Medical Expense Subsidies for Children

Coverage of the children’s medical expense subsidies system will be expanded as follows beginning in January 2022:

1. Coverage for doctor visits will be expanded to include elementary school students up to year six.
2. Parent/guardians will be expected to pay partial copayments for children not yet attending school only when calculating the initial visit fee (partial copayments will NOT be required upon follow-up visits).

• Note 1: For information regarding the income limit amounts and the standard income amount to determine copayment amounts, please see Eligibility for the Children’s Medical Expense Subsidies.
• Note 2: For those whose Recipient Card will change due to the changes to the system, a new card will be sent in late December 2021. Please use the new card when it arrives (as a rule, there is no need to apply for your card to be updated).
• Note 3: Partial copayments will be paid for each medical institution.
• Note 4: For medical institutions that perform both dental care and non-dental care: the dental and non-dental care shall be considered to be provided at separate medical institutions.
• Note 5: If you receive medicine from a pharmacy covered by insurance based on a prescription, or receive designated home medical care, licensed shiatsu massage, acupuncture, moxibustion, or judo therapy, you do not need to pay the copayment. Partial copayment will vary between medical institutions with in-house prescriptions and those with external prescriptions. 
• Note 6: “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 have different Resident Records due to being dependents who live separately from you, you will need to submit a separate application.

Eligibility for the Children’s Medical Expense Subsidies

Those who fall under all of the conditions below (1-3) are eligible for this subsidy:

1. Parents/guardians (principle earners) with custody of children with addresses in Hiroshima City.
2. Those whose income for the previous year (for children born January 1 to June 1, income from two years before) is less than the income limit amount listed in the table below (some exemptions/deductions may apply to income as detailed below).
3. Those who have health insurance.

However, those eligible for public welfare, Medical Expense Subsidies for Severely Mentally and Physically Disabled Persons, or Medical Expense Subsidies for Single-Parent Households are NOT eligible for Children’s Medical Expense Subsidies.

Income Limit Amounts and Threshold Income Amount to Determine Copayment Amount

The income limit amount (for those eligible to receive this subsidy) and threshold partial copayment amount (income amount for which the limit for partial copayments changes) are listed below:

Note: “Number of dependents (etc)” refers to the total number of the following:

• Dependent spouse sharing the same livelihood and dependent family members of the guardian as stipulated in the Income Tax Act based on the guardian’s income of the year used as the standard.
• Children who are not dependents and whose guardians sustained a living as of 12/31 of the previous year.

Exemption Amounts

For those eligible for deductions such as the following, the income after making deductions shall be considered the income amount.

• Note 1: In addition, 80,000 yen will be deducted across the board as an equivalent of social insurance premiums.
• Note 2: Medical fee deductions include those declared under the Self-Medication Tax System (special provision for medical expense deductions).
• Note 3: Regarding income amount, special deductions will be made for long- and short-term transfer income.

Subsidy Coverage

Of the total medical fees for healthcare services provided by health insurance (excluding fees for meals during hospitalizations) when children use their health insurance card to see a doctor, the amount to be subsidized by the City of Hiroshima shall be the amount after partial copayment is deducted from amount that the eligible should pay (amount equivalent to the full copayment) as stipulated by laws and regulations related to health insurance.

How to Receive the Subsidy

Present your Children’s Medical Expenses Recipient Card (issued by the City of Hiroshima) and your health insurance card to medical institutions (etc) in Hiroshima Prefecture and you will be able to receive medical care for the cost of partial copayment only.

However, if the amount equivalent to the full copayment is less than the cost of the partial copayment, you will have to pay the applicable amount equivalent to the full copayment.

Please note that in regard to health care received outside of the prefecture or before applying for medical expensive recipient cards, you will have to pay the amount equivalent to the full copayment in cash at the medical institution. In these cases, we will refund your money at a later date, so please submit an application with the medical care receipts to the Welfare Division of your local ward office. For more details, please consult with your local Welfare Division.

How to Apply

Guardians should submit an Application for Recognition as a Children’s Medical Expenses Recipient along with the following to the Welfare Division of their local ward or branch office:

• Insurance Card (with their child’s name)

  Note: If the guardian or their spouse has moved into Hiroshima City or if your Resident Record is outside of Hiroshima City (e.g. job transfers without family), you will need to provide documentation that confirms your Individual Number, i.e. 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.

• Note 1: For those born on the first, “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”.
• Note 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.
• Note 3: When children 6 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).
• Note 4: For third year elementary school students, recipient cards valid through March 31 have been sent out; however, as the system will change beginning in January 2022, new cards will be sent out in late December 2021 (you do NOT need to apply to renew your card as a rule).

Provision

Hiroshima City Children’s Medical Expense Subsidy Ordinance

Related Information (Japanese)

• Children’s Medical Expense Subsidies FAQ
• Welfare Divisions in Each Ward
• Branch Offices (English)

Forms for Download (Japanese)

• Application for Recognition as a Children’s Medical Expenses Recipient
• Application for Reissuance of/Change in Children’s Medical Expenses Recipient Card
• Application for Reimbursement of Children’s Medical Expense Payment

Inquiries regarding this page

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