If you paid the entire medical care cost up front
If you go to a medical institution without a health insurance card due to a sudden illness, or if you buy a corset or pediatric glasses, you will have to pay all medical expenses. The reimbursed medical expenses will be reimbursed as medical expenses if you apply to the health insurance association with the necessary documents for insurance medical treatment.
When you see a doctor without a health insurance card due to a sudden illness.
If you receive medical treatment without a health insurance card due to a sudden illness while traveling, or if you are forced to go to a clinic that is unavoidably covered by insurance, the amount assessed based on the treatment method and fee approved by health insurance. We will refund 70% of the amount. In this case, 70% of the actual cost may not be paid.
Please make sure to receive the receipt when requesting medical expenses, as a receipt is required.
- Medical treatment payment application
EXCEL - receipt(original)
- Medical fee statement(original)
* The medical treatment statement is not the "medical statement" issued together with the receipt.
Therapeutic equipment such as corsets
The only items that can be provided with therapeutic braces are those that the doctor has determined to be necessary for treatment and were created under the direction of the doctor.
Benefits are not provided for the purposes of daily life, for beauty purposes, or for those created after fixing symptoms.
Also, if the service life specified for each orthosis has not passed, re-creating with health insurance may not be permitted.
- Medical treatment payment application
EXCEL* Please apply monthly and at each medical institution. - receipt (Breakdown of treatment equipment)(original)
- Doctor's consent form (original)
* Application for shoe-shaped orthosis is a photograph of the orthosis (which can be confirmed to be the actual item worn by the patient)
Acupuncture, cucumber, massage fee
Only with the approval of the insurer, you can get a refund of the standard fee from the health insurance association for the operation fee of the acupuncture, massaging and masseuse.
Please note this!
- Acupuncture and acupuncture：Only when the main symptom is chronic pain such as neuralgia, low back pain, 50 shoulders, rheumatism, cervical arm syndrome, sequela of cervical sprain.
* Insurance is not applicable if the medical treatment for the target disease has been taken (also used together).
- Massage：Only for patients with muscle paralysis or joint contracture who require medical massage.
* Insurance is not applicable for fatigue recovery and comfort purposes.
- Health Insurance Insured Person Claim for Payment of Medical Care Costs Family Member(acupuncture)
EXCEL - Health Insurance Insured Person Claim for Payment of Medical Care Costs Family Member(massage)
EXCEL - Medical treatment consent form(Every 6 months)(original)
- Receipt with treatment details(original)
Eyeglasses for treatment of pediatric amblyopia, etc.
"Eyeglass and contact lenses used for the treatment of refractive correction after amblyopia, strabismus and congenital cataract in children" are eligible for payment.
Eyeglasses for simple vision correction such as myopia and astigmatism are not covered by insurance.
In addition, the insurance does not apply to eye patches and Fresnel film prisms used to correct strabismus.
If your doctor gives you instructions for wearing glasses, check "is it covered by health insurance?" And ask them to complete the documents.
Target person and benefit amount
| Target person | Dependents under 9 |
|---|---|
| Benefit amount |
Auxiliary equipment items based on the provisions of the Child Welfare Act Up to "Low-sighted glasses (¥36,700)" "Contact lenses (¥15,400 / 1 piece)" x 1.06, 70% of the actual amount paid will be covered by insurance (80% before elementary school). |
| Buy ¥30,000 glasses | ¥30,000 x 0.7 = ¥21,000 |
|---|---|
| Buy ¥50,000 glasses | ¥38,902 (upper payment ¥36,700 x 1.06) x 0.7 = ¥27,231 |
About update
- Under 5 years old：Wearing therapeutic glasses before renewal for 1 year or more
- 5 years or older：Wearing therapeutic glasses for 2 years or more before renewal
- Health Insurance Insured Person Family Claim for Payment of Medical Care Costs
EXCEL - Documents that certify the receipt or the amount of expenses when you make and purchase therapeutic glasses
Fill in the following on the receipt (original)・The address is the name of the person (child)・"Glasses for amblyopia treatment (frame circle, lens circle)" and specific "provided"・The stated amount is the actual purchase amount including tax - Copies of instructions for medical spectacles, such as medical spectacles, to be provided by medical doctors
- Patient test results (glass prescription)(original)
When you get sick or injured abroad.
If you are sick or injured while traveling or staying abroad, and the cost is incurred by a medical institution, the cost will be calculated based on the medical treatment costs specified in Japan for health insurance.
Treatment costs may vary from country to country and may be less than what you paid.
If you travel for the purpose of medical treatment, you will not be eligible for benefits.
- Health Insurance Insured Person Family Claim for Payment of Medical Care Costs
EXCEL - Attending Physician's Statement (typeA)
EXCEL - Attending Medical fee Statement (typeB)
EXCEL - Attending Dentist's Statement
EXCEL - Agreement of Authorization
WORD - Original receipt received on site
- Documents showing overseas travel period (copy of passport, etc.)
- Translation of each attached document
About limbal support type corneal abnormal contact lenses.
From April 2018, if you purchase contact lenses due to eye aftereffects of Stevens-Johnson syndrome and toxic epidermal necrolysis, you will be eligible for payment.
| Maximum amount of payment | Up to ¥158,000 per contact lens |
|---|---|
| Benefit rate |
80% before elementary school 70% after entering elementary school-69 years old 70-80% depending on income depending on income |
|
Repurchase (In case of re-application) |
5 years after the last purchase
* Please contact the Health Insurance Society if you have lost or damaged due to a disaster and have purchased again.
|
- Medical treatment payment application
* Please contact the Health Insurance Society. - Copies of doctor's (insurance doctor's) treatment eyeglasses, contact lens preparation instructions, etc.
* Items with the name of the disease
- Copy of inspection results
* Not required if stated in the instruction sheet
- receipt
* The name and breakdown of the wearer
Blood cost for blood transfusion (live blood).
When you receive a blood transfusion, the blood cost will also be refunded and you can get a refund from the Health Insurance Society.
- Medical treatment payment application
* Please contact the Health Insurance Society. - Receipt (medical treatment) statement (original)
- Certificate (original) of the medical staff who recognized that blood transfusion was necessary
- Blood receipt (original)