For elementary and junior high school students, outpatient visits cost up to ¥200 each, and hospital stays cost only meals
Medical Expense Subsidy for Children in Compulsory Education (Maru-Ko) / Tokyo Metropolitan Government (carried out by the municipality)
Medical Expense Subsidy for Children in Compulsory Education (Maru-Ko)TokyoElementary and junior high school students
For elementary and junior high school students, outpatient visits cost up to ¥200 each, and hospital stays cost only meals
Cost per outpatient visitUp to ¥200Hospital stays cost only meals; no cost at pharmacies
- Some municipalities have no cost at the counter
This Tokyo program reduces the out-of-pocket cost when elementary and junior high school students see a medical institution. It covers children from the first April 1 after the day following their 6th birthday until the first March 31 on or after their 15th birthday.
Under the TMG rules, up to ¥200 per outpatient visit remains to be paid, and for hospital stays you pay only the meal cost (the standard meal cost during hospitalization). There is no cost for pharmacies or home-visit nursing. The scope of the subsidy differs by municipality, and in some municipalities there is no cost at the counter.
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
Children from the first April 1 after the day following their 6th birthday to the first March 31 on or after their 15th birthday
Notes
Apply at the office of the municipality where you live to receive a Maru-Ko medical certificate.At each visit, show your My Number health insurance card (or eligibility certificate) and the medical certificate at the counter.If you receive care at a medical institution outside Tokyo or at one that does not handle this program, pay the out-of-pocket cost first, then take the receipt to the municipality and apply for a refund.Health checkups, vaccinations, room charge differences, and the extra first-visit fee for seeing a large hospital without a referral letter are not covered.If an injury at school is covered by the Japan Sport Council's Disaster Mutual Aid Benefit, those medical costs are not covered.Children without medical insurance, children receiving public assistance, and children placed in facilities by official placement are not covered.The medical certificate is renewed every October 1.