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NHI covers 70% - what about the other 30%?
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AndyinNZ



Joined: 18 Jan 2008
Posts: 6

PostPosted: Thu Jan 21, 2010 9:57 am    Post subject: NHI covers 70% - what about the other 30%? Reply with quote

I'm heading to Japan soon to work with Westgate.
I understand that national health insurance covers 70% of costs, but I'm worried that maybe the other 30% could be significant.
Do folks take out other forms of insurance, ie travel insurance, to cover the possibility of the other 30%, or not bother and hope for the best?

ta
Andy
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ssjup81



Joined: 15 Jun 2009
Posts: 664
Location: Adachi-ku, Tokyo, Japan

PostPosted: Thu Jan 21, 2010 11:03 am    Post subject: Reply with quote

I just figured that 30% you pay out of pocket, depending on the amount, like if it's higher than average, you pay on it monthly.
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Glenski



Joined: 15 Jan 2003
Posts: 12844
Location: Hokkaido, JAPAN

PostPosted: Thu Jan 21, 2010 12:40 pm    Post subject: Reply with quote

For the sake of argument here, let's just consider a single individual (unmarried, no dependents), ok? Let's also assume you are under 40 (over which the premiums go up).

There are also differences between corporate health insurance (shakai hoken http://www.sia.go.jp/e/ehi.html ), which is mandatorily tied to pension, or citizen's health insurance (kokumin kenko hoken), for which pension is a separate application? Some employers avoid the copayments into your premiums for the former type, so you are forced to take the latter (or risk it with private/foreign insurance). Westgate is one of those situations:
http://www.westgate.co.jp/application/university.php/2

Yes, you are responsible for 30% of the bill, usually required up front at the time you leave the clinic/hospital.

Quote:
Benefits for High-cost Medical Care
If you/your dependents� co-payments exceed the specified limits, you can apply for the reimbursement of the excess over the limit.

Amount of Reimbursement and Co-payment Limits

① If your/your dependents� total co-payments to an insurance hospital/clinic in a same month exceeds over the payment limit as shown in �Case ①� on the table below, the excess over the limit will be reimbursed (co-payments for outpatient service, inpatient service, medical service or dental service are calculated individually).

[from the table, individual copayment limit, Case 1 :
80,100+(Medical care expenses - 267,000) x 1%]
http://www.sia.go.jp/e/ehi.html

Also,
⑥Medical Treatment Expense Refund for High Cost
Those who have paid large amounts in the same month exceeding a certain ceiling are eligible for a refund. Please go to Social Insurance Office or Health Insurance Society for Health Insurance; Insurance Section of your Ward office (Hoken-Tanto)for the National Health Insurance to apply. Make sure to bring insurance certificates and your personal seal with you. Part of your expenses will be refunded after examination.

http://www.ih-osaka.or.jp/enjoy/en/sick/02.html

And, yes, some people carry extra insurance to cover large bills and extended stays in the hospital.

Quote:
6. Are all medical treatment services covered under the National Health Insurance Plan?

The following medical treatment service are not covered by National Health Insurance.

(1) Health diagnosis and group health examinations
(2) Vaccinations
(3) Cosmetic surgery
(4) Normal pregnancy and childbirth
(5) Orthodontic work
(6) Abortion or contraception induced for financial reasons
(7) Treatment received outside of Japan

The following are also excluded from treatment under the insurance plan.

(1) Injury due to an illegal act, fighting or drunkenness
(2) Self-inflicted illness or injury

NOTE: Having precious metals and any other materials used in dental work not recognized under National Health Insurance standards will not be covered by National Health Insurance.
http://www.htia.org/e/info/health_i.html#no6
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pnksweater



Joined: 24 Mar 2005
Posts: 173
Location: Tokyo, Japan

PostPosted: Thu Jan 21, 2010 10:03 pm    Post subject: Reply with quote

Glenski, I find it very interesting that national health care doesn't cover pregnancy and child birth in Japan. In America it's one of the few things government insurance will pony up for. Are the costs for a normal birth very low or something?

(sorry for hijacking the thread Embarassed )
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Mr_Monkey



Joined: 11 Mar 2009
Posts: 661
Location: Kyuuuuuushuuuuuuu

PostPosted: Thu Jan 21, 2010 10:33 pm    Post subject: Reply with quote

pnksweater wrote:
Glenski, I find it very interesting that national health care doesn't cover pregnancy and child birth in Japan. In America it's one of the few things government insurance will pony up for. Are the costs for a normal birth very low or something?

(sorry for hijacking the thread Embarassed )
My wife tells me that the hospital charged �500,000 for the birth of our youngest in 2006, although prices vary considerably from clinic to hospital, and depend on the level of service. The government also gives you money afterwards. We received a good percentage of the money that we paid out back.

I understand that the law has changed in the last three years, and that the monies involved may be better than in our experience.
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Apsara



Joined: 20 Sep 2005
Posts: 2142
Location: Tokyo, Japan

PostPosted: Thu Jan 21, 2010 11:08 pm    Post subject: Reply with quote

Although national health doesn't cover pregnancy and childbirth, separate government grants do, as mentioned above. I believe around 300,000 yen is reimbursed, and it is now paid in installments, partway through the pregnancy and then after the baby is born. It doesn't cover 100% of the costs apparently but goes a fair way towards covering them.

Last edited by Apsara on Thu Jan 21, 2010 11:39 pm; edited 1 time in total
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Glenski



Joined: 15 Jan 2003
Posts: 12844
Location: Hokkaido, JAPAN

PostPosted: Thu Jan 21, 2010 11:31 pm    Post subject: Reply with quote

I confirm Apsara's comment. We got back 300,000 yen for our child's birth, and my school was even nice enough to chip in a bit, too.
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lenoreelux



Joined: 30 Nov 2009
Posts: 44

PostPosted: Fri Jan 22, 2010 12:07 am    Post subject: Reply with quote

It seems like a way better deal than if you and your family do not have health care in the US and cannot get the government to pay.

I do understand that in Japan, the cost for health care is a lot cheaper than in the US. Doctors and insurance companies gouged the hell out of prices for medication and basic health care.

I did have high hopes about a national health care system in the US but because of one state (Massachusetts ) It may never happen.

It will be interesting to see what I get in Japan as far as health care ect.. i know the pain meds are not as powerful... and getting birthcontrol maybe a a problem but it will be interesting.
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Apsara



Joined: 20 Sep 2005
Posts: 2142
Location: Tokyo, Japan

PostPosted: Fri Jan 22, 2010 12:22 am    Post subject: Reply with quote

Hmm, the US and its aversion to a nationalised health system has always mystified me. Pretty much every other developed country in the world has one, and it works well enough.

As for the Pill, this comes up a lot, but if you want to use a particular kind of birth control, bring a large supply with you or have it sent over. If you want to get it here, there are no problems whatsoever with having it prescribed, it's just that it's not popular here so not many Japanese women are using it. Availability is not an issue though.
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flyer



Joined: 16 May 2003
Posts: 539
Location: Sapporo Japan

PostPosted: Fri Jan 22, 2010 2:26 am    Post subject: Reply with quote

yes, we have to pay the other 30% but there is a max amount per month.
In other words you don't have to pay an enormous amount if there is an emergency. You have to pay up to a certain amount (I forgot how much it is) anything over this you do not have to pay
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Glenski



Joined: 15 Jan 2003
Posts: 12844
Location: Hokkaido, JAPAN

PostPosted: Fri Jan 22, 2010 3:04 am    Post subject: Reply with quote

lenoreelux wrote:
It will be interesting to see what I get in Japan as far as health care ect.. i know the pain meds are not as powerful... and getting birthcontrol maybe a a problem but it will be interesting.
Pain meds for birth? You have to realize that many/most hospitals don't even dispense them. If you have a baby in Japan and feel you will need them, find a hospital that does.
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Apsara



Joined: 20 Sep 2005
Posts: 2142
Location: Tokyo, Japan

PostPosted: Fri Jan 22, 2010 3:31 am    Post subject: Reply with quote

Glenski, I think you misunderstood lenoreelux totally. I very much doubt she is talking about epidurals and the like- she is talking about birth control,
so it seems unlikely she is planning to have a baby any time soon, and I'm guessing that by "pain meds" she simply means analgesics and anti-inflammatories like aspirin, ibuprofen, Tylenol etc.
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lenoreelux



Joined: 30 Nov 2009
Posts: 44

PostPosted: Fri Jan 22, 2010 4:19 am    Post subject: Reply with quote

I was thinking pain meds for just general pain.. but sometimes you might need pain meds after the birth to deal with the new baby ;-P (joking!!)
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flyer



Joined: 16 May 2003
Posts: 539
Location: Sapporo Japan

PostPosted: Fri Jan 22, 2010 4:22 am    Post subject: Reply with quote

also often what happens is;
your fellow workers (Japanese) give a gift when a child is born, at least I have experienced this custom. In my experience it was 10,000 from each person. So this will add up too (??) but I am sure not all companies do this
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Glenski



Joined: 15 Jan 2003
Posts: 12844
Location: Hokkaido, JAPAN

PostPosted: Fri Jan 22, 2010 12:36 pm    Post subject: Reply with quote

lenoreelux wrote:
I was thinking pain meds for just general pain.. but sometimes you might need pain meds after the birth to deal with the new baby ;-P (joking!!)
"General pain" during pregnancy or during the birth?
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