient Card

Recipient cards can only be used during the period of validity displayed on the card.

Age	Period of Validity
Less than 12 months	From the first day they are born until the end of their first birth month
1-14	From the first day of the month after their birth month to the end of their next birth month
15	From the first day of the month after their birth month in which they turn 15 until the first March 31 that occurs after that birthday

Notes

1. For those born on the first of the month, “From the first day of the month after their birth month” becomes “from the first day of their birth month” and “to the end of their next birth month” becomes “until the end of the month before their birth month.”
2. The recipient card will be automatically updated every year on the first day of the month after your child’s birth month (first day of their birth month for those born on the first). Recipient cards will be sent to those who continue to be eligible based on a review of your income in the new fiscal year. You do not need to apply to renew your card as a rule. However, should we be unable to confirm the necessary items, we will send you an Application for Renewal: please fill it out and submit it.
3. When children six years of age become elementary schoolers, their recipient number, etc., will change. As such, Recipient Cards will be sent out for use until March 31. For those who continue to remain eligible from April 1 onward, their Recipient Card to be used beginning April 1 will be sent in late March (you do not need to apply to renew your card as a rule; please note that the partial copayment amount may change).
4. For year six elementary school students: when they become first year junior high school students, they will only be eligible for medical fee subsidies for hospitalization. As such, Recipient Cards will be sent out for use until March 31. For those who continue to remain eligible for hospitalization subsidies from April 1 onward, their Recipient Card to be used beginning April 1 will be sent in late March (you do not need to apply to renew your card as a rule).

About Reimbursements

You are entitled to a reimbursement at a later date in the following cases:

• You have paid the full copayment amount at the payment counter of the medical institution for healthcare received outside of the prefecture of before applying for your Medical Expenses Recipient Card.
• You have paid the full (100%) medical expense amount at the payment counter of the medical institution for healthcare services provided by health insurance without an insurance card or for the manufacture of orthosis, etc., for medical treatment.

If you require a reimbursement, you can request one at the Welfare Division of your local ward or branch office. For more information, please inquire at your local Welfare Division. In addition, you may be able to receive a reimbursement if you present your health insurance card and Medical Expenses Recipient Card at the medical institution in Hiroshima Prefecture at a later date. Please inquire at the medical institution for details.

What you need to apply for a reimbursement

1. Receipt for medical care received at the medical institution, etc.
   As a rule, you must present the original receipt (not a copy). However, for those who or healthcare services provided by health insurance: if it is necessary for you to submit the original receipt to your health insurance provider when applying for medical expenses, you may submit a copy to us instead.
2. Documentation with bank account information in the name of the parent/guardian (bank book, etc.)
   Bank account must be in the name of the parent/guardian listed on the Children’s Medical Expenses Recipient Card.
3. Notice of Medical Fee Payment Amount from your health insurance provider (for those that fall under the categories listed in Important Note below only)
   However, for those enrolled in Hiroshima City National Insurance: while you will need to apply for medical expenses, etc., you do not need to submit the Notice of Medical Fee Payment Amount when applying for a reimbursement from the Children’s Medical Expense Subsidy.
   1. Certificate of Diagnosis or Healthcare Directive from a doctor
      Only necessary for those who had orthosis for medical treatment made.
4. Children’s Medical Expenses Recipient Card
5. Health insurance card

Important Note

The following is information for those who

• are eligible for High-Cost Medical Expense payments
• have received medical care without your insurance card
• have had orthosis for medical treatment made

If any of these apply to you, you must first apply for medical expenses, etc., from your insurance provider. Once you have received your Notice of Medical Fee Payment Amount, then you should apply for a reimbursement from the Children’s Medical Expense Subsidy (those enrolled in Hiroshima City National Insurance must also apply for medical expenses, etc.).

Provision

Hiroshima City Children’s Medical Expense Subsidy Ordinance

Related Information (Japanese)

• こども医療費補助制度に関するQ&A
  Children’s Medical Expense Subsidies FAQ
• Contact Information for Ward Branch and Liaison Offices
  (English)

Leaflet and Forms for Download (Japanese)

• Children’s Medical Expense Subsidy Leaflet （PDF 826.4KB）
• Application for Recognition as a Children’s Medical Expenses Recipient （PDF 241.2KB）
• Application for Reissuance of/Change in Children’s Medical Expenses Recipient Card （PDF 65.0KB）
• Application for Reimbursement of Children’s Medical Expense Payment （PDF 138.1KB）

Inquiries regarding this page

Please direct all inquiries to the Welfare Division of your local ward office