Tokyo securities industry health insurance society privacy policy
Japanese sitemap
Links
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 > When you become sick or injured? > Cases not covered by health insurance
Cases not covered by health insurance
 

Cases where health insurance does not apply


Freckles, birthmarks, pimples, moles, body odor, and the like that do not obstruct job execution or interfere with everyday life

Cases where health
insurance may apply in
exceptional circumstances¨

Cases where a condition exists that requires medical treatment


Nearsightedness, farsightedness, astigmatism, and strabismus, with no chance of recovery

Cases where health
insurance may apply in
exceptional circumstances¨

Examinations, tests, and prescriptions for glasses in cases where you notice a deterioration in your eyesight and are seen by an insurance doctor


Cosmetic surgery

Cases where health
insurance may apply in
exceptional circumstances¨

Orthopedic surgery to deal with an injury


Health examinations, screening for lifestyle related diseases, and complete medical checkups

Cases where health
insurance may apply in
exceptional circumstances¨

Treatment regarded as necessary as the result of an examination


Immunizations and preventive internal medicines

Cases where health
insurance may apply in
exceptional circumstances¨

Inoculations against tetanus in cases where there is a possibility of infection


Congenital disorders that do not obstruct bodily functions

Cases where health
insurance may apply in
exceptional circumstances¨

Cases where treatment is not for cosmetic reasons, and is commonly accepted as necessary


Normal pregnancy and delivery

Cases where health
insurance may apply in
exceptional circumstances¨

Cases such as Pregnancy Induced Hypertension, abnormal birth, etc. that require treatment


Voluntary abortions for economic reasons

Cases where health
insurance may apply in
exceptional circumstances¨

Abortions in accordance with the Mother's Body Protection Law other than for economic reasons



Cases in which health insurance benefits are limited


The conditions stated below represent obstructions to the administration of the health insurance system. Benefits may be unavailable or limited in the event one of the following descriptions applies.


Incident caused intentionally

Accident resulting from a quarrel or drunkenness

Failure to follow doctors' instructions with no justifiable reason

Fraudulent or dishonest acquisition (or attempted acquisition) of benefits

Refusal to answer questions or acknowledge diagnoses according to Health Insurance Societies' instructions


Health Insurance Societies will suspend or terminate benefits as penalties for the above. They may also limit benefits when the provision thereof is practically impossible or when superseding laws so require; applicable cases of such limitation include the following.


Internment in a reformatory or imprisonment in a penal facility

Medical treatment at the expense of the state or local governments, in accordance with "laws related to the prevention and treatment of infectious diseases"



Injuries sustained during work and while commuting to work will be handled by Worker's Accident Compensation Insurance


Health insurance provides benefits for non-work-related illnesses and injuries. Injuries sustained during work and while commuting to work will be handled by Worker's Accident Compensation Insurance. Note that benefits may not be received from both health insurance and Workersf Compensation Insurance for a single illness or injury.

*When even illnesses and injuries on-the-job are not targeted for benefits of the Worker's Accident Compensation Insurance, benefits of the health insurance are provided except the duties as the officer of the corporation (except for a corporation less than five employees).



ˆę‚‘O‚Ěƒy[ƒW‚Ö Top
Related page
@ Receiving outpatient treatment
@ When you get hospitalized
Back



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