Regulatory changes detected in official sources — tracked continuously by GovToDate's monitoring.
Detected on 28 September 2026Ministry of Health, Labour and Welfare — mhlw.go.jp Review of the outpatient special provision for those aged 70 and over (from August 2026)
What changes: From the perspective of intergenerational support based on ability to pay rather than age, the outpatient special provision unique to those aged 70 and over will be reviewed. This aims to reduce the insurance premium burden for all generations of insured persons while minimizing the impact on low-income elderly individuals.
Detected on 28 September 2026Ministry of Health, Labour and Welfare — mhlw.go.jp Introduction of partial non-insurance medical care (date to be determined by cabinet order within one year of promulgation)
What changes: A system of 'partial non-insurance medical care' will be introduced for treatments using drugs that are highly substitutable with Over-The-Counter (OTC) drugs, where a portion of the drug cost will not be covered by insurance. This aims to optimize medical costs and ensure fairness in burden sharing.
Detected on 28 September 2026Ministry of Health, Labour and Welfare — mhlw.go.jp Reflection of financial income in premium calculation etc. for Late-stage Elderly Healthcare (date to be determined by cabinet order within five years of promulgation)
What changes: In the Late-stage Elderly Healthcare system, an obligation will be established for financial institutions to submit financial income, such as dividends from listed stocks, online to the Wide-Area Association for Late-stage Elderly Healthcare. This is to ensure fair reflection of such income in premium calculations and determination of co-payment ratios.
Detected on 28 September 2026Ministry of Health, Labour and Welfare — mhlw.go.jp Review of the benefit system for childbirth (date to be determined by cabinet order within two years of promulgation)
What changes: To reduce the financial burden on pregnant women associated with childbirth, the benefit system for standard childbirth costs will be reviewed. Furthermore, the establishment of standard amounts for prenatal check-ups and visualization of services and costs will be promoted.
Detected on 28 September 2026Ministry of Health, Labour and Welfare — mhlw.go.jp Expansion of the 50% reduction in per capita premiums for children under the National Health Insurance system (from April 1, 2027)
What changes: In the National Health Insurance system, the scope of the 50% reduction in per capita premiums for children will be expanded from preschool children to those in their high school years. This will reduce the financial burden on households with children.
Detected on 28 September 2026Ministry of Health, Labour and Welfare — mhlw.go.jp Review of the High-Cost Medical Expense Benefit System (basic policy to be decided around December 2025, effective date undecided)
What changes: A special committee on the future of the High-Cost Medical Expense Benefit System was established, and based on feedback from patient groups and insurers, the basic policy for reviewing the system was compiled in December 2025. The specific effective date will be determined later.
Detected on 28 September 2026Ministry of Health, Labour and Welfare — mhlw.go.jp Enactment of the Act for Partial Revision of the Health Insurance Act, etc. (enacted on May 29, 2026)
What changes: The 'Bill for Partial Revision of the Health Insurance Act, etc.' was enacted on May 29, 2026 (Reiwa 8). This reform aims to maintain and improve the reliability and acceptance of the medical insurance system across all generations by reviewing benefits and burdens, while suppressing the rise in insurance premium burdens.
Introduction of an annual maximum limit under the High-Cost Medical Expense Benefit System (from August 2025)
What changes: From August 2025, an 'annual maximum limit' will be introduced, establishing a yearly cap on out-of-pocket expenses. This may further reduce the burden for individuals undergoing long-term treatment. The aim is to ensure the overall sustainability of the system and strengthen the safety net function for long-term patients and low-income individuals.
Increase in the maximum out-of-pocket medical expense reimbursement limit under the High-Cost Medical Expense Benefit System (from August 2025)
What changes: The maximum out-of-pocket medical expense reimbursement limit will be raised for each income bracket. For example, the limit for the general category (20% co-payment) will increase from 18,000 yen to 28,000 yen (from 144,000 yen annually to 224,000 yen annually). This is part of a review aimed at reducing the insurance premium burden for all generations of insured individuals, including healthy in
Review of the benefit system for childbirth (date to be determined by cabinet order within two years of promulgation)
What changes: To reduce the economic burden on pregnant women associated with childbirth, the benefit system for standard childbirth costs will be reviewed. This aims to enhance support for the next generation, such as childbirth, and to promote prevention and health among the working-age population.
Reduction in the 'multiple-occurrence' benefit for those with an annual income of less than 2 million yen (from August 2025)
What changes: The amount for 'multiple-occurrence' benefits, which applies when an individual has exceeded the high-cost medical expense limit for three or more months within the past 12 months, will be reduced for income brackets below 2 million yen annually. This is part of strengthening the safety net function for long-term patients and low-income individuals.
Subdivision of income brackets in the High-Cost Medical Expense Benefit System (from August 2026, August 2027)
What changes: Income brackets, excluding the resident tax-exempt category, will be subdivided into three categories, with the maximum out-of-pocket limit raised according to each income level. This is a review to create a more detailed system design that reflects ability to pay. The increases will be implemented in two stages as a measure to mitigate drastic changes.
Review of the outpatient special provision for those aged 70 and over (from August 2026)
What changes: The outpatient special provision applicable to individuals aged 70 and over will be reviewed. This measure aims to reduce the insurance premium burden for all generations of insured individuals, while minimizing the impact on low-income elderly individuals, from the perspective of mutual support across all generations based on ability to pay rather than age.
Introduction of partially non-covered medical care (date to be determined by cabinet order within one year of promulgation)
What changes: A system of 'partially non-covered medical care' will be introduced, where a portion of the drug costs for treatments using drugs that are highly substitutable with OTC drugs will not be covered by insurance. This aims to achieve fairer burden sharing and ensure efficient benefits.
Reflection of financial income in premiums etc. for the medical care system for the advanced elderly (date to be determined by cabinet order within five years of promulgation)
What changes: In the medical care system for the advanced elderly, financial income such as dividends from listed stocks will be fairly reflected in the calculation of insurance premiums and the determination of co-payment ratios. To achieve this, financial institutions will be obligated to submit reports online. This aims to realize a fairer burden.
Expansion of reduction in per capita insurance premiums for children under the National Health Insurance System (from April 1, 2027)
What changes: Under the National Health Insurance System, the scope of the 50% reduction in per capita insurance premiums for children will be expanded from preschool children to those in their high school years. This aims to enhance support for the next generation, such as childbirth, and to promote prevention and health among the working-age population.
Clarification of the impact on household finances of long-term patients in the eligibility criteria for high-cost medical expense benefits (from August 1, 2025)
What changes: When determining the eligibility criteria for high-cost medical expense benefits, the impact on the household finances of long-term patients will be clarified in law to ensure it is appropriately considered. This is a measure to secure the provision of necessary medical care.
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