Japan to count financial income in over-75s' medical costs from August 2029
In short
Japan's Ministry of Health, Labour and Welfare plans to start counting financial income, such as stock dividends, when setting medical co-payments and insurance premiums for people aged 75 and over from August 2029. It presented the schedule to a Social Security Council subcommittee on October 16. Financial institutions will be required to report dividend payments and similar income online from January 2029, and income from the NISA tax-free investment scheme will not be counted.
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Japan's Ministry of Health, Labour and Welfare plans to start reflecting the financial income of people aged 75 and over, such as stock dividends and capital gains, in their medical co-payments and insurance premiums from August 2029, Yomiuri Shimbun reported. The ministry presented the plan on October 16 to the medical insurance subcommittee of the Social Security Council, an advisory body to the health minister, according to several outlets. Kyodo News, carried by Tokyo Shimbun, reported that the subcommittee approved it. Yomiuri reported that the system will be fully implemented from August 2030. [ 1 , 2 , 3 , 4 , 5 , 7 , 8 ]
Co-payments for over-75s are in principle 10%, rising to 20% or 30% for those with higher incomes. Pension and salary income is already taken into account, Mainichi Shimbun reported. Financial income such as dividends, however, is not included in municipal taxable income records unless the recipient files a tax return, so it is not counted, and this has drawn criticism as unfair. TBS reported that the aim is to remove this sense of unfairness. [ 1 , 2 , 3 , 5 , 8 ]
Under the ministry's plan, financial institutions will be required from January 2029 to submit statutory reports on payments such as dividends online. Yahoo! News reported that they will go to the prefecture-level wide-area unions, while Mainichi said they will go to the insurers that run the medical system for people aged 75 and over. NHK reported that the reports will cover dividends from listed shares. The revised Health Insurance Act, enacted in May, contains the mechanism and set implementation within five years of promulgation. [ 1 , 2 , 4 , 5 , 8 ]
Reports for 2028, due by the end of January 2029, will be reflected in co-payments and premiums from August 2029. Reports for 2029, submitted between February 2029 and the end of January 2030, will be reflected from August 2030. Kyodo reported that the income information will be updated every year. Income from the NISA small-investment tax-exemption scheme will not be counted, Kyodo and Nikkei reported. [ 2 , 5 , 7 , 8 ]
Yahoo! News reported that the ministry will build a database of statutory reports (provisional name) linked with information from tax offices and local authorities to make premiums easier to calculate. It included 5.6 billion yen in its budget request for next fiscal year and will also subsidise system upgrades by local authorities and financial institutions. [ 2 ]
Why it matters
At present, dividends and similar income count only if the recipient files a tax return, and outlets reported criticism that this is unfair. Yomiuri reported that the change aims to set the burden according to ability to pay, so over-75s' financial income will be taken into account in their co-payments and premiums. Financial institutions and local authorities will also have to change their systems to supply the data.
Key facts
- The health ministry plans to reflect financial income of people aged 75 and over in medical co-payments and insurance premiums from August 2029. [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]
- Full implementation is set for August 2030. [ 1 , 2 ]
- Financial institutions will be required to submit dividend and similar payment information online from January 2029. [ 2 , 3 , 4 , 5 , 8 ]
- Financial income for 2028 will be reflected from August 2029; 2029 income will be reflected from August 2030. [ 2 , 5 , 8 ]
- Income from the NISA small-investment tax-exemption scheme will not be counted. [ 5 , 7 ]
- Co-payments for over-75s are in principle 10%, rising to 20% or 30% for those with higher incomes. [ 1 , 2 , 3 , 8 ]
- The ministry included 5.6 billion yen in its budget request for next fiscal year, partly to subsidise system upgrades by local authorities and financial institutions. [ 2 ]
Confirmed by several sources
- The health ministry plans to reflect financial income in medical co-payments and premiums for people aged 75 and over from August 2029. [ 1 , 2 , 3 , 4 , 5 , 7 , 8 ]
- Financial institutions will be required to report dividend and similar payment information online. [ 2 , 3 , 4 , 5 , 8 ]
- The plan was presented to the Social Security Council's medical insurance subcommittee on October 16. [ 1 , 2 , 3 , 5 , 7 , 8 ]
- NISA income will not be counted. [ 5 , 7 ]
- Financial income such as dividends is currently counted only if a tax return is filed. [ 1 , 2 , 3 , 5 , 8 ]
Still unclear
- Whether the subcommittee formally approved the plan. Only Kyodo, carried by Tokyo Shimbun, reported approval; other outlets said the ministry presented the plan.
- Where the statutory reports will be sent. Yahoo! News said prefecture-level wide-area unions, Kyodo said the local government side, and Mainichi said the insurers running the system for over-75s.
- The 5.6 billion yen budget request and the planned statutory report database. Reported by Yahoo! News only.
What local media are saying
Timeline, local time
- Yomiuri reports that the ministry has settled on an August 2029 start and will present the plan to the subcommittee that day. [ 1 ]
- TBS reports that the ministry presented the plan to an expert subcommittee. [ 3 ]
- Kyodo reports that the ministry has decided on the August 2029 start and that the subcommittee approved it. [ 5 ]
- Nikkei reports that NISA income will be excluded. [ 7 ]