The high-cost medical care benefit ("high medical care cost" for persons 70 and over) can be claimed if the cost-bearing limit of medical expenses exceeds the specified amount for the month (please refer to the question: "How much would my total medical costs be with the high-cost medical care benefit?"). The full amount (30% of medical costs) is paid first and a refund later received.
Only medical fees covered by national health insurance are covered under this system. Hospital meals and other items not covered by the policy (private room, medical certificate, diapers, certain medications) are exempt.
Medical costs are calculated by month, by days of hospitalization or as an outpatient, and by medical institution. Applications can be made up to two years after payment.
As of April 1, 2007, persons under 70 are only required to pay their maximum copayment of high-cost medical expenses incurred during hospitalization at the hospital (this is already in effect with persons 70 and over). Because of this, it is no longer necessary to pay the initial 30% and apply for remuneration, thus greatly reducing payment at the hospital. To be eligible however, a claimant's certificate must first be obtained at a national health insurance office.
>>Ministry of Health, Labour and Welfare Issue in Kind of High-cost Medical Care Benefit for Persons Under 70 (pdf)