- LIVING IN SHIBUYA
Medical Care System for Older Senior Citizens
For more information, please read “An Overview of the Medical Care System for Older Senior Citizens” (in English, Chinese and Korean) on Tokyo Iki-Iki Net, the website of the Tokyo Metropolitan Association of Medical Care Services for Older Senior Citizens.
Operation of the Program
The Tokyo Metropolitan Association of Medical Care Services for Older Senior Citizens—which all metropolitan Tokyo municipalities participate in—is the main operator of the program.
● What the association does
Oversees the program, including approving membership applications, determining insurance premiums, and providing medical benefits.
● What Shibuya City does
Handles notification forms, such as change of address and application forms for benefits, issues health insurance cards, and collects insurance premiums.
Residents of Shibuya City who are:
● Seventy-five years of age or older
Membership is automatic from the seventy-fifth birthday (excluding those who receive public financial assistance for everyday living)
● Sixty-five years of age or older with a designated level of disability
Apply at the municipal office; enrollment begins the day the regional association approves your application.
Health Insurance Card
One Older Senior Citizen health insurance card is issued per member.
As a rule, this health insurance card is valid for two years.
Although the card is renewed every two years, the card must be renewed whenever there is a change in any of the items written on it (such as the percentage of personally borne expense).
When you receive treatment at a medical institution, you must show your health insurance card and pay the percentage written on your health insurance card.
- General members = 10%
- Those with a designated level of income or more = 30% (income-earner level)
Insurance premiums are calculated on an individual basis, and are based on the income the person earned during the previous year.
Insurance premiums for those who enrolled during the fiscal year (those who turn seventy-five years of age, or move into Shibuya City) are calculated from the month of enrollment.
If you become ineligible, your premiums are calculated until the month before you lose eligibility.
How to pay your insurance premiums
Please pay by the end of each month using either of the following methods:
① Payment with invoice
Invoices will be mailed in July.
They can be paid at financial institutions (such as banks) or at post offices, convenience stores or the Shibuya City Office or a branch office service counter.
② Payment by financial account debit
You can pay automatically from your financial institution account, such as a bank, or from a post office savings account.
You can receive actual benefits (provision of medical services) and cash benefits (provision of medical fees) through the Medical Care System for Older Senior Citizens.
- High medical expenses/high nursing care total expenses
The high medical expense benefit is provided if the personally borne expense you paid to medical institutions within the same month exceeds the personally borne expense ceiling.
The excess is reimbursed.
In addition, the high nursing care total expense benefit is provided if members in the same household have both medical and nursing care expenses, and the annual total (from August 1 through July 31 of the following year) exceeds the designated ceiling.
To receive either of these benefits, you need to receive the application form from the association.
- Medical Expenses
If you receive medical treatment without showing your health insurance card—such as in an emergency or for other unexpected situations—or if your doctor authorizes the purchase of equipment such as a corset, you can receive a partial refund by filing an application later.
If a member dies, the person who conducts the funeral will be provided ¥70,000 to offset the expense of the funeral.
Please bring your health insurance card, the receipt for the funeral, and a copy of the bank account number of the person who conducted the funeral and file an application.
Note: You can file an application within two years from the day after the funeral was conducted.
National Health Insurance Division, Senior Citizens’ Medical Benefits Section
☎3463-1897 FAX 5458-4940