List of insurance benefits

Health Insurance System

An Insured Individual Benefits List

If you become sick or are injured

edical Care Benefits	70% of the medical expenses for both out-patient and in-patient care
High Agregate Cost for Long-term Care Service	80% of the medical expenses for both out-patient and in-patient care * However, 70% for individuals age 70 to age 74 who are earners of income comparable to active service.
High Agregate Cost for Long-term Care Service	70% of the medical expenses for treatment within the scope of health insurance if combined with non-covered treatment
Medical Care Expenses	A standard amount will be paid if you submit a claim to the Health Insurance Society after paying expenses yourself.
High-Cost Medical Care Benefits	If, for a single medical expense incurred in a given month, your out-of-pocket cost exceeds the applicable cap, the excess amount will be reimbursed. (For low-income individuals and those aged 70–74, different caps apply.) When the total out-of-pocket expenses incurred over one fiscal year (August 1 of the previous year through July 31) exceed the "Annual Maximum" for the income bracket as of the standard date (July 31), in principle, the amount exceeding the ceiling will be paid as "High-Cost Medical Care Expenses."
Non-insured Associated Medical Care Expenses	If there are two or more cases of out-of-pocket payments of ¥21,000 or more during the same month and in the same household, and the combined total exceeds the maximum amount, the excess amount
Copayment refund/ Aggregated high medical expenses additional amount (additional benefit)	The amount resulting from deducting ¥20,000 from the out-of-pocket amount is paid.
Combined total of high-cost nursing care expenses	If the combined total of out-of-pocket payments of medical and nursing care expenses for one year exceeds the maximum limit, the excess amount proportionally divided according to the ratio of medical and nursing care
In-patient dietary treatment expenses/ In-patient daily living treatment expenses	The amount of meal expenses exceeding ¥550 for each meal, for up to three meals per day. (In the case of in-patient daily living treatment expenses) The amount of housing expenses exceeding ¥430 per day * There are measures available to mitigate the burden on low income earners, etc.
Home-visit Nursing Expenses	70% of the stipulated expenses
ome-visit Nursing Expenses Additional amount (additional benefit)	The amount resulting from deducting ¥20,000 from the out-of-pocket amount is paid.
Transportation Expenses	The actual expenses within the range of the standard amount calculated by the Health Insurance Society

If you take time off from work due to sickness

Injury and Sickness Allowance	Amount equal to two-thirds of the average standard monthly remuneration over the most recent 12-month period÷30 paid per day off over 18 months,starting from the fourth day off

Childbirth

Maternity Allowance	Amount equal to two-thirds of the average standard monthly remuneration over the most recent 12-month period÷30 paid per day off over the period starting from the 42nd day prior to the anticipated due date (98th day prior to anticipated due date for multiple births;also paid for days after anticipated due date if the birth is late) through the 56th day after delivery
Lump-sum birth/childcare benefit	Pays ¥500,000/child When deliver it at hospitals of a case of the delivery within number 22 weeks and the obstetrics medical care compensation system non-participation in a week for gestational ages;¥488,000)
Lump-sum birth/childcare benefit Additional amount (additional benefit)	Pays ¥120,000 per child

Death

Funeral Expenses/ Funeral Costs	Pays ¥50,000
Burial fees additional amount (Additional benefit)	One month of the standard monthly compensation (¥360,000 max.)

Family (Dependent) Benefits List

When an individual has suffered an illness or injury

Family medical treatment expenses	70% of the medical expenses for both out-patient and in-patient care
Family medical treatment expenses (Children before entry to elementary school/Individuals age 70 to age 74)	80% of the medical expenses for both out-patient and in-patient care * However, 70% for individuals age 70 to age 74 who are earners of income comparable to active service.
Expenses for combined covered/ non-covered medical care*	70% of the medical expenses for treatment within the scope of health insurance if combined with non-covered treatment
Medical treatment expenses*	A standard amount will be paid if you submit a claim to the Health Insurance Society after paying expenses yourself.
High-Cost Medical Care Benefits	If, for a single medical expense incurred in a given month, your out-of-pocket cost exceeds the applicable cap, the excess amount will be reimbursed. (For low-income individuals and those aged 70–74, different caps apply.) When the total out-of-pocket expenses incurred over one fiscal year (August 1 of the previous year through July 31) exceed the "Annual Maximum" for the income bracket as of the standard date (July 31), in principle, the amount exceeding the ceiling will be paid as "High-Cost Medical Care Expenses."
Aggregated high medical expenses	If there are two or more cases of out-of-pocket payments of ¥21,000 or more during the same month and in the same household, and the combined total exceeds the maximum amount, the excess amount
Additional amount for family medical treatment expenses/ Additional amount for aggregated high medical expenses(additional benefit)	The amount resulting from deducting ¥20,000 from the out-of-pocket amount is paid.
Combined total of high-cost nursing care expenses	If the combined total of out-of-pocket payments of medical and nursing care expenses for one year exceeds the maximum limit, the excess amount proportionally divided according to the ratio of medical and nursing care
In-patient daily living treatment expenses	The amount of meal expenses exceeding ¥550 for each meal, for up to three meals per day. (In the case of in-patient daily living treatment expenses) The amount of housing expenses exceeding ¥430 per day * There are measures available to mitigate the burden on low income earners, etc.
Family home-visit nursing expenses	70% of all stipulated expenses
Family home-visit nursing care expenses Additional amount (additional benefit)	The amount resulting from deducting ¥20,000 from the out-of-pocket amount is paid.
Family transportation costs	The actual expenses within the range of the standard amount calculated by the Health Insurance Society

* When "expenses for combined covered/non-covered medical care," "treatment expenses," "in-patient dietary treatment expenses," or "in-patient daily living treatment expenses" are paid to a dependent, they are paid as "family medical treatment expenses."

When an individual has given birth

Family lump-sum birth/ childcare benefit	¥500,000 per child (¥488,000 if birth took place before 22 weeks or the individual gave birth at a hospital, etc., that is not a member of the Japan Obstetric Compensation System for Cerebral Palsy)
Family lump-sum birth/childcare benefit Additional amount (additional benefit)	¥120,000 per child

When an individual has died

Family member burial fees	Uniform ¥50,000
Family member burial fees additional amount (Additional benefit)	Uniform ¥50,000

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