22 Jul High-Cost Medical Expense Benefit (Eligibility Certificate for Ceiling-Amount Application)

High-Cost Medical Expense Benefit

高額療養費　Kogaku-ryoyo-hi

If the total amount you pay out of pocket at a medical institution within a single month exceeds a certain limit, the amount exceeding this limit can be reimbursed upon application. Please note this limit excludes expenses not covered by insurance, such as meal costs during hospitalization.
This limit is called the Copayment Ceiling (自己負担限度額, Jiko-futan-gendogaku).
The copayment ceiling varies depending on factors such as your age, household income, and residence tax status, so it differs for each household.

Please refer to the City of Sapporo website (which has an automatic English translation) for details and to check your applicable ceiling amount (search with the keywords 札幌市 高額療養費). You may also contact the Sapporo Help Desk for assistance.

NOTES

For those with National Health Insurance;

At medical institutions and pharmacies that accept the Myna Health Insurance Card, you can present either your Myna Health Insurance Card or your Certificate of Eligibility to limit your out-of-pocket expenses (excluding non-insured medical expenses and meal fees) to the designated maximum co-payment amount, without needing to apply in advance. If you present a Certificate of Eligibility instead of the Myna Health Insurance Card, your consent will be required.

For those with other health insurance;

If you have Myna Health Insurance Card, you may also be able to use this benefit without prior application. However, if you only have a traditional health insurance card or a Certificate of Eligibility, you may still need to apply for the High-Cost Medical Expense Benefit in advance. Please check with your health insurance provider to confirm the necessary procedures.

Information from Sapporo City (in Japanese)

Last reviewed, July 21, 2025