National Health Insurance and Social Health Insurance cover 70% of the following services.
- Doctor’s Consultation
- Dental Consultation and Procedures
- Medical Tests
- Medical Treatments
- Hospital Admission
Note that they only apply to the insurance-covered services. For example, cosmetic surgery is not covered by insurance therefore they will not pay the 70%.
Both National Health Insurance and Social Health Insurance offer the benefits below:
Lump-sum Childbirth Benefit
Insurance does not cover prenatal checkups and delivery. Instead, they provide Lump-sum childbirth benefit of 420,000 yen. This can be paid directly to the hospital or receive it after childbirth.
A funeral fee (about 50,000 yen) is provided to the deceased holder.
Additional Benefits of Social Health Insurance
Sick Benefits are provided when a beneficiary needs to take a long sick leave. The insurer pays two third of the beneficiary’s average salary up to 18 months. The average salary is calculated based on the insurer’s standards and is not the actual amount of the salary.
The insurer pays two third of the beneficiary’s average salary during maternity and childcare leave (from 42 days before childbirth until 56 days after birth). The average salary is calculated based on the insurer’s standards and is not the actual amount of the salary.
National Health Insurance does not offer the benefits above.