** Benefits in parentheses are paid to dependents.
If you have received medical care for a nonoccupational sickness or injury using your health insurance card
Medical Care Benefits (Dependents' Medical Care Expenses)
70-90% 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 (Dependents' Medical Care Expenses)
Patient pays a copayment of 360 yen/meal, with the remainder 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 and 370 yen/day (200 yen for patients with high degrees of medical necessity, 0 yen for patients with designated intractable diseases） in accommodation expenses. The rest is provided as benefits.
If you paid the entire medical care costs up front
Medical Care Expenses (Secondary Dependent Medical Costs)
Reimbursed based on requests if you receive medical care without a health insurance card due to unavoidable circumstances or purchase prosthetic equipment for treatment purposes
High-Cost Medical Care Benefits (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 for 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).
If your combined copayments for health insurance and long-term care insurance are high
High Agregate Cost for Long-term Care Service (High Aggregate Cost for Long-term Care Service)
When the aggregate total of copayments paid on medical and long-term care over a single year exceeds the maximum, the amount in excess of the maximum, corresponding to the ratios of medical and long-term care costs.
If you take at least four unpaid days off from work due to nonoccupational sickness or injury
Injury and Sickness Allowance
Amount equal to two-thirds of average standard monthly remuneration over the most recent 12-month period ÷ 30 paid per day off over 18 months, starting from the fourth day off
If you take unpaid time off from work for childbirth
Amount equal to two-thirds of the average standard monthly remuneration over the most recent 12-month period ÷ 30 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