Japan’s High-Cost Medical Expense Benefit Calculator

Japan's high-cost medical expense benefit

This Japanese scheme reimburses the amount exceeding a specified limit when out-of-pocket medical expenses for a calendar month (from the first to the last day) are high. Hospital meal charges, extra bed charges and advanced medical treatment costs are excluded.

Household aggregation

Out-of-pocket expenses can be combined within a household when several members receive treatment in the same month, or one person receives care at multiple institutions or both inpatient and outpatient care at one institution. The amount exceeding the household limit is reimbursed. For people under 70, only out-of-pocket amounts of JPY 21,000 or more qualify for aggregation; the qualifying amount is included, not just the portion exceeding JPY 21,000. For people aged 70 or over, all out-of-pocket amounts can be combined.

How out-of-pocket expenses are grouped

Calculate separately for each medical institution. Even at the same institution, medical inpatient care, medical outpatient care, dental inpatient care and dental outpatient care are calculated separately. Medical care here includes non-dental specialties, not only internal medicine. Payments to a dispensing pharmacy for a prescription are included with the expenses of the institution that issued the prescription.

All monetary inputs and outputs are in Japanese yen (JPY). This calculator concerns Japan's system, not another country's insurance system.

According to the Japanese source, this library includes the revisions for August 2026 (Reiwa 8) and August 2027 (Reiwa 9). Income categories are subdivided for August 2027. The August 2027 amounts are based on the linked MHLW review document and the current revision policy, and may change when formally finalized. Individual-specific calculations, benefits for repeated high-cost months and annual caps are not supported. The site accepts no responsibility for results or information and does not provide individual consultations.