If you receive medical care at home
“Home-Visit Nursing Care Expenses” will be paid when a person requiring continuous care at home receives medical care and necessary assistance, such as nursing on a visitation basis from a visiting nurse station, on the instruction of his or her regular physician.
Home-Visit Nursing Care Expenses (for dependents, ”Dependents' Home-Visit Nursing Care Expenses”)
When a person whose condition requires continuous care at home (i.e., a person diagnosed by a doctor as having an intractable disease or similar condition under Ministry of Health, Labour and Welfare standards) receives nursing on a visitation basis or long-term care services from a designated provider of nursing services on a visitation basis for the sake of treatment in comfortable surroundings at home, he or she is required to pay only 30% of the costs of such care. The remaining 70% is paid as Home-Visit Nursing Care Expenses.
Using its own independent benefits (additional benefits), the Health Insurance Society can reduce copayments still further (Home-Visit Nursing Care Additional Sum).
In covering Home-Visit Nursing Care Expenses, the Health Insurance Society will pay an amount equal to the total amount of related copayments minus 20,000 yen at a later date as “Home-Visit Nursing Care Additional Sum” (for dependents,“Dependents' Additional Home-visit Nursing Care Expenses”).
This payment is calculated and made automatically based on “the Rezept (medical cost details)” sent by the hospital to the Health Insurance Society. Payment will occur roughly three months end of the month after the month of the medical care.
- ** The benefits will not be paid if the calculated amount is less than 500 yen.
- ** See “How High-Cost Medical Care Benefits are Calculated” for a specific calculation example.
Eligible persons include those with intractable diseases or severe handicaps, those bedridden due to cerebral apoplexy in the prime of life, or those with cancer wishing to spend their final days at home.
- If you are also eligible for long-term care insurance benefits, long-term care insurance will in principle take priority.
- You will need to cover costs (e.g., actual cost of transportation or adult diapers) and special fees if you wish to receive special services, such as care outside regular business hours.