Japan raises the income threshold for the municipal-inhabitant-tax-exempt bracket of the monthly out-of-pocket cap (負担上限月額) on medical care such as independence-support medical care (自立支援医療) and designated chronic pediatric diseases (小児慢性特定疾病): 809,000 yen → 826,500 yen (effective July 1, 2026)
Source material is a Japanese government announcement (in Japanese); this page is a summary.
From July 1, 2026, the income threshold that divides the monthly out-of-pocket cap (負担上限月額) brackets for households exempt from municipal inhabitant tax rises from 809,000 yen or less a year to 826,500 yen or less. It covers five benefits — medical expenses for designated chronic pediatric diseases (cap 1,250 yen), outpatient medical care for children with physical disabilities (15,000 yen), residential medical care for children with disabilities (15,000 yen), designated independence-support medical care (2,500 yen), and designated long-term care medical services, etc. (15,000 yen) — and the new threshold applies to medical care received on or after July 1, 2026 (care received up to June 30 stays under the previous threshold).
Key facts
| Effective date / legal basis | Effective July 1, 2026 (令和8年7月1日) — 「児童福祉法施行令等の一部を改正する政令」 (令和8年6月3日政令第192号 / Cabinet Order No. 192, promulgated June 3, 2026) |
|---|---|
| Revised income threshold | Combined amount of 809,000 yen (80万9千円 / 八十万九千円) or less → 826,500 yen (82万6,500円 / 八十二万六千五百円) or less |
| Items included in the combined amount | The household must be exempt from municipal inhabitant tax (市町村民税世帯非課税), and the total is ① public pension and similar income for the previous year (the year before last if the month of care falls in January through June) + ② total income (合計所得金額) for the previous year + ③ benefits specified by ministerial ordinance that were paid in the previous year, such as the Basic Disability Pension (障害基礎年金) or the Special Child Rearing Allowance (特別児童扶養手当) |
| Covered benefits and the monthly out-of-pocket cap for this bracket | Medical expenses for designated chronic pediatric diseases (小児慢性特定疾病医療費) 1,250 yen / outpatient medical care for children with physical disabilities (肢体不自由児通所医療) 15,000 yen / residential medical care for children with disabilities (障害児入所医療) 15,000 yen / designated independence-support medical care (指定自立支援医療) 2,500 yen / designated long-term care medical services, etc. (指定療養介護医療等) 15,000 yen |
| Transitional measure | The amended provisions apply to medical care received on or after the effective date (July 1, 2026); for medical care received before the effective date, the former provisions continue to apply |
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On June 3, 2026 the Japanese government promulgated the 「児童福祉法施行令等の一部を改正する政令」 (Cabinet Order No. 192 of Reiwa 8), raising from 809,000 yen to 826,500 yen the income threshold for the bracket defined as "a household exempt from municipal inhabitant tax (市町村民税世帯非課税) whose combined pension and other income does not exceed a set amount" within the monthly out-of-pocket cap (負担上限月額) on medical care related to disabilities and chronic pediatric diseases. It takes effect on July 1, 2026. Five provisions were amended: Article 22, paragraph 1, item 5 (medical expenses for designated chronic pediatric diseases, cap 1,250 yen), Article 25-13, paragraph 1, item 3 (outpatient medical care for children with physical disabilities (肢体不自由児通所医療), 15,000 yen) and Article 27-13, paragraph 1, item 3 (residential medical care for children with disabilities (障害児入所医療), 15,000 yen) of the 児童福祉法施行令, plus Article 35, item 4 (designated independence-support medical care (指定自立支援医療), 2,500 yen) and Article 42-4, paragraph 1, item 3 (designated long-term care medical services, etc. (指定療養介護医療等), 15,000 yen) of the 障害者総合支援法施行令 — in all five, only the monetary threshold changed, from 809,000 yen to 826,500 yen. The combined amount used for the assessment is the sum of ① public pension and similar income for the previous year (the year before last when the care falls in January through June), ② total income for the previous year, and ③ benefits specified by ministerial ordinance that were paid in the previous year, such as the Basic Disability Pension (障害基礎年金) or the Special Child Rearing Allowance (特別児童扶養手当). The supplementary provisions apply the amended rules to "medical care received on or after the effective date," while the former provisions continue to apply to medical care received before the effective date.
Summaries below are factual notes based on government announcements and primary sources — not evaluations or opinions.
Summaries reflect national-level programs. Municipal (city/ward/town) programs may differ — confirm with the official desk before applying.
FAQ
What exactly changed?
Among the income brackets that determine the monthly out-of-pocket cap (負担上限月額) for medical care, the monetary threshold for the bracket defined as "a household exempt from municipal inhabitant tax whose combined pension and other income does not exceed a set amount" rose from 809,000 yen to 826,500 yen. The cap amounts themselves (1,250 yen, 2,500 yen and 15,000 yen) were not changed by this Cabinet Order; only the threshold line moved.
From which treatment dates does it apply?
From medical care received on or after July 1, 2026. The supplementary provisions state that the amended rules apply to benefits for medical support for designated chronic pediatric diseases, outpatient medical care for children with physical disabilities, residential medical care for children with disabilities, designated independence-support medical care and long-term care medical services, etc. received on or after the effective date, while the former provisions continue to apply to medical care received before the effective date.
How do I check which bracket my monthly out-of-pocket cap falls into?
The monthly out-of-pocket cap is set by Cabinet Order according to the eligibility certification (支給認定) category of each scheme — certification for medical expenses by the prefecture for designated chronic pediatric diseases, and certification by the municipality or a similar body for independence-support medical care. This amendment adjusted only the combined-income threshold line within those categories, so you need to confirm which bracket applies to you at the certifying counter for each scheme (the prefecture, the municipality, and so on).