Staying in Hospital and National Insurance

My wife who pays national insurance has recently checked into a hospital. A little bit earlier than normal in order to monitor the baby's growth. Anyway, she seems to think that the insurance doesn't cover checking into the hospital. I thought that that would be ridiculous but who knows. Err, who knows?

I know that she will get some money back (300,000 yen) after the baby is born but because she is in there early that will not be nearly enough. Today she was moved into a new room as well which might cost 40,000/day. That seems crazy I know.

Anyway, does anyone know where I can find out whether this will be covered by insurance. I know it only covers 70% but that would make a huge difference.

Thanks.

I found this but it has no details:
http://www.kokuho.or.jp/english/index.htm

There are a lot of details we don't know about your situation.
Examples:
Do you have only one type of insurance plan?
Why did she get the private room -- her idea or the doctor's?
Why is she in early -- problem that requires treatment?
When it the baby due?

Bottom of the first page will give you the (disappointing) news you want.
http://www.ih-osaka.or.jp/enjoy/en/sick/02.html

⑨Cases where the Medical Insurance is not Applicable
In principle, Health Insurance does not cover the following cases:
（１）Medical treatment and drugs which are not covered by Health Insurance nor does the National Health Insurance cover extra charges incurred by a private patient's room or non-essential dental treatment.
(2) Normal pregnancy and child birth.
(3) Medical checkups, inoculation and vaccination
(4) Cosmetic Surgery
(5) Straightening of teeth

Hey thanks. Great find. Well...
I'll have to see if we can qualify as abnormal pregnancy then.

As the saying goes, I took the time to help, you could take the time to answer my questions. Sigh. Good luck, whatever.

deadhippo said:

Anyway, does anyone know where I can find out whether this will be covered by insurance.

Click to expand...

This is very much akin to people coming here and asking us immigration/visa questions instead of just contacting a Japanese embassy.

You can find out at the national health insurance office in your community. Probably located in or near City Hall. The folks who issued your wife's national health insurance card in the first place, in other words.

She'll get 380,000, by the way.

Links to help find the office in your area

Glenski said:

As the saying goes, I took the time to help, you could take the time to answer my questions. Sigh. Good luck, whatever.

Click to expand...

I do appreciate the help and I hope you can forgive my lack of consideration.

I'm sorry. It wasn't intentional. I didn't even notice your questions for some reason but it could be that I was either tired or distracted. You know, three jobs, wife in the hospital, a few extra chores. I am probably f%%king **** up on all types of levels. Don't take it personally.

I don't think that's really a saying.

The questions:
1. She has another insurance plan and she thinks it may cover some of the cost. She'll check.
2. The doctor/nurse (I'm not sure which) asked her to move to the other room.
3. She is in early for observation (I don't want to give details. I'm sure you can understand.)
4. Baby's due March 10th.

I didn't have much information to go but I have a few updates today. I have just gotten back from the hospital and it seems like I won't have as much to worry about as I thought although we should find out for sure tomorrow.

I'm not sure why she was moved into that room but it seems that it might be just so she can get more rest. The three other ladies in the former room have all given birth so you can imagine it's noisy. Anyway, we were told today that even though we will have to pay the 40,000 yen we will get it all back (100%). We guess we will have to pay the normal room rate though but again we don't know for sure.

We think that the current time in hospital may qualify for insurance as it is not standard procedure to go in early. Hopefully we can find that out tomorrow too. A special Admin nurse will be there and we are told that she has all the answers.

@Mike Cash - Thanks for the info but we know about the cash back program. Unfortunately not many of these places were open last night after I got home from the hospital. As I said, I was tired and this new development was preying on my already worried mind. You know how it is when you have a lot of questions, if you can even get one answered you feel like you are making progress.

Anyway guys, I apologize once more for by behavior and I appreciate the help and assistance you provided. I think though that this topic would be helpful for people in similar situations in the future so please don't feel like you are wasting your time answering those hit and run questions. They help the community grow and make jref an even better resource. I can't count how many times I have found answers to my questions just from searching a message board, including this one.

Sounds to me like your wife is not explaining everything to you, because she doesn't know the answer or she simply can't communicate with you. That extra insurance plan sounds like what we had, so you are probably secure there. I can understand your concerns, so just be patient until you hear from the admin nurse. I have a feeling things will work out just fine.

Thanks for answering my questions.

LOL, we don't really have communication issues, thankfully. Yep, she doesn't know the answers because this is is kind of an unexpected situation but hopefully we can find out more today.
Thanks for the support and I'll let you know how it turns out.

Best of luck to the three of you. I should have recalled what it was like when I was going through the same thing for the first time and been a bit more considerate.

Thanks Mike. Here's a bit of an update. Things seem to be much better than we had hoped. As some of you may know there is the option of getting the "cashback" paid directly to the hospital saving you the trouble of paying first and claiming later. We found this out yesterday and today I went to the ward office and processed it.

Back at the hospital we were told by the admin that we would pay a maximum of 80,100 and the govt would pay the rest. We have to pay for the meals separately but I think that may be standard practice here and they said it costs about 1,800 per day. To be honest it seems too good to be true and there are some inconsistencies so we will check back in about a week.

My wife is going to call her insurance company tomorrow to see if it will cover what the govt doesn't.

Anyway, I'll update when I know more.