Managing the cost of healthcare in Japan

By Liam Carrigan

Sports injuries are never fun.

I was recently reminded of this when I clashed with another teacher at my city’s inter school teacher basketball tournament. I didn’t even know red cards existed in basketball — until I received one!

In my anger — and with the adrenaline still flowing — I hadn’t noticed the damage this surprising physical contact had caused. My little finger seemed to be hanging awkwardly. A couple of days later, it still wasn’t right. I couldn’t straighten it and there was a shooting pain whenever I tried to use it. A trip to the hospital seemed to be the only way to go.

It turned out I had sustained a broken finger with a fracture right on the joint of two of the bones. Surgery was going to be needed — and this is where the real nightmare began.

Hopefully today, you can learn from my experience and avoid some of the costs I incurred as a result of this injury with a little planning and knowledge of Japanese national health insurance.

Accidents and insurance

The insurance coverage provided for competitors in this event — which I was signed up for automatically via my workplace — only covered up to ¥3,000 for a hospital visit. Considering that many hospitals charge around ¥5,000 just for a consultation, this wasn’t going to get me very far at all.

A note on this point for those just starting work in Japan: employers should have employee accident insurance — always. As a teacher, this is something you should ask about as soon as you begin employment. My board of education (BOE) has this, however it didn’t apply in my case.

If you choose to participate in school events such as sports tournaments or parties outside of your working hours, any injuries sustained at these events will not be covered by employee accident insurance. In the case of the school tournament I was in, the burden of insurance fell upon the local teachers union who sponsored the event. The union has little available funds and that was why the coverage was minimal.

Of course, I’m on the Japanese national health insurance plan. However, unlike my native Scotland where universal health care ensures that all costs are covered — Japan’s system only covers 70 percent. This is still a big help, of course, but even with this assistance my treatment to date has still left me tens of thousands of yen out of pocket. Further surgery may be required later, with the possibility that there may be long-term damage.

Had I known then what I know now about Japan’s health insurance system, some of this pain — in the financial sense at least — could have been avoided.

As you’re probably aware — and it bears repeating — all foreign residents in Japan (those staying here for more than three months) are required by law to enroll in one of the two national healthcare programs: kokumin kenko hoken (Japan’s National Health Insurance) or kenko hoken  (Employee Health Insurance offered through your workplace).

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This article is very sad! It seems to show that English teachers are so poor that if they have a relatively small accident like breaking a finger they will be out of so much money that they will need crowd funding to pay for it. I'm sorry but being out Y45000 for surgery and all the other care is not a huge amount. Try living in the US where you would be on the hook for the whole amount.

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If you spend more than Y100000 on medical costs each year you can claim an extra income tax deduction and get some of it back. If you keep all your medical and medicine receipts you can file for this towards the end of each financial year.

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Can i file for Tenga's do u know?

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Tell us more about the clash and red card.

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Due to my age and retirement my maximum for a month in hospital is only now ¥12,000.

We pay 30% of the medical healthcare but additional private insurance is available to cover it, and stays in hospital which will provide with ¥15,000 per day for your personal needs.

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The yen figures give the impression of it being a lot but once translated it is not that huge. I find it herd to believe that anyone organising a sports event insurance cover would limit it to the equivalent of £20.00.

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It's not the cost I'm concerned about, it's the treatment received. 20 years of going to hospitalS for treatment for major back problems after a motorcycle accident, including a ruptured disc and slipped disc at least once a year. I only started to show improvement three years ago when I stopped going to to hospitalS and started going to a sports trainer which of course is not covered on my health care insurance plan. At 500USD per month, I'd say it was money well spent. I can now do so much more to enjoy life. I actually can ride a motorcycle again.

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