Act on Assurance of Medical Care for Elderly People

An Association of Medical Care Systems for the Elderly Aged 75 and older or the NHI federation must, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, report the status of services pertaining to Old-old Medical Care (in the case of an Association, including the status of services reported by a Municipality pursuant to the provisions of the following paragraph to the head of the Association (in the case of an Association that has a board of directors in place of a head pursuant to the provisions of Article 287-3, paragraph (2) of the Local Autonomy Act as applied mutatis mutandis pursuant to Article 291-13 of that Act, the board of directors; the same applies in the following paragraph)) to the Prefectural Governor.

A Municipality, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare, must report the status of its services pertaining to Old-Old Healthcare to the head of an Association of Medical Care Systems for the Elderly Aged 75 and older.

The mayor of a municipality (including the head of a special ward and, in the case of a designated city under Article 252-19, paragraph (1) of the Local Autonomy Act, a ward head or a general ward head) may, pursuant to the provisions of the Municipal Ordinance of the municipality, certify free of charge, to an Association of Medical Care Systems for the Elderly Aged 75 and older or a person who receives old-old medical care benefit, matters concerning the family register of the insured or a person who was insured.

If the Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary in relation to eligibility as an insured, a medical care benefit for the old-old, and insurance premiums, it may order the insured, the spouse of the insured, or the householder or any other member or former member of the household to which the insured belongs to submit or present a document or any other item, or may have its official ask them questions.

A Municipality, when it finds it necessary in relation to the collection of insurance premiums, may order the insured, the spouse of the insured, or the householder or any other member or former member of the household to which the insured belongs to submit or present a document or any other article, or may have its personnel question such person.

The provisions of Article 16-10, paragraph (2) apply mutatis mutandis to questions pursuant to the provisions of the preceding two paragraphs, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding two paragraphs.

When an Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary in relation to the qualifications of insured, old-old medical care benefit, and insurance premiums, it may request a Municipality or other public agencies or Pension Insurers to provide access to necessary documents or to provide necessary materials, or may request banks, trust companies, other institutions, employers of the insured, or other relevant persons to make a report, with regard to the matters necessary to confirm that the grounds on which the insured received old-old medical care benefit arose from the act of a third party, the status of assets or income of the insured, the spouse of the insured, or the head of the household to which the insured belongs or other members of that household, or the status of payment of an Old Age, etc., pension benefit prescribed in Article 107, paragraph (2) to the insured.

If a Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary in relation to eligibility as an insured, it may request other Association of Medical Care Systems for the Elderly Aged 75 and older and insurers (or municipalities in the case of national health insurance programs) to provide necessary materials, including the names and addresses of the insured and subscribers of medical care for the elderly provided by other Association of Medical Care Systems for the Elderly Aged 75 and older (or the insured domiciled within the area of the relevant municipality in the case of national health insurance programs), and the name and location of the applicable place of business as prescribed in Article 3, paragraph (3) of the Health Insurance Act.

A Municipality, when it finds it necessary in relation to the collection of insurance premiums, may request public agencies or Pension Insurers to provide access to necessary documents or to provide necessary materials, or may request a report from banks, trust companies, other institutions, employers of the insured, or other relevant persons, with regard to the status of assets or income of the insured, the spouses of the insured, or the head of the household or other members of the household to which the insured belongs, or the status of payment of an Old Age, etc., pension benefit as prescribed by the Article 107, paragraph (2) to the insured.