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ssjup81
Joined: 15 Jun 2009
Posts: 664
Location: Adachi-ku, Tokyo, Japan
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 Posted: Fri Sep 02, 2016 6:11 pm Post subject: Insurance Coverage Question |
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I saw a couple of other threads, but I didn't want to hijack them.
Anyway, since moving to Tokyo, I've been paying into the NHI plan since the companies don't offer social insurance, like my Yamagata jobs did. It was good having social insurance up there. Being diabetic, having any kind of coverage is good.
So, anyway, there's a surgical procedure I want to have done and saw the doctor today regarding it. Unfortunately, it's not covered by NHI. What should I do? The doctor feels it would be good to have this procedure, but I can't pay like ¥2,000,000 out of pocket. What alternatives do I have? Is there a way to buy extra insurance to help with the costs?
I've been reading around online but nothing came up for this specific issue.
I apologize but my knowledge of health insurance is very limited as I never had it stateside after reaching a certain age. I was on my mother's company insurance but it was lost once I started working. |
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ssjup81
Joined: 15 Jun 2009
Posts: 664
Location: Adachi-ku, Tokyo, Japan
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| Posted: Sat Sep 03, 2016 4:53 pm Post subject: |
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| So no advice from anyone? ^^ |
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nomad soul
Joined: 31 Jan 2010
Posts: 11454
Location: The real world
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| Posted: Sat Sep 03, 2016 5:26 pm Post subject: |
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| There's always medical tourism. |
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ssjup81
Joined: 15 Jun 2009
Posts: 664
Location: Adachi-ku, Tokyo, Japan
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| Posted: Sat Sep 03, 2016 6:00 pm Post subject: |
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| nomad soul wrote: |
| There's always medical tourism. |
What do you mean by medical tourism? |
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taikibansei
Joined: 14 Sep 2004
Posts: 811
Location: Japan
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| Posted: Sat Sep 03, 2016 8:21 pm Post subject: |
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| ssjup81 wrote: |
| nomad soul wrote: |
| There's always medical tourism. |
What do you mean by medical tourism? |
Medical tourism refers to the practice of traveling to one of the countries where treatment for many medical conditions is lower than that found in more developed countries. Thailand is a good example of this--apparently (I have never done it) people will travel there just to have surgery done, as it's supposedly much less expensive there for most procedures.
Regarding your OP, why is the procedure not covered? Is it because it's still considered experimental? If so, there's a chance it will be covered after a few more years.
As you are a diagnosed diabetic and as this procedure is intended to treat your preexisting condition, there is most likely no way to buy extra insurance now to help with the costs. I say this only because unscrupulous insurers may try to sell you additional coverages saying that these will help defray costs for the procedure. In just about every case, any new insurance you get now would include an exclusion for all procedures designed to treat a preexisting condition, which would mean you'd get nothing.
My advice would be to clarify in writing that this particular procedure would be covered immediately upon signing the contract. If the insurance agent hesitates to provide written assurance, then walk away. And yes, maybe research medical tourism. |
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nomad soul
Joined: 31 Jan 2010
Posts: 11454
Location: The real world
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| Posted: Sat Sep 03, 2016 9:14 pm Post subject: |
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| taikibansei wrote: |
| My advice would be to clarify in writing that this particular procedure would be covered immediately upon signing the contract. If the insurance agent hesitates to provide written assurance, then walk away. And yes, maybe research medical tourism. |
Plus, when it comes to costly and/or risky surgery, get a second and even third medical opinion. |
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mitsui
Joined: 10 Jun 2007
Posts: 1562
Location: Kawasaki
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| Posted: Sun Sep 04, 2016 4:18 am Post subject: |
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Get insurance from Coop. Not only a supermarket but it has health insurance.
It saved my wife a ton of money. |
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ssjup81
Joined: 15 Jun 2009
Posts: 664
Location: Adachi-ku, Tokyo, Japan
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| Posted: Sun Sep 04, 2016 5:04 pm Post subject: |
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I was trying to find the site for Coop but didn't come across one.
I'm also going to assume that international health insurance wouldn't be good. |
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ssjup81
Joined: 15 Jun 2009
Posts: 664
Location: Adachi-ku, Tokyo, Japan
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| Posted: Sun Sep 04, 2016 5:21 pm Post subject: |
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| taikibansei wrote: |
| ssjup81 wrote: |
| nomad soul wrote: |
| There's always medical tourism. |
What do you mean by medical tourism? |
Medical tourism refers to the practice of traveling to one of the countries where treatment for many medical conditions is lower than that found in more developed countries. Thailand is a good example of this--apparently (I have never done it) people will travel there just to have surgery done, as it's supposedly much less expensive there for most procedures. |
Oh, makes sense.
| Quote: |
| Regarding your OP, why is the procedure not covered? Is it because it's still considered experimental? If so, there's a chance it will be covered after a few more years. |
Actually, there are different procedures and the lowest, and cheapest, level is covered, but it wouldn't be helpful for me. The more expensive one is the one the doctor and I agree would work best for my situation.
| Quote: |
| As you are a diagnosed diabetic and as this procedure is intended to treat your preexisting condition, there is most likely no way to buy extra insurance now to help with the costs. I say this only because unscrupulous insurers may try to sell you additional coverages saying that these will help defray costs for the procedure. In just about every case, any new insurance you get now would include an exclusion for all procedures designed to treat a preexisting condition, which would mean you'd get nothing. |
I was diagnosed in my early 20s. After being kicked off my mother's insurance all those years ago I was without insurance up until moving to Japan in my late 20s. It was nice being able to take medicine for a change. Stateside, I was always rejected because of the pre existing condition.
| Quote: |
| My advice would be to clarify in writing that this particular procedure would be covered immediately upon signing the contract. If the insurance agent hesitates to provide written assurance, then walk away. And yes, maybe research medical tourism. |
Good idea. |
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taikibansei
Joined: 14 Sep 2004
Posts: 811
Location: Japan
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| Posted: Sun Sep 04, 2016 8:37 pm Post subject: |
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| ssjup81 wrote: |
| Quote: |
| As you are a diagnosed diabetic and as this procedure is intended to treat your preexisting condition, there is most likely no way to buy extra insurance now to help with the costs. I say this only because unscrupulous insurers may try to sell you additional coverages saying that these will help defray costs for the procedure. In just about every case, any new insurance you get now would include an exclusion for all procedures designed to treat a preexisting condition, which would mean you'd get nothing. |
I was diagnosed in my early 20s. After being kicked off my mother's insurance all those years ago I was without insurance up until moving to Japan in my late 20s. It was nice being able to take medicine for a change. Stateside, I was always rejected because of the pre existing condition. |
Just so there's no confusion, the social health insurance system (社会保険) and the national health insurance system （国民健康保険）--the two main insurance options in Japan--have to take everyone eligible for coverage, regardless of preexisting conditions. The premiums are "high" (though very reasonable to my mind) because of this.
The problem will be finding supplemental insurance to cover you--and particularly this additional (and expensive) procedure. Supplemental coverages tend to be much cheaper, as insurers bank on the probability that you will never need to use them. Providers of these policies necessarily want to make a profit, which they can't do if they sell coverage for $100/month to somebody they know will soon be needing surgery to the tune of $20,000. If I knew a company in Japan that would do so, I'd give you their name--unfortunately, the Japan-based supplemental insurance I have all excludes preexisting conditions. (I checked before writing yesterday.)
I would look online, but I would also be suspicious of any providers promising to cover you immediately. There are a lot of scams out there, so be very careful. Good luck. |
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ssjup81
Joined: 15 Jun 2009
Posts: 664
Location: Adachi-ku, Tokyo, Japan
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| Posted: Sun Sep 04, 2016 10:03 pm Post subject: |
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I have a question about social insurance. When living in Yamagata, I had it. It helped when I was hospitalized two years ago. I was there for about six weeks. It cost me only about ¥500,000. I also had a private room. As I was saying before was that I've been stuck with NHI since moving to Tokyo.
Now, my question is, are there any restrictions as to what social insurance won't cover? Let's say I was badly burnt and wanted surgery to fix it, would the person in need be denied even if referred to a specialist? Does this vary from company to company? |
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mitsui
Joined: 10 Jun 2007
Posts: 1562
Location: Kawasaki
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| Posted: Mon Sep 05, 2016 1:01 am Post subject: |
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My wife spent just 200,000 with three weeks in a hospital.
Had surgery but shared a room with three women.
The snoring was a problem and made it harder for her to sleep.
So the private room is understandable. |
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