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High-cost medical expense benefit: monthly ceiling and annual cap, under 70, 13 income bands (care from August 2027)

{"over_16.5m":{"formula":"342,000円+(医療費-1,140,000)×1%","multi_month":140100,"annual_cap":1680000,"band":"標報127万円以上"},"14.1m_to_16.5m":{"formula":"303,000円+(医療費-1,010,000)×1%","multi_month":140100,"annual_cap":1680000,"band":"標報103万~121万円"},"11.6m_to_14.1m":{"formula":"270,300円+(医療費-901,000)×1%","multi_month":140100,"annual_cap":1680000,"band":"標報83万~98万円"},"10.4m_to_11.6m":{"formula":"209,400円+(医療費-698,000)×1%","multi_month":93000,"annual_cap":1110000,"band":"標報71万~79万円"},"9.5m_to_10.4m":{"formula":"194,400円+(医療費-648,000)×1%","multi_month":93000,"annual_cap":1110000,"band":"標報62万~68万円"},"7.7m_to_9.5m":{"formula":"179,100円+(医療費-597,000)×1%","multi_month":93000,"annual_cap":1110000,"band":"標報53万~59万円"},"6.5m_to_7.7m":{"formula":"110,400円+(医療費-368,000)×1%","multi_month":44400,"annual_cap":530000,"band":"標報44万~50万円"},"5.1m_to_6.5m":{"formula":"98,100円+(医療費-327,000)×1%","multi_month":44400,"annual_cap":530000,"band":"標報36万~41万円"},"3.7m_to_5.1m":{"formula":"85,800円+(医療費-286,000)×1%","multi_month":44400,"annual_cap":530000,"band":"標報28万~34万円"},"2.6m_to_3.7m":{"amount":69600,"multi_month":44400,"annual_cap":530000,"band":"標報20万~26万円"},"2.0m_to_2.6m":{"amount":65400,"multi_month":44400,"annual_cap":530000,"band":"標報16万~19万円"},"under_2.0m":{"amount":61500,"multi_month":34500,"annual_cap":410000,"band":"標報15万円以下"},"resident_tax_exempt":{"amount":36900,"multi_month":24600,"annual_cap":290000}} JPY/month per household (formula or amount; multi_month = 4th and later month in 12; annual_cap = per year)

from 2027-08-01 · verified 2026-10-24 against the official source · next expected change 2027-08-01

(令和9年8月~) 約1,650万円 ~ 127万円以上 342,000 +(医療費-1,140,000)× 1%
key
jp/benefits/high-cost-medical-under-70-from-2027-08
value
{"over_16.5m":{"formula":"342,000円+(医療費-1,140,000)×1%","multi_month":140100,"annual_cap":1680000,"band":"標報127万円以上"},"14.1m_to_16.5m":{"formula":"303,000円+(医療費-1,010,000)×1%","multi_month":140100,"annual_cap":1680000,"band":"標報103万~121万円"},"11.6m_to_14.1m":{"formula":"270,300円+(医療費-901,000)×1%","multi_month":140100,"annual_cap":1680000,"band":"標報83万~98万円"},"10.4m_to_11.6m":{"formula":"209,400円+(医療費-698,000)×1%","multi_month":93000,"annual_cap":1110000,"band":"標報71万~79万円"},"9.5m_to_10.4m":{"formula":"194,400円+(医療費-648,000)×1%","multi_month":93000,"annual_cap":1110000,"band":"標報62万~68万円"},"7.7m_to_9.5m":{"formula":"179,100円+(医療費-597,000)×1%","multi_month":93000,"annual_cap":1110000,"band":"標報53万~59万円"},"6.5m_to_7.7m":{"formula":"110,400円+(医療費-368,000)×1%","multi_month":44400,"annual_cap":530000,"band":"標報44万~50万円"},"5.1m_to_6.5m":{"formula":"98,100円+(医療費-327,000)×1%","multi_month":44400,"annual_cap":530000,"band":"標報36万~41万円"},"3.7m_to_5.1m":{"formula":"85,800円+(医療費-286,000)×1%","multi_month":44400,"annual_cap":530000,"band":"標報28万~34万円"},"2.6m_to_3.7m":{"amount":69600,"multi_month":44400,"annual_cap":530000,"band":"標報20万~26万円"},"2.0m_to_2.6m":{"amount":65400,"multi_month":44400,"annual_cap":530000,"band":"標報16万~19万円"},"under_2.0m":{"amount":61500,"multi_month":34500,"annual_cap":410000,"band":"標報15万円以下"},"resident_tax_exempt":{"amount":36900,"multi_month":24600,"annual_cap":290000}} JPY/month per household (formula or amount; multi_month = 4th and later month in 12; annual_cap = per year)
period
—
effective
2027-08-01 to date
source
https://www.mhlw.go.jp/content/001726232.pdf
verified
2026-10-24 — fresh (13 days ago; next check by 2026-11-28)
next expected change
2027-08-01 (irregular: changed by statute or order on no fixed date)
source checked
2026-11-02 (the newest day the automated check fetched the source page)
scope
児童手当 amounts from 令和6年10月分 (no income limit; paid in even months for the previous two months). 出産育児一時金 from April 2023. 高額療養費 for patients under 70: the table for care up to July 2026, the August 2026 – July 2027 table with the new 年間上限, and the 13-band table from August 2027 (健保 bands by 標準報酬月額; 国保 by 旧ただし書き所得 — see the PDF). 70歳以上 tables are not included.
hash
sha256:45ca22f125b1664fcfeeada6c947ed82fa3af2493889526f7021904cc48a57ee
signature
EdDSA, key db-2026-10 — keys

As JSON

curl -s https://databutler.dev/f/jp/benefits/high-cost-medical-under-70-from-2027-08?max_age=30d — schema; verify with npx verified-facts verify https://databutler.dev/f/jp/benefits/high-cost-medical-under-70-from-2027-08

{
  "protocol": "verified-facts/0.3",
  "key": "jp/benefits/high-cost-medical-under-70-from-2027-08",
  "label": "High-cost medical expense benefit: monthly ceiling and annual cap, under 70, 13 income bands (care from August 2027)",
  "value": {
    "over_16.5m": {
      "formula": "342,000円+(医療費-1,140,000)×1%",
      "multi_month": 140100,
      "annual_cap": 1680000,
      "band": "標報127万円以上"
    },
    "14.1m_to_16.5m": {
      "formula": "303,000円+(医療費-1,010,000)×1%",
      "multi_month": 140100,
      "annual_cap": 1680000,
      "band": "標報103万~121万円"
    },
    "11.6m_to_14.1m": {
      "formula": "270,300円+(医療費-901,000)×1%",
      "multi_month": 140100,
      "annual_cap": 1680000,
      "band": "標報83万~98万円"
    },
    "10.4m_to_11.6m": {
      "formula": "209,400円+(医療費-698,000)×1%",
      "multi_month": 93000,
      "annual_cap": 1110000,
      "band": "標報71万~79万円"
    },
    "9.5m_to_10.4m": {
      "formula": "194,400円+(医療費-648,000)×1%",
      "multi_month": 93000,
      "annual_cap": 1110000,
      "band": "標報62万~68万円"
    },
    "7.7m_to_9.5m": {
      "formula": "179,100円+(医療費-597,000)×1%",
      "multi_month": 93000,
      "annual_cap": 1110000,
      "band": "標報53万~59万円"
    },
    "6.5m_to_7.7m": {
      "formula": "110,400円+(医療費-368,000)×1%",
      "multi_month": 44400,
      "annual_cap": 530000,
      "band": "標報44万~50万円"
    },
    "5.1m_to_6.5m": {
      "formula": "98,100円+(医療費-327,000)×1%",
      "multi_month": 44400,
      "annual_cap": 530000,
      "band": "標報36万~41万円"
    },
    "3.7m_to_5.1m": {
      "formula": "85,800円+(医療費-286,000)×1%",
      "multi_month": 44400,
      "annual_cap": 530000,
      "band": "標報28万~34万円"
    },
    "2.6m_to_3.7m": {
      "amount": 69600,
      "multi_month": 44400,
      "annual_cap": 530000,
      "band": "標報20万~26万円"
    },
    "2.0m_to_2.6m": {
      "amount": 65400,
      "multi_month": 44400,
      "annual_cap": 530000,
      "band": "標報16万~19万円"
    },
    "under_2.0m": {
      "amount": 61500,
      "multi_month": 34500,
      "annual_cap": 410000,
      "band": "標報15万円以下"
    },
    "resident_tax_exempt": {
      "amount": 36900,
      "multi_month": 24600,
      "annual_cap": 290000
    }
  },
  "unit": "JPY/month per household (formula or amount; multi_month = 4th and later month in 12; annual_cap = per year)",
  "period": null,
  "effectiveFrom": "2027-08-01",
  "effectiveTo": null,
  "source": "https://www.mhlw.go.jp/content/001726232.pdf",
  "quote": "(令和9年8月~) 約1,650万円 ~ 127万円以上 342,000 +(医療費-1,140,000)× 1%",
  "verifiedDate": "2026-10-24",
  "nextScheduledRefresh": "2026-11-28",
  "changeCadence": "irregular",
  "nextExpectedChange": "2027-08-01",
  "sourceCheckedAt": "2026-11-02",
  "status": "fresh",
  "ageDays": 13,
  "maxAgeDays": null,
  "scope": "児童手当 amounts from 令和6年10月分 (no income limit; paid in even months for the previous two months). 出産育児一時金 from April 2023. 高額療養費 for patients under 70: the table for care up to July 2026, the August 2026 – July 2027 table with the new 年間上限, and the 13-band table from August 2027 (健保 bands by 標準報酬月額; 国保 by 旧ただし書き所得 — see the PDF). 70歳以上 tables are not included.",
  "hash": "sha256:45ca22f125b1664fcfeeada6c947ed82fa3af2493889526f7021904cc48a57ee",
  "signature": {
    "alg": "EdDSA",
    "kid": "db-2026-10",
    "jws": "eyJhbGciOiJFZERTQSIsImtpZCI6ImRiLTIwMjYtMTAifQ..ki36BJt-a9GIO4DWVM166jrEas4sDRNrcDNVWDxL-HHuXy5QbCfLDjLXfEtP1WlR0B54Qqm-Xq8YrUYqjOCbCg",
    "keys": "https://databutler.dev/.well-known/jwks.json"
  },
  "publisher": {
    "name": "Data Butler",
    "url": "https://databutler.dev/"
  },
  "cite": {
    "url": "https://databutler.dev/facts/jp/benefits/high-cost-medical-under-70-from-2027-08",
    "text": "databutler.dev, verified 2026-10-24 against https://www.mhlw.go.jp/content/001726232.pdf"
  }
}