Affording medical bills and nursery school is difficult. Any suggestions?

18 comments

1. Please check out the medical resources on the [wiki!](https://www.reddit.com/r/japanlife/wiki/medical)

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3. I see four possible ways to resolve this issue:

   1. City hall has some sort of free nursery program for low income families. This seems like it would vary widely from city to city so you’d probably need to go back to city hall. You could also ask about free yochien (after the baby turns age 3) as they might have different rules.
   2. Since you are home on maternity leave, you could potentially pull your older child out of nursery for a time. I think this could be quite difficult with a young baby at home, and I don’t know if it would cause you to lose your spot? Plus, you might only break even if the child is eating food at nursery (depending on what you cook).
   3. Reduce other costs
   4. Increase your income

   Assuming you can’t increase your income at work, it seems like your side hustle needs to be a more profitable use of time. Given your english seems quite good, one possibility I’ve heard is to use italki or amazingtalker. There was one poster on here who reported earning 400,000 yen a month from italki alone (just as a side-hustle).

   Best of luck, I know with a young baby it might be incredibly difficult, so please reach out to loved ones when you need support.

4. City hall should be able to cap your medical expenses and cut the medication costs. You might qualify for a child payment (I don’t recall exactly how much it was but we got monthly payments for having kids from the city). I’d be looking for different jobs though.

5. >I have the high-cost cap so my payments are 57000 a month. 44000 after 3 months of paying this higher amount.

   Sounds like you’re already using 高額療養費制度 which is a form of social welfare for medical fees, so I think it will be difficult to reduce it even more.

   Considering your high annual medical fees you can claim pretty significant tax reductions on the year end tax adjustment (年末調整). Anything exceeding ¥100,000 can be used to reduce your tax, considering you recently had a baby as well that is a large chunk of medical fees that can be used (even if the government payment covered it all).

   For more child care support, it will depend on any programs your city has in place so you’ll have to speak to them.

   Honestly I wouldn’t usually advocate this, but you would probably be better off financially if one of you (probably you, as you have a chronic medical issue) quits your job so you can meet the low salary requirements to use welfare (生活保護制度) if you are enrolled in the welfare system then childcare, medical, rent etc can be heavily subsidised or even free depending on circumstances.

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7. I’m very surprised you’re paying so much for nursery school. By nursery school do you mean hoikuen? Public hoikuen? Did your income recently change since last year? Public hoikuen payment is determined by your income. There are different brackets depending on how much residence tax you pay. If you’re very low income then you’re also exempt from paying for hoikuen. My husband and I make a bit more than you a year combined and our hoikuen is free. Last year it was ¥10,000/ month (I guess our income changed a bit from year to year)

8. Looks like you have animation talent! That’s huge! My wife makes an off-books killing as do many others in the commission space. You won’t always get to draw what you like, but if you can compromise, you can get paid.

   Deductions, deductions, deductions. Your two children and medical expenses entitle you to various forms of support. Talk to your city hall. They’ll work to help you understand.

   Ibaraki-ken is a pretty chill place and city officials have been helpful in my limited interactions with them. Good luck, neighbor!

   – I can’t believe I had to preface this with a magical word called ” n u a n c e.” Don’t let any johnny mcjackass who has no idea what you’re going to do try to use a thin dog whistle like “freeloader” to tell you how you can and can’t get by. Pathetic. There’s even a threshold of income you can make on the side that isnt taxed. But that doesn’t matter to people like that.

9. You’re spending ~¥567,000 per year on medical bills? Then as u/LukeIsAshitLord pointed out make sure you utilize the medical expense tax deduction which kicks in after ¥100,000 per year. Meaning annual medical bills of ¥567,000 would get you a tax deductible of ¥467,000 which is extremely substantial, and on your income may even bring your taxable income down to ¥0 when combined with basic deduction + employment income deduction + Shakai Hoken deduction (or national pension deduction/health insurance deduction if not enrolled in Shakai Hoken)

   So if you have not been utilizing that medical expenses deduction then you can back file taxes for up to 5 years which could yield you a very substantial 5 year income tax and resident tax refund

10. Possible to move? In my district houikuen would be free and healthcare for your child is totally free. You just show his/her insurance card for ID when you enter the doctor’s office and that’s it. When you are done you leave.

11. How much do you pay for your rent? If so, might help if you look into applying for public housing.

12. > Please don’t write mean comments I cry easily.

    🫂 🤗

13. I think really the only reasonable way out of this predicament is for your husband to find a better job.

    As your post says, you are essentially tapped out on benefits, but at 2.3M your husband is almost 50% below the average income nationally and more than that if considering only the Kanto region. There HAS to be room here to improve things.

14. Are you receiving the ward subsidies for kids? It isn’t huge, but something around 15,000 per child I think.

    Also, many wards have some assistance or subsidy for out of pocket medical expenses is higher than a certain amount.

15. OP, does your chronic illness fall onto the list of illnesses that is considered “難病/incurable”? Most autoimmune diseases, systemic diseases, and organ disorders are included. If it does, you’ll have to pay up to your limit for 6 consecutive months, but then you’ll get most of it back and your expenses will be capped at around 20,000 going forward. On top of that you also qualify for a 15,000/month medical stipend. It’s not that much, but maybe that extra 30,000-40,000 a month in savings might help?

    [mhlw site](https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/kenkou/nanbyou_allergie/index.html)

16. Don’t have much to say, but I deal with some physical health issues too so wish you all the best. I know how exhausting it is dealing with normal life on top of it all.

17. Sounds like you’ve got the problem called “life”

18. I can’t fathom why it’s OK for foreigners to live what is essentially a parasite lifestyle in Japan. Immigration laws require foreign residents to be self-sufficient and not be a drain on public services, which should be reserved for Japanese citizens who are in need.