IBM Japan Health Insurance Association

IBM Japan Health Insurance Association

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When you receive benefits from national or local government

In some cases, national or local government may cover all or part of medical care costs by drawing on public funds, depending on factors such as type of illness or patient condition.

Cases in which medical care costs are paid from public funds

Cases including the following are eligible for payment of medical care costs by public funds. For details, consult with your doctor when receiving treatment for an eligible condition or when hospitalized.

  • Cases involving national responsibility, such as medical care for war sick and wounded and atomic-bomb survivors
  • Cases involving control of infectious diseases
  • Cases involving social welfare benefits, such as medical care for those with physical disabilities
  • Illnesses caused by pollution attributable to corporate activities
  • Treatment of serious illnesses, medical care for research purposes, etc.

Medical care benefits provided by local governments independently

In addition to national systems that use public funds to cover medical care costs, local governments, including prefectures and municipalities, provide numerous benefits. Primary examples include subsidies for medical care for infants, subsidies for medical care for those with physical or mental disabilities, and subsidies for medical care for the aged. The nature of the subsidies and other details vary by prefecture or municipality. Check with the relevant office within your prefecture or municipal government for more information.

Main types of medical care eligible for public funding

Medical care eligible for health insurance benefits is limited to types certified in advance by the government of Japan as eligible for insurance coverage and recognized as safe and effective medical treatments.

Law Details Coverage

Law for Special Aid to the Wounded and Sick Retired Soldiers

  • Benefits provided for: Injury or illness sustained in official duties
  • Rehabilitation: Medical care needed to enable those with disabilities to return to active roles in society

Entire amount covered by national treasury
(No copayment)

Medical Treatment for Atomic Bomb Victims Act

  • Treatment authorized for: Illnesses due to atomic-bomb exposure

Law Concerning the Prevention of Infectious Diseases and Medical Care for Patients Suffering Infectious Diseases

  • New infectious diseases: Infectious diseases individually designated for emergency response by the prefectural governor with guidance and advice from the Minister of Health, Labour and Welfare

Entire amount covered by public funds
(A copayment applies in some cases)

  • Tuberculosis (appropriate treatment): Ordinary patients

Priority given to use of health insurance
(Copayment: 5% of medical care costs)

Implementation guidelines for medical aid for specific chronic diseases

Cases of so-called “intractable diseases” whose causes are unclear, for which no treatment methods have been established, and that have aftereffects (e.g., Behcet’s disease, Crohn’s disease)

Priority given to use of health insurance
A system of differing maximum costs applies depending on the income of the chief income earner in the household (per institution, per month; no copayment for low-income individuals)

Child Welfare Law
(Specific chronic diseases of children)*2

Chronic diseases affecting children (under 20 years of age; must have received benefits for the treatment before the age of 18) and requiring extended treatment (e.g., cancer, asthma, collagen disease)

Services and Support for Persons with Disabilities Act*3
(Treatment supporting self-sufficient living)

  • Medical aid for children with potential disabilities: Medical care for children less than 18 years of age with physical disabilities
  • Rehabilitation: Medical care needed to enable those with disabilities to return to active roles in society
  • Outpatient psychological care: Outpatient care for those with mental disorders

Priority given to use of health insurance
In principal, the copayment is 10% of the medical care costs (persons with income at or above a certain level are not eligible for treatment in support of self-sufficient living)
Maximum copayment amounts apply for low-income individuals and persons requiring high-cost medical care on a continuing basis

Mental Health and Welfare Law

  • Involuntary commitment: Patients deemed to present the risk of harming themselves or others

Priority given to use of health insurance
(A copayment applies in some cases.)

Child Welfare Law

  • Medical aid for children with potential disabilities: Children less than 18 years of age with physical disabilities

Maternal and Child Health Law

  • Medical aid for premature infants: Premature infants requiring hospitalization

Public Assistance Law

  • Medical assistance:I Illness of or injury to needy persons

Law Concerning the Prevention of Infectious Diseases and Medical Care for Patients Suffering Infectious Diseases*1

  • Inpatient care
    • Type I infectious diseases:plague, Ebola hemorrhagic fever, etc.
    • Type II infectious diseases: tuberculosis, diphtheria, etc.

Preventive Vaccinations Law

  • Relief measures: Authorized victims of health conditions

Priority given to use of health insurance
(No copayment)

Law Concerning the Relief of Atomic Bomb Survivors

  • General medical treatment: Illness or injury affecting atomic-bomb survivors

Implementation guidelines for medical aid for specific chronic diseases

Patients with intractable diseases, specifically subacute myelo-optico-neuropathy, fulminant hepatitis, serious chronic pancreatitis, and prion disease, and patients with serious conditions markedly impeding everyday living

Child Welfare Law
(Specific chronic pediatric conditions)

Serious chronic diseases and hemophilia affecting children (under 20 years of age; must have received benefits for the treatment before the age of 18)

Pharmaceuticals and Medical Devices Agency

Persons suffering from harmful side effects despite proper use of drugs or biological products

Act on Asbestos Health Damage Relief (asbestos health damage relief system)

  • • Relief benefits: Patients with designated conditions of health damage due to asbestos (mesothelioma, lung cancer) not eligible for workers’ compensation, etc.

Act on Compensation, etc. of Pollution- related Health Damage

Patients with designated conditions attributable to serious cases of air pollution, water pollution, etc.

Entire amount covered by polluter
(No copayment)

  • *1 The Law Concerning the Prevention of Infectious Diseases and Medical Care for Patients Suffering Infectious Diseases was amended in April and June 2007 to integrate it with the earlier Tuberculosis Prevention Law.
  • *2 The copayment system dependent on income was implemental on April 1, 2005 due to revisions in the Child Welfare Law.
  • *3 With the enactment of the Services and Supports for Persons with Disabilities Act, the system of medical care covered by public funds for disabilities was shifted to a system of treatment supporting self-sufficient living in April 2006.

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