"I'm Worried About the Cost of Treatment" — The High-Cost Medical Expense Benefit, Long-Term Care Insurance, and Other Support
Don't give up on treatment because of money worries. There are several public systems that reduce what you pay for medical care.
This column describes Japan's public health insurance and support systems. They cover everyone living in Japan, including foreign residents enrolled in National Health Insurance or an employer's plan. If you live outside Japan, the systems and amounts will be different.
These systems and the amounts involved can change. For details, check with your hospital's patient support office or your local municipal office.
"If I need surgery, I'm worried about the money..."
Now and then a patient tells me this quietly in clinic. It's a perfectly reasonable worry.
Japan has several public systems that reduce the cost of medical care for patients. Here are the main ones.
If you speak up about money worries, there are people who will help.
The Main Systems to Know
| System | How it works |
|---|---|
| High-Cost Medical Expense Benefit (高額療養費制度) | Caps what you pay out of pocket for medical care each month. It applies to hospital stays and surgery too |
| Long-term care insurance (介護保険) | Once you're certified as needing support or care (要支援・要介護), you can use it for assistive equipment, home modifications, rehab, and more |
| Medical expense tax deduction (医療費控除) | If your medical expenses for the year go over a certain amount, you may get some tax back when you file your tax return |
The High-Cost Medical Expense Benefit is the one I most want you to know about. Even if surgery or a hospital stay runs up a large bill, what you pay has a monthly cap. If you get a limit-application eligibility certificate (限度額適用認定証) in advance, even the amount you pay at the hospital's billing counter stays within the cap.
What Long-Term Care Insurance Can Do
You may think long-term care insurance has nothing to do with you yet. But it can also be used for home modifications, such as installing handrails or removing steps, and for assistive equipment such as walkers.
You can apply at your municipal office or at a regional comprehensive support center (地域包括支援センター). It's fine to go just to ask whether you qualify.
Where to Ask First
It's normal to find all these systems confusing, and you don't have to research them all yourself.
- For hospital stays and surgery: the hospital's medical social worker (patient counselor)
- For care and daily living: the regional comprehensive support center
These people know money matters and support systems. They'll look at your situation and point you in the right direction. Don't hold back wondering whether a question is OK to ask. Helping you is their job.
Summary
- Several public systems help with medical costs
- The High-Cost Medical Expense Benefit caps what you pay for hospital stays and surgery
- Long-term care insurance can also be used for home modifications and assistive equipment
- Start with the hospital's counselor or the regional comprehensive support center
Money worries are hard to say out loud. But if you ask, there are systems you can use and people who will guide you through them.