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When you incur high medical care costs

Your copayment for medical care costs is capped. If your copayment calculated based on certain standards exceeds the maximum, the excess amount will be paid as "High-Cost Medical Care Benefits".

When you want to reduce the amount of medical care costs you pay at the medical care institution
To receive specific disease treatment
When you face high copayments for medical care or long-term care
Loans for high-cost medical expenses

When you want to reduce the amount of medical care costs you pay at the medical care institution

Required documents	Request for issuance of Maximum Co-payment Certificate for Health Insurance Sample completed form
Applies to	Insured persons or dependents who expect to pay more than their Cost-sharing Maximum Amounts for medical care costs at the medical facility over a period of one month.
Submit to	〒103-0015 10F, Daiwa River Gate South Wing, 36-2, Nihonbashi, Hakozaki-cho, Chuo-ku, Tokyo IBM Japan Health Insurance Association
Notes:	You can use this system for both inpatient and outpatient costs. Return your Certificate of Application of Maximum Copayment Amount to the Health Insurance Association at the earliest possible date when any of the following reasons apply. - The Certificate expires. - The insured person is no longer eligible (this includes changes in the health insurance card symbol or number). - The person in question is no longer a dependent. - Changes in the standard monthly remuneration result in relevant changes in the applicable category (A or B). - The current month is the month subsequent to the month in which the 70th birthday of the person in question falls. - The person in question becomes an insured person under the Medical Care System for the Advanced Elderly before his/her 70th birthday.

To receive specific disease treatment

Required documents	Health Insurance Application Form for Certificate Issued for Specific Disease Treatment Sample completed form Contact the Health Insurance Association before submitting this application form.
Deadline	At the earliest possible date
Applies to	Insured persons and dependents receiving treatment for the following conditions: Hemophilia (congenital blood clotting factor VIII or factor IX deficiency) Chronic renal failure requiring dialysis Acquired immunodeficiency syndrome for which antivirals are administered (limited to individuals certified by the Minister of Health, Labour and Welfare, including cases of HIV infection)
Submit to	〒103-0015 10F, Daiwa River Gate South Wing, 36-2, Nihonbashi, Hakozaki-cho, Chuo-ku, Tokyo IBM Japan Health Insurance Association
Notes

When you face high copayments for medical care or long-term care

Required documents	Application for Payment of High Aggregate Cost for Long-Term Care Service
Required documents	Documents to attach Copayment certificate for long-term care insurance
Deadline	At the earliest possible date
Applies to	Insured persons making copayments for both medical care and long-term care in the same household for whom the total copayment amount paid under both systems over a one-year period exceeds the maximum amount
Address inquiries to	Base amounts may differ with differences in the age distribution of household members and income categories. For more information, contact your municipality's long-term care insurance office.
Submit to	〒103-0015 10F, Daiwa River Gate South Wing, 36-2, Nihonbashi, Hakozaki-cho, Chuo-ku, Tokyo IBM Japan Health Insurance Association
Notes:	For calculation purposes, the one-year period above refers to the period August 1 – July 31.

Loans for high-cost medical expenses

Required documents	Contact the Health Insurance Association to request a loan application form.
Applies to	Insured persons expecting to receive High-cost Medical Care Benefits who have been billed by the medical care institution for medical care costs during a month subject to payment of High-cost Medical Care Benefits or who have already paid such costs
Loan amount	80% of expected amount of High-cost Medical Care Benefits to be paid (interest-free)
Period of loan	Until the date of payment of the High-cost Medical Care Benefits corresponding to the loan
Deadline	At the earliest possible date
Submit to	〒103-0015 10F, Daiwa River Gate South Wing, 36-2, Nihonbashi, Hakozaki-cho, Chuo-ku, Tokyo IBM Japan Health Insurance Association