Daily Life Lessons · Childcare
Understand the out-of-pocket share for children's medical costs under national insurance and how municipal medical expense subsidies work, and be able to apply for the medical certificate, show it when seeing a doctor, and apply for a refund yourself.
When a child sees a doctor, the out-of-pocket share under public medical insurance is, in principle, 20% before starting elementary school and, in principle, 30% after that. In addition, every municipality runs a children's medical expense subsidy program (こども医療費助成) that reduces this cost further or makes it free. The eligible age (most often until the end of the fiscal year in which the child turns 18), income limits, the amount paid per visit and so on differ by municipality.
Once your child is enrolled in health insurance, apply at your municipality to receive a medical certificate (医療証). When your child sees a doctor, show your My Number health insurance card (マイナ保険証) or similar together with the medical certificate at the reception counter.
If you forget the medical certificate or your child is treated outside your prefecture, you pay your share first and may be able to get a refund later by applying. Costs not covered by insurance are not covered by the subsidy.
子どもが 病院に 行くと、お金を 払います。
- 小学校に 入る 前：ふつう 2割（わり） - 小学生から：ふつう 3割
それに 加えて、市（し）や 区（く）が お金を 助けて（たすけて）くれます。無料に なる ことも あります。 何さいまでか、いくらか は、市や 区で ちがいます。
1. 子どもの 健康保険（けんこうほけん）に 入ります。 2. 市役所（しやくしょ）・区役所（くやくしょ）に 申請（しんせい）して、医療証（いりょうしょう）を もらいます。 3. 病院で、マイナ保険証などと 医療証を 見せます。
医療証を 忘れた ときは、あとで お金が 戻る（もどる） ことが あります。市や 区に 聞きましょう。
Under public medical insurance, what is the out-of-pocket share, in principle, for children who have not yet started elementary school?
It is 20% in principle before starting elementary school and 30% in principle after that. On top of this, there are municipal subsidies.
What about the eligible age and payment amounts of the children's medical expense subsidy?
Every municipality provides a subsidy, but the eligible age, income limits and payment amounts differ by municipality.
What do you need to do first to receive the subsidy?
Enrollment in health insurance is a prerequisite. When you apply, you are issued a medical certificate.
What do you show at the reception counter when your child sees a doctor?
Show both something that confirms insurance eligibility and the medical certificate.
What happens if you forgot the medical certificate and paid your share?
Refund methods and deadlines differ by municipality. Keep your receipts.
Q. What happens to the medical certificate if we move?
A. The medical certificate is issued by the municipality where you live, so the old one can no longer be used after you move. When you complete the moving-in procedure, also apply for the children's medical expense subsidy at your new municipality.
Q. Are meals during a hospital stay also free?
A. Whether meal costs during a hospital stay are covered by the subsidy differs by municipality. Costs not covered by insurance, such as extra charges for a private or semi-private room, are not covered by the subsidy. Check with the municipality where you live.
Q. Is this different from the child allowance?
A. Yes, they are different programs. The children's medical expense subsidy helps with costs when your child sees a doctor, while the child allowance (児童手当) is money paid to families raising children. Each requires its own separate procedure.
This practice tool asks questions in random order (it works when JavaScript is enabled). You can still read all the questions and explanations above without it.
Systems and procedures may differ depending on the city, ward, town or village where you live and on the time of year. Please check the latest information from your local government or the relevant organizations.
Content checked on: 2026-09-28
This page is a translation of the Japanese original. If the translation and the original differ, the Japanese version takes precedence. View the Japanese original