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Health insurance system
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List of insurance benefits

Introduced below are the insurance benefits provided by the Society.

  • Description
  • FAQ

If you become sick or are injured

When benefits are paid Insurance benefits
If you have received medical care for a nonoccupational sickness or injury by using your health insurance card Medical Care Benefits
70-80% of medical care costs are provided as benefits-in-kind.
See here for details.
For meal and other expenses during hospitalization

Inpatient Meal Expenses, Impatient Living Expenses
Patient pays a copayment of 460 yen/meal, and the remainder is provided as benefits-in-kind.

  • ** For patients with intractable diseases or specific chronic diseases of children, the patient cost-sharing amount is 260 yen/meal.
  • ** For patients aged 65 or older hospitalized in a convalescent facility, the patient pays copayments of 460 yen/meal(360 yen for patients with high degrees of medical necessity, 260 yen for patients with designated intractable diseases) and 370 yen/day(The copayment for accommodation expenses for patients with designated intractable diseases is 0 yen) in accommodation expenses. The rest is provided as benefits-in-kind.(Accommodation expenses: Change on October 1, 2017)

See here for details.

If you paid the entire medical care cost up front
If you had prosthetic equipment prepared

Medical Care Expenses
The amount calculated based on your request will be paid if you receive medical care without a health insurance card due to unavoidable circumstances or to purchase prosthetic equipment or eyeglasses for treatment purposes.

See here for details.

If you used medical transportation services

Transportation Expenses
Amount calculated based on society's standards will be paid upon your request when transported as instructed by a doctor.

See here for details.

If you received nursing care on a visitation basis

Home-Visit Nursing Care Expenses
70-80% of medical care costs are provided as benefits-in-kind.

See here for details.

If you incurred high medical care costs

High-Cost Medical Care Benefits
When your copayment on medical care costs for a single case in one month exceeds the Cost-Sharing Maximum Amount in your income category, the excess amount is paid (Measures to reduce cost burden, for example, by calculating on the basis of total medical expenses paid by one household, are available).

See here for details.

Additional benefits:
When your copayment on medical care costs for a single case in one month exceeds 25,000 yen, the amount in excess of 25,000 yen is paid.

See here for details.

If you received non-insured associated medical care

Non-insured Associated Medical Care Expenses
Benefits-in-kind for 70–80% of regular medical care costs.

See here for details.

If you take time off from work due to sickness

When benefits are paid Insurance benefits
If you take at least four unpaid days off from work due to nonoccupational sickness or injury

Injury and Sickness Allowance
Amount equal to 85% of the average standard monthly remuneration over the most recent 12-month period ÷ 30 is paid per day off over 30 months, starting from the fourth day off.

See here for details.

Childbirth

When benefits are paid Insurance benefits
Childbirth after at least four months (85 days) of pregnancy

Childbirth and Childcare Lump-Sum Grant
Pays 500,000 yen/child.

See here for details.

If you take time off from work for childbirth

When benefits are paid Insurance benefits
If you take time off from work for childbirth
If you take unpaid time off from work for childbirth

Maternity Allowance
Amount equal to two-thirds of the average standard monthly remuneration over the most recent 12-month period ÷ 30 is 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.

See here for details.

Death

When benefits are paid Insurance benefits
Death due to nonoccupational reasons

Funeral Expenses/Funeral Costs
Pays 50,000 yen

See here for details.

After you leave your employer

When benefits are paid Insurance benefits
If you were receiving Injury and Sickness Allowance at the time you left your employer

Injury and Sickness Allowance

See here for details.

If you were receiving Maternity Allowance at the time you left your employer

Maternity Allowance

See here for details.

If childbirth occurred within six months after leaving the employer

Childbirth and Childcare Lump-Sum Grant

See here for details.

In the event of death within three months after leaving the employer

Funeral Expenses/Funeral Costs

See here for details.

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