What does the public health insurance not cover?

Hi all,

I’m aware that the public health insurance in japan covers 70% of medical expenses. It is just not clear to me what type of expenses are not covered. Do i need to get a private insurance to cover some major diseases or old age medicare?

Thank you

5 comments
  1. It covers whatever you need.

    It doesn’t cover whatever you want (ie ceramic implants instead of metal fillings, optional things like private rooms in hospitals, voluntary surgeries like LASIK, etc)

  2. * Meal expenses during hospitalization
    * Miscellaneous expenses and daily necessities due to hospitalization
    * Upgraded hospital bed/room fees
    * Highly advanced/experimental medical expenses
    * Transportation expenses for visiting family members
    * Work-related illnesses and injuries (covered by workers’ comp)
    * Accidents that occur on the way to work (covered by workers’ comp)
    * Treatments such as seikotsu clinic, acupuncture, massage, etc. for stiff shoulders and lower back pain without a medical cause
    * Preventive injection
    * Normal childbirth
    * Elective cosmetic surgery
    * Health checkup, medical checkup, etc.
    * Injuries due to willful involvement in a fight, organised sporting events (including motorsports), or drunken misadventures.
    * Vision correction procedures that can be handled with glasses (LASIK no, cataract surgery yes)

  3. Transgender care. Hormones, surgeries, etc. There are some narrow but pretty much not realistic ways to get some of them covered, but overall expect it not to be covered.

    (Exception: hormones are covered if you’ve legally changed your gender)

  4. Pretty much all well-established treatments for common sicknesses are covered. This also means that the latest treatment methods that are available in the US/Eu may not be covered.

    You can get insurance for those, but there is just a handful of hospitals that offer them, so it’s pretty much impossible to get a spot.

    There is also a cap on maximum out of own pocket expenses, around 80,000/month.

    For the vast majority of people, supplemental insurance is not needed.

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