When a parent's monthly co-payments cross an income-based ceiling, the excess comes back, sometimes automatically and sometimes only if you apply. The catch is the application: families abroad leave money unclaimed because no one filed. Ask the municipality whether the parent's refund is automatic or needs a form, and check the first time costs run high. Watching this ceiling keeps a heavy-care month from spiraling.
Monthly caps by income
This benefit refunds co-payments above a monthly cap set per household by income. The English translation of the Long-Term Care Insurance Act calls it the allowance for high-cost long-term care service.
Most households have a cap of ¥44,400 a month. When everyone in the household is exempt from resident tax, the cap is ¥24,600. The lowest band, which includes recipients of the old-age welfare pension, is capped at ¥15,000 per person.
Higher earners pay more before the refund starts. The cap is ¥93,000 when someone aged 65 or over in the household has taxable income of ¥3.8 million up to ¥6.9 million. It rises to ¥140,100 at ¥6.9 million and above.
What counts
Only co-payments for covered services count. Meals, room charges and private services are excluded. Units used above the care level's monthly ceiling are excluded too, since those are paid in full.
Medical bills fall under a separate high-cost medical benefit. A yearly scheme combines the two for households paying heavily for both.
Claiming the refund
The first time a parent goes over the cap, the municipality usually mails an application form. Once it is filed, later refunds generally go to the same bank account without a new form. Claims expire after two years.
Families abroad should make sure the form reaches someone who can sign it and that the payout account stays open. The high-cost care refund article covers the paperwork. The cost simulator estimates a monthly bill before and after the cap.
Read more: The high-cost care refund
Related terms
- 自己負担（jiko futan）— co-payment
- 限度額適用認定証（gendogaku nintei-shou）— limit application certificate
- 差額ベッド代（sagaku bed dai）— private room charge
Where to go next
This word will come back at the home assessment or in the first care plan. The full Japanese elder care glossary holds 54 terms, and the long-term care insurance guide shows where each one sits in the process.
If you would rather someone handled the Japanese side, our care navigation service does that, and the first consultation is 30 minutes and free. Definitions here are general orientation and rules vary by municipality; see our editorial policy or contact us with your situation.