Today I learnt a painful lesson about Japanese health insurance system.
To cut it short, if you’re living in Japan and you’re sick; better make sure you have your health insurance card with you. Don’t ever pay the full amount in cash thinking you could make a claim for that amount afterwards!!!
If you’re like me who happened not to have that card (because it is not ready on arrival) when you visit the doctor; you’re dead set in getting yourself swindled of more money than you have to.
The hospitals has an agreement with the insurance company in setting a fixed amount to the medical costs. This amount is based on a point system.
So for example:
1) doctor’s fee: 1000 yen
2) Medicine: 1000 yen
3) medical certificate: 3000 yen
4) tax: 5%
Firstly the item that can be claimed from insurance is item no. 1 and 2 only.
Secondly the point system works like this; 1 point = 10 yen
So, the above list equates to:
1) doctor’s fee: 100 points
2) Medicine: 100 points
So in your hospital or medical bill, the total points will be reflected right under the bill.
Now, that ratio is FIXED between the hospital or any medical institution with the insurance company.
BUT, if you don’t have the insurance card with you yet, and you had no choice but to pay the full amount in cash, that point system ratio shown above DOES NOT APPLY!!!
The hospital can set any ratio, from 1 point = 10 yen to maybe 1 point = 21 yen (for my case!)
So in my case, the hospital actually charged me the following below:
1) doctor’s fee: 2100 yen
2) Medicine: 2100 yen
But the insurance company will only look at the POINTS!!!! So the insurance company will pay only 70 percent of 200 points which equates to 2000 x 70% = 1400 yen
I thought I could get back this amount:
(2100 + 2100) x 70% = 2940 yen.
I lost 2940 – 1400 = 1540 yen in this case!!!
So I lost a lot of money to that money grubbing hospital in Tokyo Shinjuku!
This is just an example.
The REAL amount I lost was close to 22000 yen or more.
That got me really freaking angry.
Well that’s a lesson for me, and I hope for you too.
Moral of the story, don’t get sick before your health insurance paperwork is done.
