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Article ID:0000003240Updated on:2020年6月24日更新印刷ページ表示

Medical Expense Subsidies for Children

The system of medical expense for children for the City of Hiroshima will change in January of 2017.

Parents of elementary and junior high school students who are now covered by the system due to the expansion of the covered ages should be aware that an application is required to be certified as a recipient of the medical expense subsidies for children.

Purpose of the Revision

In order to further promote the healthy growth of more children, the city will increase the money for subsidies and significantly expand the covered ages. Also, in order to carry out stable and sustainable system management from the perspective of beneficiary burden, we will partially revise the copayment, requesting that households with a certain income pay an amount based on their income while also making considerations for limiting doctor visits for households with low income, so that there is a general feeling of fairness.

Due to the revision of this system, an additional of students from grades 1 to 3 in elementary school (approx. 28,000 people) and students from grade 4 in elementary school to grade 3 in junior high school (approx. 59,000 people) are now covered by the medical expense subsidy system. Also, for children who have not yet entered school, who have been covered by the system before revision (approx. 68,000 people), we will raise the upper limit for partial copayment for doctor visits for some households (approx. 17,000 people) with relatively high income (standard amount of 2,952,000 JPY (amount that adds 380,000 JPY per dependent)). However, when we look at the total up to students in grade 3 of junior high school, the burden on guardians will decrease (the partial copayment for the remaining households (approx. 51,000 people) will not change).

Content of the Revision

(1) Covered ages

Covered ages for doctor visits were expanded to grade 3 in junior high school, and covered ages for hospital stays to grade 3 in elementary school.

Before Revision (Until December 31, 2016)

After Revision (Starting January, 2017)

For both hospital stays and doctor visits, children who have not yet entered elementary school, or students in grade 1 or 2 of elementary school with developmental disabilities

  • Hospital stays: Children up to grade 3 in junior high school
  • Doctor visits: Children up to grade 3 in elementary school

(2) Partial copayment

The upper limit for partial copayments of doctor visits will change depending on the guardian income.

 

Before Revision (Until December 31, 2016)

After Revision (Starting January, 2017)

Doctor visits

Limit of 500 JPY per day when calculating initial visit fee (Up to 4 days a month)

1. If the guardian's income is less than the standard amount

Limit of 500 JPY per day when calculating initial visit fee (Up to 4 days a month)

2. If the guardian's income is the standard amount or higher

(1) Children who have not yet entered school

Limit of 1,000 JPY per day (Up to 2 days a month)

* There is no limit on when calculating the initial visit fee. (Fees apply for both initial visits and return visits.)

(2)   Grades 1 to 3 in elementary school

Limit of 1,500 JPY per day (Up to 2 days a month)

* There is no limit on when calculating the initial visit fee. (Fees apply for both initial visits and return visits.)

(3) Third child and younger

Limit of 500 JPY per day when calculating initial visit fee (Up to 4 days a month)

Hospital stays

No partial copayment

No partial copayment (No change)

* Partial copayments are paid for each medical organization.

* For medical agencies that perform dental care and non-dental care at the same time, the dental care and non-dental care shall be considered as separate medical agencies.

* If you receive medicine from an insurance pharmacy based on a prescription, or receive specified visiting nursing, licensed massage shiatsu, acupuncture and moxibustion, or judo therapy, you do not need to pay partial copayment. The partial copayment varies between medical agencies with in-hospital prescriptions and those with external prescriptions.

For the standard amounts for partial copayment, see here.

Standard Amounts for Partial Copayment [PDFファイル/29KB]

For the timing of changes in the partial copayment for the children who have not yet entered elementary school and students in grade 1 or 2 of elementary school with developmental disabilities, see here.

Timing of Changes in the Partial Copayment for the Children who have not yet Entered Elementary School and Students in Grade 1 or 2 of Elementary School with Developmental Disabilities [PDFファイル/25KB]

For children who are the third child or younger, see here.

Third Child and Younger [PDFファイル/11KB]

For the difference between medical agencies with in-hospital prescriptions and those with external prescriptions, see here.

Difference between Medical Agencies with In-hospital Prescriptions and Those with External Prescriptions [PDFファイル/18KB]

(3) Income limitations

The income amounts that are covered by the system are not changed after the system revision.

For the income limitations, see here.

Income Limitations [PDFファイル/28KB]

Application Procedure

(1) Guardians for students in grades 1 of elementary school to grade 3 of junior high school

An application is required to be certified as a recipient of medical expense subsidies for children.

* However, no application is required for guardians of students in grades 1 or 2 of elementary school with development disabilities who are already covered by medical expense subsidies for infants, etc., or children who are covered by public assistance, medical expense subsidies for those with a severe mental or physical disabilities, or medical expense subsidies for homes with single parents.

Please being the following documents to your local Ward Office's Health and Welfare Division or branch office to apply.

  • Health insurance card (with the child's name listed)
  • Seal (which used a red ink pad)
  • Income certificate issued by the mayor of your municipality (*)

* If a guardian or spouse moved into Hiroshima City, the income certificate is required. If your spouse is not a dependent according to tax law, the spouse's income certificate is also necessary.

For details about income certificates, see here.

Income Certificates

(2) Guardians of children who have not yet entered elementary school, or students in grade 1 or 2 of elementary school with developmental disabilities

For those that are already covered by the medical expense subsidy system for infants, etc, you can continue to use your recipient certificate while it is still valid.

When you renew your recipient certificate, the new system is applied.

For details, refer to the information which we will send regarding the renewal procedure the month before your recipient certificate expires.

For details about the revised content of the system, see here.

Related Information

Welfare offices and health centers

Downloads

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See the Health and Welfare Division of your ward office.

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