Long-life Medical Insurance plan 後期高齢者医療保険

Long-life Medical insurance plan

"Long-life Medical insurance plan" covers people over the age of 75 and certain challenged people at the age from 65 through 75. The insureds of this plan are required far less spending when they visit doctors and pharmacies, because this plan is financed a lot by the general budget of the national government and the contributions from other public health insurance plans. Elder people usually cannot work hard and get sick more often than youngers. Therefore, this treatment has been regarded as fair and impartial. However, as the Japanese economic conditions deteriorate, more and more people question the sustainability of this preferential treatment due to the age.

[In Japanese]

Enrollment Procedures

The enrollment procedures for the Long-life medical Insurance plan shall be conducted by the relevant bureau of the municipalities and the insureds have nothing particularly to do by themselves, regarding people over 75. In case people at the age from 65 through 75 would like to join this plan due to certain kinds of disability, they have to submit applications at the municipal office.

[In Japanese]

Insurance premiums

The Long-life Medical Insurance premiums amount is determined and notified by a local body, established in each prefecture to manage the insurance plan. The premiums amount can vary with prefectures you live in.

The premiums amount is levied on each insured. The calculation elements are usually income basis and per capita basis. The maximum limitation of the premiums amount is uniformed across the country, but the limitation is rising year by year.

[In Japanese]

a sharp increase of insurance premiums at the age of 75

Most of the people at the age around 70 are covered by the National Health Insurance plan. The premiums for the National health insurance plan are levied on each household, which often have 2 or more family members. If a member of such a household reaches 75 years old, he/she will be excluded from the National Health Insurance plan and enrolled into the Long-Life Medical Insurance plan. Premiums for the latter will be newly levied, but premiums for the former do not always decrease correspondingly. As a result, the total amount of the public insurance premiums can be much higher.

Besides, in case an insured of the Social Health insurance plan gets 75 years old, he gets excluded from the insurance plan to join the Long-life medical expense. Then, the qualified dependents shall also be excluded from the Social health insurance plan, and they usually have to join the National health insurance plan and pay the premiums. In this case, the premiums burden on the household may increase dramatically.

[In Japanese]
70歳代の人の多くが国民健康保険の被保険者となっています。その保険料は世帯ごとに課されていますが、2人世帯あるいは3人以上の世帯というのが一般的です。 そこで、家族の1人が75歳に達すると、その人は国民健康保険から脱退し、後期高齢者医療保険に加入することとなります。そして、後期高齢者医療保険料が新たに課されることとなりますが、国民健康保険料がそれに対応して減るとは限りません。 結果として、公的医療保険の保険料が激増することがあります。


payment method

You shall pay the premiums at a financial institute or a convenient store with the payment slips sent from the relevant bureau. I recommend applying for the automatic transfer from your bank account. It prevents you from omitting the payments and saves you the trouble of going to a bank and waiting for your turn.
Besides, if you receive public pensions of 180 thousand yen or more per year, the premiums shall be deducted from the public pensions under the Special Collection method.

[In Japanese]

Actual case of the premium calculation

I introduce 2 actual cases of the premium calculation. One is that in Gotsu city, Shimane prefecture. The other is that in Kita ward, Tokyo.

Long-life Medical insurance premiums in Gotsu city for 2023

Element Premium amount/rate
Income ※1 9.35%
Per capita ※2 50,880yen/each
Maximum Limitation 660,000yen

Long-life Medical insurance premiums in Kita ward, Tokyo for 2024

Element Premium amount/rate
Income ※1 9.67%
Per capita ※2 47,300yen/each
Maximum Limitation 800,000yen

※1 The calculation basis is the total sum of the income amount (after 430,000yen deduction for each insured) gained by the insureds in the household for the previous years.
※2 The calculation basis is the number of the insureds in the household.

Several preferential treatments are prescribed for those who are assumed to have a difficulty to bear the regular premiums amount. But the range of the eligible persons to these preferential treatments has been narrowed these days. You can refer to the guidance issued by the Tokyo Union of the insurers of this plan for the details from the link below.

[In Japanese]

島根県江津市の後期高齢者医療保険料 2023年

算定要素 保険料率/額
所得割 9.35%
均等割 50,880円
最大限度額 660,000円

東京都北区の後期高齢者医療保険料 2024年

算定要素 保険料率/額
所得割 9.67%
均等割 47,300円
最大限度額 800,000円

※1 世帯内の被保険者の前年分課税所得の合計額(43万円控除後)
※2 世帯内の被保険者の人数


Guidance prepared for foreingers

Guidance for the Long-life medical insurance plan