From elementary school through high school age, no medical co-payment at the counter, not even the ¥200 per outpatient visit
Medical Expense Subsidy for Compulsory-Education-Age Children and Medical Expense Subsidy for High School-Age Children (city covers the co-payment) / Akiruno City
Medical Expense Subsidy for Compulsory-Education-Age Children and Medical Expense Subsidy for High School-Age Children (city covers the co-payment)Akiruno CityNo income limitMedical certificate application required
Up to high school age, ¥0 at the counter, not even ¥200
Health insurance co-payment¥0The city also pays the ¥200 per outpatient visit left under the Tokyo program
- Elementary and junior high school students (Maru-Ko) and high school-age children (Maru-Sei)
- Meal costs during a hospital stay and items not covered by insurance are excluded
Under the Tokyo program, elementary and junior high school students (Maru-Ko) and high school-age children (Maru-Sei) still pay up to ¥200 per outpatient visit. Akiruno City pays this ¥200 for you. As a result, you do not pay the health insurance co-payment at the counter (meal costs during a hospital stay and similar items are not covered). There is no income limit. You need to apply for a medical certificate (iryōshō). In principle it can be used from the date you apply. If you moved into the city, apply within 30 days from the day after your move-in date and you can use it from the move-in date.
Nationality and residence status
The official page (checked in October 2026) sets no condition on nationality or residence status that we found. Eligibility follows the official conditions, not the language of this page; many programs require resident registration in the municipality.
Who is eligible
Elementary and junior high school students living in the city (Maru-Ko), and children from the first April 1 on or after their 15th birthday until the first March 31 on or after their 18th birthday (Maru-Sei)
Notes
Maru-Sei (medical expense subsidy for high school-age children) also has no ¥200 co-payment per outpatient visit: https://www.city.akiruno.tokyo.jp/kosodate/0000016466.html
From October 2025, the income limit was removed across all of Tokyo (the city had already been issuing medical certificates to people above Tokyo's income limit before that).