Is this a bill? Do I have to pay?

No. The medical-expense notice tells you what your medical costs were; it is not a bill, and there is nothing to pay now. It is useful for the medical-expense deduction on a tax return, so keep it.

I don't file a tax return. Do I need this?

If you won't claim the medical-expense deduction, there is nothing to pay or submit. But keeping it as a record of the year's medical costs is handy if you later decide to claim.

A treatment I received is missing.

Visits after the notice's period (often late in the year) may roll into next year's notice or not appear. Keep those receipts and add them yourself at tax time. If an amount is clearly wrong, check with the insurer.

Can I throw away my receipts now?

For anything covered by this notice, keeping the notice is enough to claim the deduction even without receipts. But you still need receipts for visits not on the notice, so keep those until your tax return is done.

City hall

医療費のお知らせ: Japan Medical Expense Notice Explained

A document labelled 医療費のお知らせ or 医療費通知 is a summary, from your health insurer (協会けんぽ, a company health union, or municipal 国民健康保険), of the medical costs you paid during a period. It lists the months of treatment, the clinics or hospitals, and your out-of-pocket amounts. ⛔ It is not a bill and there is nothing to pay now. What matters is that you can use it as proof of medical spending when you claim the 医療費控除 (medical-expense deduction) on a 確定申告 (tax return). Instead of collecting and totalling every receipt, this notice lets you skip most of the 医療費控除 statement. Keep it; do not throw it away.

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Who receives it

Anyone enrolled in health insurance who saw a doctor during the year, sent by their insurer: 協会けんぽ or a company union for employees, or municipal 国民健康保険 for the self-employed and retired. Some insurers send one notice for the whole year, others every few months. Nationality does not matter, and it may list expenses for dependent family members together with yours.

What to do

1Confirm this is a notice (お知らせ), not a bill. There is nothing to pay now.
2If you plan to claim the 医療費控除 on a tax return, keep the notice (returns are filed the following February-March).
3When you file, use the notice in place of, or alongside, the 医療費控除 statement so you don't have to total each receipt by hand.
4For visits not on the notice (often October-December, outside its period), keep those receipts yourself and add them in.
5If something is clearly wrong (a treatment you never had), contact the insurer printed on the notice (協会けんぽ, your union, or the municipality).

About the deadline

There is no payment deadline. If you use it for the deduction, keep it until the tax-return window (generally about February 16 to March 15 of the following year). The 医療費控除 generally covers the out-of-pocket amount above 100,000 yen a year (this threshold varies with income). You can also file retroactively (a refund claim) within about five years from the year after the expenses.

Common misunderstandings

Is this a bill? Do I have to pay?: No. The medical-expense notice tells you what your medical costs were; it is not a bill, and there is nothing to pay now. It is useful for the medical-expense deduction on a tax return, so keep it.
I don't file a tax return. Do I need this?: If you won't claim the medical-expense deduction, there is nothing to pay or submit. But keeping it as a record of the year's medical costs is handy if you later decide to claim.
A treatment I received is missing.: Visits after the notice's period (often late in the year) may roll into next year's notice or not appear. Keep those receipts and add them yourself at tax time. If an amount is clearly wrong, check with the insurer.
Can I throw away my receipts now?: For anything covered by this notice, keeping the notice is enough to claim the deduction even without receipts. But you still need receipts for visits not on the notice, so keep those until your tax return is done.

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