Receiving medical care due to illness or injury
When the insured person (or dependent) is sick or injured, he / she will be presented with an insurance card at a hospital or clinic so that he / she can receive medical treatment such as medical examination / treatment / medicine if he / she bears part of the medical expenses.
Self-pay for hospitalization
/outpatients
Percentage of self-pay
| 70-74 years old |
20% burden * 30% of the burden is paid to active income earners
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|---|---|
| After entering elementary school-69 years old | 30% burden |
| Preschool | 20% burden |
Meal charges when hospitalized
The cost of meals when you are hospitalized will be borne by the patient himself / herself for the amount of money set for each meal. (Same amount for both insured and dependents) If the meal fee at the time of admission exceeds the prescribed amount per meal, the excess will be paid to the medical institution as "dietary medical expenses at admission"...
However, if you wish to have a special menu, you will have to pay the special charges for that as well as the special charges such as the difference in bed charges when you are hospitalized in a special room.
The standard cost of meals is not subject to high medical expenses.
Standard charge for meals at the time of hospitalization (per meal)
| General | ¥460 |
|---|---|
|
Low income (Households exempt from municipal tax) |
Hospitalization until the 90th day：¥210 Hospitalization after the 91st day：¥160 |
| Elderly recipients of low-income households | ¥100 |
When you receive medical care overseas.
If the insured / dependent receives medical treatment at an overseas medical institution, you may be able to receive medical treatment payment if you apply for part of the medical treatment cost you paid.
However, the Japanese insured card (health insurance card) cannot be used overseas, so if you receive medical treatment or medication at a local medical institution due to sudden illness or injury, you will have to pay the full medical expenses once and the medical institution will replace it. Pay the medical fee to the Health Insurance Society and apply for medical expenses after returning to Japan. Based on the application, we will pay the medical expenses calculated based on the "medical expenses deemed to have been treated in Japan" ("overseas medical expenses") from the Health Insurance Society. Whether or not it will be recognized as medical expenses will be judged based on the same standard as in Japan, so it will not be accepted except for "medical care that is approved by health insurance."
| Medical treatment that can be paid |
"Out of work" illnesses and injuries
* Not applicable to work-related illnesses / injuries and commuting accidents.
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|---|---|
| Scope of accepted medical treatment |
"Medical examination", "supply of drug or therapeutic material", "procedure / surgery and other treatment" necessary for the person who treats illness or injury
* All non-prescription over-the-counter medicines, treatments associated with orthodontics, use of materials not covered by health insurance, treatments / treatments not covered by health insurance in Japan, normal childbirth, health checkups, vaccinations, etc. are all covered. Outside In addition, medical treatment for overseas travel for medical treatment is not included in the overseas medical treatment expenses.
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Calculation and payment of overseas medical expenses
The health insurance association calculates the medical expenses based on the contents described in the medical treatment statement, based on the medical expenses when receiving medical treatment in Japan, and pays "self-payment" and "overseas medical treatment". In that case, compare the medical cost based on the domestic standard with the amount paid to the local medical institution and calculate the "lower amount" as the medical cost.
For the "Japanese currency conversion rate" used to calculate payments for overseas medical expenses, the foreign exchange conversion rate (sale rate) on the payment determination date is used. However, this conversion rate does not use the one for commercial transactions, but uses the rate when an individual converts yen into foreign currency.