How much do hospitals and clinics actually charge for the medical treatment they provide?
Insured persons and dependents pay only 30 percent of their medical care cost respectively, at the hospital upon the receipt of treatment. When hospitalized, insured persons and dependents must cover the standard amounts for meals and living expenses. It is difficult under this system for insured persons and dependents to determine the actual cost of treatment.
You can review the medical care cost information and the notice of the payment amount of High-cost Medical Care Benefits or other benefits on the Society website.

Click here to log in to the web service. (This service is only available in Japanese.)

* User registration is required to use the service (for first-time users).

■About user registration (This manual is only available in Japanese.)
(Please have the postcard informing of the web service ready for user registration.)

>> Deduction for medical care costs

● Assessment of reduced payment

If you or a family member is treated for an illness or injury at a medical care institution, the institution will submit a bill for the cost of the treatment to the Health Insurance Claims Review & Reimbursement Services (HICRRS).
The HICRRS will review the appropriateness of the items and amounts invoiced. Based on this review, the amount billed may be reduced.
The Health Insurance Society notifies (*) individuals for whom such reviews have identified reductions of 10,000 yen or more in copayments paid at medical care institutions.

* Check the Web service (medical care cost inquiries: https://kosmoweb.jp) for notifications.
“Assessment of reduced payment” is indicated in the remarks field on the medical care cost inquiry screen.

● If you are notified of an assessment of reduced payment

If your medical care cost information indicates an assessment of reduced payment, you can request a refund of the amount you overpaid in your copayment or other payments from the medical care institution.
Note that if the medical care institution requests reexamination by the HICRRS, the overpaid amount will not be refunded immediately. Additionally, if reexamination assesses that the medical care was appropriate, your refund request may be rejected altogether.
Submit refund requests directly to medical care institutions. Do not submit to the Health Insurance Society.