Koto Ward: child medical expense subsidy
In Koto Ward, Tokyo, the child medical expense subsidy covers both outpatient and inpatient care through the end of the fiscal year in which the child turns 18 (end of high-school age). Income limit: none. 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.
In Tokyo, 62 of 62 municipalities cover outpatient care through age 18, and Koto Ward is one of them.
Koto Ward is one of 44 municipalities in Tokyo that meet all three conditions: coverage through age 18 for both outpatient and inpatient care, no income limit, and no co-payment.
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 18(April 1, 2025)
- Covered until (Inpatient)
- Age 18(April 1, 2025)
- Income limit
- No(April 1, 2025)
- Co-payment
- No(April 1, 2025)
- Coverage through age 18
- Yes(April 1, 2025)
- Population
- 541,685(Resident register, 2024)
- Share under 15
- 12.7%(2020 census)
For applications, refunds and visits outside the prefecture, check the official website of Koto Ward.
Child medical expense subsidy
| Item | Outpatient | Inpatient |
|---|---|---|
| Covered until | Age 18 through the end of the fiscal year in which the child turns 18 (end of high-school age) | Age 18 through the end of the fiscal year in which the child turns 18 (end of high-school age) |
| Income limit | No | No |
| 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 Koto Ward subsidize child medical expenses?
Both outpatient and inpatient care are covered 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 Koto Ward?
Yes. Both outpatient and inpatient care are covered through the end of the fiscal year in which the child turns 18 (the end of the third year of high school).
Does Koto Ward apply an income limit?
No (as of April 1, 2025).
Do the conditions differ between outpatient and inpatient care in Koto Ward?
No. Both are covered through the end of the fiscal year in which the child turns 18 (end of high-school age); income limit: no; co-payment: no.
Has Koto Ward 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 Koto Ward compare with other municipalities in Tokyo?
In Tokyo, 62 of 62 municipalities cover outpatient care through age 18, and Koto Ward is one of them.
Koto Ward is one of 44 municipalities in Tokyo that meet all three conditions: coverage through age 18 for both outpatient and inpatient care, no income limit, and no co-payment.
If I move out of Koto Ward, 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 Tokyo: Edogawa Ward, Itabashi Ward, Suginami Ward, Hachioji City, Katsushika Ward, Machida City, Shinagawa Ward, Kita Ward
Nursery and after-school club waiting lists in Koto Ward
Koto Ward had 0 children on the nursery waiting list as of April 1, 2026 (14,670 applicants, 14,459 enrolled; 0 waiting a year earlier). After-school clubs had 43 children waiting as of May 1, 2026 (preliminary; 5,387 registered).
| Item | Value | As of |
|---|---|---|
| Nursery waiting list | 0 | Apr 1, 2026 |
| Waiting list a year earlier (April 1, 2025) | 0 | Apr 1, 2025 |
| Nursery applicants | 14,670 | Apr 1, 2026 |
| Children enrolled in nurseries | 14,459 | Apr 1, 2026 |
| After-school club waiting list | 43 | May 1, 2026 (prelim.) |
| After-school club registrations | 5,387 | 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 Koto Ward
Koto Ward has 179 urban parks (236.5 ha), or 4.4 m² per resident (Rank 24 of 62 in Tokyo). It has 11 libraries, 0 community centers, 180 nursery schools and 45 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 | 179 | Rank 16 of 62 in Tokyo | Mar 31, 2025 |
| Urban park area | 236.5 ha | — | Mar 31, 2025 |
| Urban park area per residentDivided by the population of the city-planning area (MLIT's calculation) | 4.4 m² | Rank 24 of 62 in Tokyo | Mar 31, 2025 |
| Libraries | 11 | Rank 49 of 62 in Tokyo | 2021 |
| Community centers | 0 | — | 2021 |
| Nursery schools | 180 | Rank 22 of 62 in Tokyo | 2023 |
| Kindergartens | 28 | — | 2024 |
| Elementary schools | 45 | — | 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 Koto Ward
- PopulationResident register, 2024
- 541,685Rank 9 of 62 in Tokyo2024
- Share under 15
- 12.7%Rank 11 of 62 in Tokyo2020 census
- Share 65 and over
- 21.0%2020 census
- Share of foreign residents
- 5.5%2020 census
- Net migration (move-ins minus move-outs)2024. A positive number means more people moved in than moved out
- +2,063Rank 40 of 62 in Tokyo2024
- Births per 1,000 residents
- 6.6Rank 15 of 62 in Tokyo2023
- Nursery schools
- 1802023
- Nursery schools per 1,000 children under 15
- 2.71Rank 22 of 62 in Tokyo2023
- Kindergartens
- 282024
- Elementary schools
- 452024
- Doctors per 10,000 residents
- 27.2Rank 24 of 62 in Tokyo2022
- Clinics per 10,000 residents
- 8.72023
- General hospitals
- 202023
- Owner-occupied homes
- 44.2%2023
- Floor area per dwelling
- 56.4 m²2023
- Fiscal strength indexAbove 1 means local tax revenue covers standard spending
- —2022
- Restaurants
- 1,8972021
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 Tokyo
| Municipality | Population | Outpatient until | Income limit | Co-payment (outpatient / inpatient) | Nursery waiting list |
|---|---|---|---|---|---|
| Koto Ward | 541,685 | Age 18 | No | No / No | 0 |
| Edogawa Ward | 693,570 | Age 18 | No | No / No | 75 |
| Itabashi Ward | 578,914 | Age 18 | No | No / No | 35 |
| Suginami Ward | 577,147 | Age 18 | No | No / No | 0 |
| Hachioji City | 559,083 | Age 18 | No | Yes / No | 43 |
| Katsushika Ward | 469,916 | Age 18 | No | No / No | 0 |
| Machida City | 430,170 | Age 18 | No | Yes / No | 90 |
| Shinagawa Ward | 412,786 | Age 18 | No | No / No | 0 |
| Kita Ward | 362,089 | Age 18 | No | No / No | 103 |
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.