Ako City: child medical expense subsidy
In Ako City, Hyogo Prefecture, the child medical expense subsidy covers outpatient care through the end of the fiscal year in which the child turns 15 (end of junior high school) and inpatient care through the end of the fiscal year in which the child turns 18 (end of high-school age). Income limit: yes. Co-payment: none. (As of April 1, 2025, Children and Families Agency survey.) There is no out-of-pocket charge for insured care, so it is effectively free.
Ako City does not meet coverage through age 18 and no income limit of the three conditions (coverage through age 18, no income limit, no co-payment). In Hyogo Prefecture, 22 of 41 municipalities meet all three.
Municipalities call this program by different names (小児医療費助成, こども医療費助成, 乳幼児医療費助成, 子育て支援医療). This site uses the national survey's term, "child medical expense subsidy".
- Covered until (Outpatient)
- Age 15(April 1, 2025)
- Covered until (Inpatient)
- Age 18(April 1, 2025)
- Income limit
- Yes(April 1, 2025)
- Co-payment
- No(April 1, 2025)
- Coverage through age 18
- No (outpatient to Age 15, inpatient to Age 18)(April 1, 2025)
- Population
- 44,179(Resident register, 2024)
- Share under 15
- 11.4%(2020 census)
For applications, refunds and visits outside the prefecture, check the official website of Ako City.
Child medical expense subsidy
| Item | Outpatient | Inpatient |
|---|---|---|
| Covered until | Age 15 through the end of the fiscal year in which the child turns 15 (end of junior high school) | Age 18 through the end of the fiscal year in which the child turns 18 (end of high-school age) |
| Income limit | Yes | Yes |
| Co-payment | No | No |
No change since April 1, 2024
Source: Children and Families Agency, Survey on Municipal Child Medical Expense Subsidies (municipal form, attachment 3) (As of April 1, 2025). Last checked September 24, 2026
The national survey records conditions as of April 1 and is published in December. Some municipalities have expanded coverage since then. Confirm the current conditions on the municipality's official website.
Frequently asked questions
Until what age does Ako City subsidize child medical expenses?
Outpatient care is covered through the end of the fiscal year in which the child turns 15 (end of junior high school) and inpatient care through the end of the fiscal year in which the child turns 18 (end of high-school age) (as of April 1, 2025).
There is no out-of-pocket charge for insured care, so it is effectively free.
Are high school students covered in Ako City?
Outpatient coverage ends through the end of the fiscal year in which the child turns 15 (end of junior high school), so high school students are not covered for outpatient care, but inpatient care is covered through the end of the fiscal year in which the child turns 18 (end of high-school age).
Does Ako City apply an income limit?
Yes (as of April 1, 2025).
Do the conditions differ between outpatient and inpatient care in Ako City?
Yes. Outpatient care is covered through the end of the fiscal year in which the child turns 15 (end of junior high school) (income limit: yes; co-payment: no); inpatient care is covered through the end of the fiscal year in which the child turns 18 (end of high-school age) (income limit: yes; co-payment: no).
Has Ako City changed its conditions since last year?
No. The national surveys as of April 1, 2024 and April 1, 2025 record the same conditions.
How does Ako City compare with other municipalities in Hyogo Prefecture?
Ako City does not meet coverage through age 18 and no income limit of the three conditions (coverage through age 18, no income limit, no co-payment). In Hyogo Prefecture, 22 of 41 municipalities meet all three.
If I move out of Ako City, do the same conditions apply?
No. The subsidy is run by the municipality you live in, so the new municipality's conditions apply. Check its page on this site, and confirm the procedure on that municipality's official website.
Municipalities of similar size in Hyogo Prefecture: Miki City, Tatsuno City, Tamba City, Ono City, Minamiawaji City, Kasai City, Awaji City, Sumoto City
Nursery and after-school club waiting lists in Ako City
Ako City had 0 children on the nursery waiting list as of April 1, 2026 (403 applicants, 381 enrolled; 6 waiting a year earlier). After-school clubs had 0 children waiting as of May 1, 2026 (preliminary; 575 registered).
| Item | Value | As of |
|---|---|---|
| Nursery waiting list | 0 | Apr 1, 2026 |
| Waiting list a year earlier (April 1, 2025) | 6 | Apr 1, 2025 |
| Nursery applicants | 403 | Apr 1, 2026 |
| Children enrolled in nurseries | 381 | Apr 1, 2026 |
| After-school club waiting list | 0 | May 1, 2026 (prelim.) |
| After-school club registrations | 575 | May 1, 2026 (prelim.) |
"Waiting" follows the national definition: applicants not enrolled, excluding those on parental leave, those who want only a specific facility, and those who have paused their job search. Zero does not guarantee a place at a preferred facility. After-school club figures are preliminary and may be revised.
Source: Children and Families Agency, Summary of Nursery Care Status (April 1, 2026) / Children and Families Agency, Status of After-School Clubs (May 1, 2026, preliminary)
Parks, libraries, community centers and nursery schools in Ako City
Ako City has 51 urban parks (190.5 ha), or 44.3 m² per resident (Rank 7 of 41 in the prefecture). It has 1 libraries, 9 community centers, 7 nursery schools and 10 elementary schools.
Urban parks: MLIT inventory as of March 31, 2025. Libraries and community centers: e-Stat, 2021. Nursery and elementary schools: e-Stat.
| Item | Value | Rank in prefecture | As of |
|---|---|---|---|
| Urban parks | 51 | Rank 17 of 41 in the prefecture | Mar 31, 2025 |
| Urban park area | 190.5 ha | — | Mar 31, 2025 |
| Urban park area per residentDivided by the population of the city-planning area (MLIT's calculation) | 44.3 m² | Rank 7 of 41 in the prefecture | Mar 31, 2025 |
| Libraries | 1 | Rank 27 of 41 in the prefecture | 2021 |
| Community centers | 9 | — | 2021 |
| Nursery schools | 7 | Rank 11 of 41 in the prefecture | 2023 |
| Kindergartens | 11 | — | 2024 |
| Elementary schools | 10 | — | 2024 |
Source: MLIT, Inventory of Urban Parks (end of FY2024, as of March 31, 2025) / e-Stat, Statistical Observations of Municipalities 2026 (Statistics Bureau of Japan)
Population, share of children, net migration and doctors in Ako City
- PopulationResident register, 2024
- 44,179Rank 18 of 41 in the prefecture2024
- Share under 15
- 11.4%Rank 26 of 41 in the prefecture2020 census
- Share 65 and over
- 32.9%2020 census
- Share of foreign residents
- 0.8%2020 census
- Net migration (move-ins minus move-outs)2024. A positive number means more people moved in than moved out
- -212Rank 23 of 41 in the prefecture2024
- Births per 1,000 residents
- 4.5Rank 27 of 41 in the prefecture2023
- Nursery schools
- 72023
- Nursery schools per 1,000 children under 15
- 1.34Rank 11 of 41 in the prefecture2023
- Kindergartens
- 112024
- Elementary schools
- 102024
- Doctors per 10,000 residents
- 25.6Rank 12 of 41 in the prefecture2022
- Clinics per 10,000 residents
- 8.82023
- General hospitals
- 42023
- Owner-occupied homes
- 76.1%2023
- Floor area per dwelling
- 121.0 m²2023
- Fiscal strength indexAbove 1 means local tax revenue covers standard spending
- 0.66Rank 18 of 41 in the prefecture2022
- Restaurants
- 2052021
Source: e-Stat, Statistical Observations of Municipalities 2026 (Statistics Bureau of Japan)
"—" means e-Stat has no value for this item (the Housing and Land Survey does not cover towns and villages).
Compare with similar-sized municipalities in Hyogo Prefecture
| Municipality | Population | Outpatient until | Income limit | Co-payment (outpatient / inpatient) | Nursery waiting list |
|---|---|---|---|---|---|
| Ako City | 44,179 | Age 15 | Yes | No / No | 0 |
| Miki City | 73,091 | Age 18 | No | No / No | 0 |
| Tatsuno City | 72,271 | Age 18 | No | No / No | 0 |
| Tamba City | 60,033 | Age 18 | No | No / No | 0 |
| Ono City | 46,825 | Age 18 | No | No / No | 0 |
| Minamiawaji City | 43,732 | Age 18 | Yes | No / No | 0 |
| Kasai City | 41,455 | Age 18 | No | No / No | 0 |
| Awaji City | 41,364 | Age 18 | Yes | Yes / Yes | 0 |
| Sumoto City | 40,767 | Age 18 | Yes | No / No | 0 |
Outpatient age limit, income limit and co-payment are the national survey values as of April 1, 2025.
Page updated: . You may quote this table. Please credit Machishirabe and the original survey.