IBM Japan Health Insurance Association

IBM Japan Health Insurance Association

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  • japanese
  • English

Health insurance benefits

Measures are established to reduce the burden of medical care costs paid by members of health insurance when they visit the hospital for a cold or are hospitalized for childbirth.

List of health insurance benefits

Insurance benefits

Describes benefits available if you become sick or are injured

  • Benefits paid for nonoccupational sickness and injury
  • When you cannot use health insurance
  • System for payment of medical care costs

List of insurance benefits

Describes the benefits paid by the Society

  • If you become sick or are injured
  • If you take time off from work due to sickness
  • Childbirth
  • Death
  • After you leave your employer

If you become sick or are injured

Describes benefits available if you become sick or are injured

  • Medical Care Benefits
  • Meals during hospitalization

If you become sick or are injured due to the actions of another party

What to do if you are injured due to the actions of another party, as in the case of a traffic accident or contact with another person during athletic activities

  • Be sure to notify the Health Insurance Association.
  • If you have been in a traffic accident
  • Injury due to the actions of another party
  • If the cause is a workplace accident

When you incur high medical care costs

Describes benefits available when you incur high medical care costs.

  • High-Cost Medical Care Benefits
  • If you want to make sure the amount you pay at the reception desk of the hospital will not exceed the Cost-Sharing Maximum Amount
  • How High-Cost Medical Care Benefits are calculated
  • If your copayment is reduced still further
  • If copayments for medical care and long-term care are high

When you receive medical care which requires payment of the difference

Describes benefits available when you receive medical care which requires payment of the difference

  • Non-insured Associated Medical Care Expenses
  • Combination of insured and non-insured medical care is permitted when certain conditions are met.
  • Treatment under evaluation
  • Patient-requested care
  • Elective treatment

If you paid the entire medical care cost up front

Describes benefits available if you paid the entire medical care cost up front.

  • If you paid the entire medical care cost up front
  • If you cannot walk to or between hospitals

If you receive medical care at home

Describes benefits available if you receive medical care at home

  • Home-Visit Nursing Care Expenses
  • Eligible persons

If you take time off from work due to sickness

Describes benefits available if you take time off from work due to sickness.

  • Injury and Sickness Allowance
  • Conditions for payment
  • Cases in which you are eligible to receive the Injury and Sickness Allowance and Maternity Allowance concurrently
  • If you become eligible for Disability Employees' Pension
  • If the cause is a workplace accident

Childbirth

Describes benefits available for childbirth.

  • Childbirth and Childcare Lump-Sum Grant
  • We encourage you to take advantage of systems available to reduce the amount paid at the hospital.
  • Childbirth
  • The maternity medical care compensation scheme

If you take time off from work for childbirth

Describes benefits available if you take time off from work for childbirth.

  • Maternity Allowance
  • Payment period
  • Cases in which you are eligible to receive the Maternity Allowance and Injury and Sickness Allowance concurrently
  • You are exempt from paying insurance premiums during the period of childcare or similar leave.

Death

Describes benefits available in the event of death.

  • Funeral Expenses/Funeral Costs
  • “Bereaved family members supported by the insured person”
  • If the cause is a workplace accident

When you receive benefits from national or local government

Describes benefits available if you take time off from work for childbirth.

  • Maternity Allowance
  • Payment period
  • Cases in which you are eligible to receive the Maternity Allowance and Injury and Sickness Allowance concurrently
  • You are exempt from paying insurance premiums during the period of childcare or similar leave.

Benefits for the elderly

Describes benefits available in the event of death.

  • Funeral Expenses/Funeral Costs
  • “Bereaved family members supported by the insured person”
  • If the cause is a workplace accident

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