Japan to include elderly financial income in medical costs

Japan's Ministry of Health, Labour and Welfare plans to begin reflecting the financial income of elderly citizens in their medical insurance premiums and out-of-pocket costs starting in August 2029. Under a law to be promulgated in June 2026, financial institutions will submit statutory reports online to the medical insurance associations.

The reform aims to capture income from listed stock dividends and capital gains, including those not reported through tax returns. By August 2029, approximately 80% of annual statutory reports for the 2028 fiscal year will be reflected in premium and cost calculations. By August 2030, all financial income from 2029 statutory reports will be included.

While the government frames this as ensuring “fair burden according to ability to pay,” critics argue the move focuses on finding new revenue sources rather than addressing the root causes of rising medical expenditures. Some suggest that instead of refining income tracking, the system should address the gap between the 10% standard co-payment for those aged 75 and over and the 30% standard for the working-age population.