Tokyo securities industry health insurance society privacy policy
Japanese sitemap
Introduction to Kenpo Seach by life stage when you need long-term care when you become sick or injured List of application forms
Additional health insurance information Guide to recreation facilities Health examinations, disease prevention Guide to directly managed clinic Other activities
Pritection of personal information
HOME > Introduction to Kenpo > What are insurance benefits?
What are insurance benefits?

Health insurance provides insured persons and their family members (dependents) with medical treatment in the event they fall sick or sustain injuries while off duty, and fixed amounts of various cash benefits in the event they give birth, or pass away.
Medical treatment and cash benefits provided in the cases stated above are referred to as "insurance benefits." See here for list of insurance benefits >> "List of insurance benefits"

Benefits in kind and benefits in cash

There are two ways to provide benefits-through the provision of medical service for the treatment of sickness and injuries and through the provision of expenses required for such treatment. Medical service provided through health insurance is referred to as "benefits in kind." Cash supplied through health insurance is known as "benefits in cash."

Statutory benefits and additional benefits

Statutory benefits are prescribed benefits under the Health Insurance Act. They are available to persons covered by Health insurance plan managed by the National Health Insurance Association (Kyokai Kenpo) as well as to persons covered by Society-managed Health Insurance.
"Additional benefits" consist of benefits of its own provided by the respective Health Insurance Societies. Health Insurance Societies provide these benefits in addition to statutory benefits.

Breakdown of benefit ratios according to age

The breakdown of benefit ratios for illness and injury is determined by age.

Benefits ratios - Illustration

*Although plans had called for elderly persons aged 70-74 (excluding those continuing to earn income at the same levels as active workers) to pay 20% of the cost of medical treatment as cost-sharing (with the remaining 80% covered by insurance benefits) starting in April 2008, implementation of this increase was put on hold. Cost-sharing for those in this category remained at 10%, with the 10% increase paid by the Japanese government.
For persons turning 70 on or after April 1, 2014 (those born on or after April 2, 1944), the cost-sharing will be 20% starting with examinations or treatments in the month following the month in which they turn 70.
*Cost-sharing will remain at 10% (20% for injury or illness caused by the actions of a third party) for persons turning 70 on or before March 31, 2014 (those born during the period April 2, 1939 through April 1, 1944).
*See here concerning individuals aged 75 or over:
Elderly persons aged 75 or over to be enrolled in Medical Care System for the Advanced Elderly.

Index Top
Introduction to Kenpo
  Health insurance outline
  What is health insurance?
  Tasks performed by Health Insurance Society
  Administration of Health Insurance Society
  What are insurance benefits?
  List of insurance benefits
  Table of monthly insurance premiums
  Medical care cost information
  Data Health Plans
  The Social Security and Tax Number System

Copyright© 2004 Tokyo securities industry health insurance society All rights reserved.