This page covers the high-cost medical expense benefit (kogaku ryoyohi). It caps what you pay for medical care in a calendar month under Japanese public health insurance.
Choose your age and insurance.
Choose your income category. The table below helps.
Enter the total medical cost for the month (100%), and whether it was inpatient or outpatient.
For another month, or the 4th time in a year, change it below the result.
Monthly limits from August 2026
Under 70, per household. The amount in brackets applies from the 4th time in 12 months.
Standard monthly remuneration
Monthly limit
Yearly cap
¥830,000 or more
¥270,300 + (cost − ¥901,000) × 1% (¥140,100)
¥1,680,000
¥530,000 to ¥790,000
¥179,100 + (cost − ¥597,000) × 1% (¥93,000)
¥1,110,000
¥280,000 to ¥500,000
¥85,800 + (cost − ¥286,000) × 1% (¥44,400)
¥530,000
¥260,000 or less
¥61,500 (¥44,400)
¥530,000
Exempt from residence tax
¥36,900 (¥24,600)
¥290,000
Age 70 and over, “general” income: outpatient ¥22,000 a month per person, ¥61,500 per household including inpatient care. From August 2027 the categories under 70 split into 13. The calculator has all three sets of limits.
How the calculator works it out
Your share is the cost × your rate (30%, 20% or 10%). Rounding to ¥10 at the counter is ignored.
The 1% part is rounded to the nearest yen.
Age 70 and over: the outpatient limit per person first, then the household limit.
National Health Insurance and late-stage elderly insurance use the same amounts. Only the way your category is set differs.
How to claim
Use your My Number card as your health insurance card, or show a limit certificate from your insurer. The hospital then charges only up to your limit. Otherwise you pay your share and claim the rest from your insurer. Under the Health Insurance Act, the right to a benefit expires 2 years after you can claim it.
Sources and date checked
Sources: Order for Enforcement of the Health Insurance Act (Cabinet Order No. 240 of 2026), the Ministry of Health, Labour and Welfare and Kyokai Kenpo. Checked .
The calculator uses the same value file and calculation as the Japanese calculator on this site.
Frequently asked questions
How is the high-cost medical expense benefit calculated?
Your income category sets a monthly limit. What you pay above it comes back. Under 70, with income of about ¥3.7 to ¥7.7 million and ¥1,000,000 of costs, the limit from August 2026 is ¥92,940.
Can foreigners use the high-cost medical expense benefit in Japan?
Yes. It is part of Japanese public health insurance, so it applies if you are enrolled in employee health insurance, National Health Insurance or late-stage elderly insurance.
How do I avoid paying the full amount at the hospital?
Use your My Number card as your health insurance card, or show a limit certificate from your insurer. The hospital then charges only up to your limit. Otherwise you pay your share and claim the rest.
What is the yearly cap on medical costs?
From August 2026 there is also a cap on your costs from August to the next July. It is ¥530,000 for income of about ¥3.7 to ¥7.7 million. Claims start in August 2027.
How long do I have to claim the benefit?
Under the Health Insurance Act, the right to a benefit expires 2 years after you can claim it. Ask your insurer for the form.
Notes and your data
This is an estimate. The final amount is decided by your health insurer.
Your inputs are saved only in this browser (localStorage, key seido-keisan_highcost_draft) and are never sent anywhere.
An exported file contains your medical costs. There is no share link.