Medical Expenses Notice

"In the prime of life, health is all the more an important issue."

Cover of the notice

Some of you have probably received in the past this blue document. It is called Iryō Hi Ni Tsuite No Oshirase (医療費についてのお知らせ) in Japanese and is edited by the Social Insurance Center. The following is a proposed translation of the document's content. First and foremost, keep in mind that it is not a bill, and it does not require you to pay anything.

In case you or members of your family receive medical treatment covered by health insurance, the medical expenses due to medical institutions are covered by government subsidies and by the insurance premiums that you and your employer paid.

In order to make effective use of these precious insurance premiums, it is advisable to both take good care of one's own health and to pay very good attention to the different ways of getting proper medical treatment.

Description of this notice

1. This notice is a statement of your medical expenses based on invoices issued by medical institutions after your visit(s). (Due to delays in the invoicing from these institutions, payment can appear on the month following the notice of the actual consultation).
2. 70% of the medical expenses amount written on this notice is covered by Health Insurance and paid to medical institutions. (For children under the age of 3 the ratio is 80% and for elderly people this ratio goes up to 80 or 90%).
3. Medical expenses not covered by health insurance such as room upgrade fees (if you choose a private room instead of a group room, resulting extra expenses are your responsibility) during hospitalization are not included in the amounts mentioned in this document.
4. The number of hospital/clinic visits may include house calls by a doctor from a different institution from the one you actually visited. They can also include phone calls to medical institutions for instructions and medical advice. This document also mentions the number of times you received prescriptions.

How to appropriately receive health insurance treatment?

• Work-related illnesses or diseases/wounds and injuries received on the way to work are not covered by Health Insurance (these are for example subject to the Workers' Accident Compensation Insurance).
• When receiving medical care, please make sure you always submit your insurance card at the counter of the medical institution you are visiting.
• Please consult during office hours as long as it is not an emergency case.
• Avoid ordering/asking for medical injections or drugs when this is not necessary.
• Avoid constantly changing medical institutions as this can make consistent treatments difficult and cause delays in recovery from a disease.
• Upon using your insurance card for example when involved in a car accident, make sure you send documents immediately to your local social insurance office.
• When retiring, please hand back your card as well as your whole family's insurance cards.

Note: Your own medical fee receipts from medical institutions can in some cases be used by health nurses during medical consultations implemented by your local social insurance branch as part of the Promotion for Social Security General Health Management.

Red note: This notice has the sole purpose of letting you know about your medical expenses. Consequently, you are not required to do anything upon receiving it. Also, as information concerning you and your entire family are displayed on this same notice, if you or a member of your family wishes to have his/her/their own notice, please do not hesitate to call or visit your local social insurance office, listed below.

Office	Address	Telephone	Access
Ibaraki Social Insurance Center	2-3-32 Ō-machi, Mito-shi 310-0062	029‑226‑3911	Across from Mito Nikō High School
Mito Branch Office	2-5-17 Yanagi-chō, Mito-shi 310-0817	029‑225‑5481	Along the Sakura River, next to the Kōminkan Citizens' Hall
Tsuchiura Branch Office	2-7-29 Shimotakatsu Tsuchiura-shi 310-0812	029‑822‑7081	Next to Kokuntsu State Hospital
Shimodate Branch Office	1720 Sugaya, Chikusei-shi 308-8520	0296‑22‑6011	Close to the route 294 bypass, at the tracks
Hitachi Branch Office	2-10-22 Saiwai-chō, Hitachi-shi 317-0073	0294‑22‑9031	Next to the Court of Justice

Note: each office is not far from a train station.

Medical Expenses Notice (back)

Back of the notice

About government-managed health insurance benefits

There are different kinds of government-managed health insurance payments. Please refer to your local Social Insurance Center to learn more about the different submission forms (written request style application forms and submission method).

For further and more detailed information concerning the various types of benefits. Please use the following Social Insurance Agency link: http://www.sia.go.jp/.

Kind of Benefit	When?	Amount of Benefit	Procedure
Medical Expense	When due to unavoidable circumstances the insurance card could not exceptionally be submitted at all.	Reimbursement of medical expense, based on standard treatment fees, minus deductible.	Submission of the "Medical Expense Benefit Application Form" (or Ryōyō-Hi Shikyū Shinseisho) along with the medical institution's detailed receipt.
Sickness and Injury Allowance	When the insured did not get paid for 4 days of work during his/her sickness or injury leave.	The insured gets 60% of a 1-day-slip of his remuneration standard for each day he/she was absent from work, starting from the 4th day on a period of 18 months.	Submission of the "Sickness and Injury Allowance Application Form" (or Shōbyō-Teate-Kin Seikyūsho) along with a certificate delivered by the employer and an advice note from the doctor.
Lump-Sum Birth Allowance	When the insured or nonworking dependent give birth.	The insured gets 300,000 yen per child born, a dead birth, stillborn, born prematurely or aborted after the 4th month of the mother's pregnancy.	Submission of the "Lump-Sum Application Form" (or Shussan Ikuji Ichiji-Kin Seikyūsho) along with the doctor's birth certificate (or Shussan Shōmei)
Maternity Allowance	When the insured did not get paid during her maternity leave.	The insured gets 60% of her pay for each day she had to miss work within 42 days before and 56 days after (planned) delivery	Submission of the "Maternity Allowance Application Form" (or Shussan Teate-Kin Seikyūsho) along with a certificate issued by the employer and an advice note from the doctor.
High-Cost Medical Care	When the insured paid a very large medical expense.	The insured gets back the amount exceeding the fixed amount of personal burden paid to the same institution within the same month, or the amount exceeding the fixed amount paid to the same institution for the entire household.	Submission of the "High-Cost Medical Care Benefit Application Form" (or Kōgaku Ryōyō-Hi Shikyū Shinseisho)
Burial Allowance	When the insured or the non working dependent dies.	One month's worth of salary is given (at least 100,000 yen) when the insured dies. When a non working dependent dies, this amount is a uniform 100,000 yen.	Submission of the "Burial Allowance Application Form" (or Maisō Ryōhi Seikyūsho) along with a certificate from the employer.

Disclosure of medical fee receipts and the like

In case you or a dependent member of your family wishes to get a detailed breakdown of medical expenses incurred, it is possible to make a disclosure request of medical fee receipts (reseputo レセプト) by following the procedure and meeting the criteria below.

1. Who can request a receipt?
   The person who received treatment or his/her bereaved family.
2. How to get a receipt?
   Please follow the procedure at your nearest Social Insurance Center/Office upon bringing the documents bringing the documents with you. But, in case it is difficult for you to get to the Social Insurance Center, please know it is possible to do this procedure by mail (shipment of documents is at your own expense).
3. What documents do you need?
   
   1. The Medical Fee Receipt Disclosure Request Form (or "Shinryō Houshū Meisai-Sho Tō Kaiji Seikyū-Sho")
   2. A valid document proving the identity of the receipt claimant. Note: When doing the procedure via mail, please provide a copy of your residence certificate (or "Jūmin-Hyō")