Treatment Costs and the High-Cost Medical Expense Benefit

What Changed in August 2026

1. Monthly caps rose in every income category (for example, under 70 at ¥3.7–7.7M: ¥80,100 → ¥85,800 + 1%; 70 and over, general, outpatient: ¥18,000 → ¥22,000).
2. The frequent-user cap is frozen, so people in long-term treatment do not pay more.
3. A new annual cap was introduced. Once your out-of-pocket total from August to the following July reaches the annual cap, the rest is refunded by your insurer. This also covers people whose monthly bills never reach the monthly cap. A refund under the annual cap may require an application, so read the notices from your insurer.