HIROSHIMA — The Hiroshima District Court on June 17 denied full medical coverage for survivors of the atomic bombing of Hiroshima who now live in the United States.

The court turned down 13 plaintiffs’ demand for revoking earlier decisions by the state and Hiroshima prefectural governments that rejected their requests for full coverage under the Atomic Bomb Survivors Relief Law.

The plaintiffs, who survived the Aug. 6, 1945 atomic bombing and most of whom are in their 70s and 80s, argued that they should be able to receive full medical coverage even if they live abroad and receive treatment there.

In the ruling, Presiding Judge Keiichiro Umemoto said the law basically provides for treatment at designated medical institutions in Japan.

“Coverage is approved on the premise that both medical service and expenses are fair. We cannot ensure such fairness at medical institutions outside the country.”

The 13 plaintiffs included Atsushi Endo, who died last July at age 84 after serving as chairman of the U.S. Committee of Atomic Bomb Survivors.

Earlier Japanese court rulings were divided over whether full medical coverage should be extended to atomic bomb survivors who live overseas and seek treatment there.

The Osaka High Court in June 2014 upheld an Osaka District Court ruling that supported full coverage for South Korean victims, while the Nagasaki District Court in March the same year turned down similar survivors’ demand.

Under the law, which took effect in 1995, the Japanese government covers all medical expenses for survivors who receive treatment at designated medical institutions in Japan. The provision in principle does not cover expenses paid outside Japan.

In the suit, the state argued that it is difficult to provide full coverage to atomic bomb survivors who receive treatment overseas because each country has its own health-care system and insurance premiums and medical expenses differ from country to country.

Overseas atomic bomb victims can receive Japanese assistance if they undergo treatment in Japan. But many of them are too old or sick to visit Japan for treatment.

Separately, the state provides financial aid to atomic bomb survivors living abroad. The ceiling for the subsidy was raised from roughly 180,000 yen ($1,456) to 300,000 yen ($2,427) per year in April last year.