Could I lose my permanent residency over this?

Hi everyone.

I was recently diagnosed with MS and have come to my home country (Australia) for three months to get some treatments: my Japanese neurologist didn’t think it was necessary yet, but my Australian neurologist said I should have started months ago.

Since I haven’t been living in Australia for 7 years, I no longer apply for Medicare benefits. Since treatment here would cost a LOT of money, I’m trying to go about applying for a Medicare card, but to do so I need to claim that I’m returning to Australia permanently. My question is: could I lose my PR if I claim to be a resident of Australia? Would it be fraud to claim that I’m returning permanently when technically my flight back to Japan is in November?

Also: if I get a prescription here for the MS medication, would I be able to show that to doctors in Japan and they would just make a new prescription based on that? I’m worrying about how I’ll get the medicine when I move back (its a medicine called Kesimpta and is legally available in Japan)

15 comments
  1. It sounds like an Australian problem, not a Japan one. ~~I believe one of the valid reasons for a PR holder leaving Japan for an extended period (i.e. ending residency and applying for a 5-year reentry permit) is for medical treatment.~~ Japan shouldn’t have an issue with it.

    Can’t you get a second, or third, opinion in Japan? That sounds like the easier route.

  2. Hello ,

    IANAD however I live with MS in japan

    This is my suggestion, I would switch doctors and just tell them to put you on kesimpta ; the thing is you have to understand that even in Australia it could be possible that on technicality; kesimpta is not the first line of defense ;usually you’d be put on something like tecfidera and then if that fails they will switch you over to another treatment such as gilenya or tysabri unless you’re JC virus positive …

    I suggest you get a recommendation for juntendo and see a neurologist for this i suppose . Not sure what other information I could share with you in regards to the PR however.

    Kesimpta will run you around 70,000 a month and usually they will say something to get you to get 2 or 3 at a time and keep in your house .

    Just an FYI

    Additionally I have left japan for a year and came back and got on treatment right away so it’s a bit different.

    If you need anything else lmk I hope this information is helpful .

  3. I don’t imagine it would be a problem, your PR is permanent you just have to return for your new card periodically, right?
    I didn’t realise you lost Medicare benefits when you leave if you’re still a citizen, but I guess it makes sense if you’re not paying Aus tax.

    But as others have said, it’s probably just easier to get a second opinion from a doctor here if the drug is available. Or at the very least get one private prescription in Aus and then bring it back to show a Neuro here that you’re on it? (looks like it’s $6000 on the PBS site, there is a slight possibility you could get this cheaper if you happen to see a Neuro in a public clinic in NSW because of how funding works for NSW health)

  4. The only issue I could see is that you might have to send in tax forms for both countries if you return to Aus.

  5. No, what you claim to Australia will not affect your status in Japan. Just make sure to always return within the reentry permit validity.

  6. Sorry to hear about your MS diagnosis.

    The process you are going through for residency in Aus will not impact your PR in Japan. Japan only requires that **you** intend to return to Japan in the future, and that you have a valid re-entry permit, to keep your PR. They do not care that you establish residency (“permanent” or otherwise) elsewhere.

  7. It is possible to lose your permanent residency if you lie about your intentions to return to Australia. You should speak to a migration agent to get advice on your specific situation.

    As for the MS medication, you should be able to show your Japanese doctor the prescription from Australia and they should be able to write a new prescription for you.

  8. If you have a prescription and your medical file, you shouldn’t have too much issues with pursuing your treatment here. However, you may want to have a letter from your Australian doctor explaining the situation.

    If you don’t trust your previous Japanese neurologist, try and find a new one. I know it’s easier said than done, but it will serve you in the long run.

    Another thing to consider is that you may be able to apply for reimbursement of your (overseas) medical fees at your shiyakusho of residence. You’ll need to look into that and if you fulfill the conditions for this, but it may be worth checking.

  9. Most people have touched on most parts of your question so Im just gonna say, that certainly sounds like health fraud to me

  10. I am a doctor and I also have MS. Basically if you go to a neurologist here and get all of the paperwork the treatment/visits/scans are maximum ¥20,000/month and any amount over your exempted amount (¥100,000) you’ll get back when you file taxes.

    For MS you have to go through the diagnostic process IN JAPAN to get the medication. There is no way around this. You’ll still have to get new MRIs etc. The doses of the MS medicines are not different in Japan than elsewhere because they are standardized. As I’m sure you are aware it won’t be possible to bring MS medication back and forth.

    If you are in Tokyo the doctors at U Tokyo, NCNP, or Juntendo can take care of you. They will start you on Kesimpta without any argument as it is their first recommendation followed by Tysabri.

    If you need help with the process I’m happy to walk you through it or recommend doctors here that can help you.

    Edit: [Here](https://www.nanbyou.or.jp/entry/5460) is the page about paying for intractable illness treatment and the benefits you qualify for. I’m sorry it’s only available in Japanese, but I’m happy to explain the steps. This needs to be paired with the monthly medical fee limit paper from your ward/city office.

  11. You think that the Japanese government and the Aussie government keep in touch?

    Man, the Japanese government and the Japanese government don’t even keep in touch.

  12. > Since I haven’t been living in Australia for 7 years, I no longer apply for Medicare benefits.

    Wait what that’s a thing now?

  13. No, you won’t lose pr. The aus government won’t say anything to Japan, and neither should you. Many, many people hold dual passports despite Japan technically not allowing it. This isnt much different.

    Will you be able to get the same prescription? Basically yes, but you might need to try a few different doctors first until you find one that listens to you. Any supporting documentation you can bring might make it easier, but then again if it’s not in Japanese they might ignore it. Try some English speaking doctors if need be.

  14. Sorry for your complications.

    For what it’s worth, I got my PR revoked when I moved back to Australia. I stayed there for four years, went on Medicare, because you kinda have to. I dunno about your situation, but I found the healthcare system better in Australia than Japan. I was planning on staying in Aus, so I didn’t really chase up the PR. In hindsight that was silly. Australia was kinda tough, so we came back to Japan for family reasons, for better or worse.

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