Japan to Raise Caps on Out-of-Pocket Medical Expenses

From Jiji

July 18 2026

TOKYO – Japan will raise the caps on medical expenses borne by patients as part of changes in its high-cost medical care benefit system from August that are designed to curb ballooning national medical costs. 
   The ceilings on monthly out-of-pocket medical expenses will be raised next month and in August 2027. The total margin of increases will reach 4 pct to 38 pct, varying depending on the annual income.
   Under the high-cost medical care benefit system, patients excluding members of households exempt from resident tax are divided into four categories based on incomes.
   In principle, the ceilings are set at levels calculated by adding a fixed amount based on the annual income to a variable amount, which is 1 pct of the patient’s total medical costs minus a certain sum. Expenses exceeding the caps will be covered by public medical insurance.
   The current fixed amount is about 80,000 yen for middle-income patients with annual incomes of 3.7 million yen to 7.7 million yen. This amount will rise to about 86,000 yen next month.