Medical Expense Subsidy for Persons with Severe Disabilities

Niseko Town provides financial assistance to cover part of the medical expenses (for treatments covered by health insurance) for people with severe physical or mental disabilities.
To receive this subsidy, registration is required.
　After applying, eligible applicants will be issued a "Medical Expense Beneficiary Certificate for Persons with Severe Disabilities."

Reside in Niseko Town, have medical insurance, and meet one of the following conditions:
* For those aged 65 or older enrollment in the Late-Stage Elderly Medical Care System is required.

• Hold a Physical Disability Certificate (Grade 1–3). For Grade 3, only if the disability involves the heart, kidneys, respiratory organs, bladder, rectum, small intestine, liver, or immune system caused by HIV.
• Have a severe intellectual disabilities, or hold a Intellectual Disability Certificate (Category A).
• Hold a Mental Disability Health and Welfare Certificate (Grade 1).

*Since fiscal year 2021, income limits have been removed.

For medical services covered by health insurance, your personal payment will be as follows:
*Hospital meal fees and costs not covered by insurance (such as vaccinations, container fees for medicines, medical checkups, and medical certificates) must be paid in full by the patient.

(1) When visiting medical institutions in Hokkaido
At the reception of the medical institution, please present your My Number health insurance card (or proof of insurance coverage) together with your Medical Expense Recipient Certificate.
* In rare cases, you may be charged an incorrect amount for your out-of-pocket portion. In that case, please ask the medical institution to confirm with the Town Hall. If you have already paid the amount, please follow the reimbursement procedure described in (2) below.

(2) When visiting medical institutions outside Hokkaido
The certificate cannot be used outside Hokkaido. Please pay the full out-of-pocket amount at the medical institution first, and then bring the following items to the Town Hall to apply for reimbursement: Medical Expense Recipient Certificate, receipt, medical treatment statement (showing treatment points), and bankbook of the account where you wish to receive the transfer.

(3) When using acupuncture, moxibustion, massage, or osteopathic clinics
If you are unable to use your certificate, please follow the same reimbursement procedure as in (2).

(4) If you forget to bring your certificate
… Please follow the same procedure as in (2).

(5) When purchasing prosthetic devices or therapeutic eyeglasses
Please pay the full medical cost first (100%), then submit a Medical Expense Reimbursement Application to your health insurance provider. After you receive the insurer’s payment for their portion (70% or 80%), you can then apply for reimbursement at the Town Hall as described in (2).
*When submitting your application to your insurer, you must send the original receipt, so please make a copy for your records before sending it.
*You will receive a "Notice of Payment Decision" from your insurer. Be sure to bring it when you apply for reimbursement.

Items required for reimbursement

• Medical Expense Recipient Certificate
• Receipt
• Medical treatment statement (with treatment points listed)
• Personal seal (of the applicant or guardian)
• Bankbook (or cash card) of the account to receive payment

*Please note that reimbursement claims expire five years after the month following the date of treatment.

The certificate is valid until July 31 each year. A new certificate, valid from August 1, will be sent to your home in July after confirming your household income status.

For those aged 64
The certificate is valid until the day before your 65th birthday. To continue using the certificate after turning 65, you must enroll in the Late-Stage Elderly Medical Care Insurance. Please contact the person in charge for more details.

• Injuries or illnesses that occur at school are not covered by this medical assistance. Please do not present your recipient certificate at medical institutions in such cases. These are covered under the JSC (Japan Sport Council) Injury and Accident Mutual Aid Benefit System. For details on how to apply, please check with your child’s school.
• Those who receive medical expenses subsidies under Independent Living Support Medical Care or the Specified Disease Medical Care Subsidy, those programs take priority over this one.

In the following cases, please be sure to notify the Town Hall. Failure to report may result in losing eligibility for the subsidy.

• Change of address or name
• Moving out of Niseko Town
• Change in health insurance type, code, or number
• Loss of the recipient certificate
• Beginning to receive public assistance
• Any other changes to you registered information