Childbirth and Childcare Lump-Sum Grant (for dependents, “the Dependents' Childbirth and Childcare Lump-Sum Grant”)

In cases of childbirth, 500,000 yen/child is paid to help with the costs of birth. This benefit is called “the Childbirth and Childcare Lump-Sum Grant”.

The society's additional benefits: “Childbirth and Childcare Additional Sum”

The Health Insurance Society also provides its own independent benefits (additional benefits) beyond the Childbirth and Childcare Lump-Sum Grant.
The amount of the Childbirth and Childcare Additional Sum is 90,000 yen/child.

We encourage you to take advantage of systems available to reduce the amount paid at the hospital

Since you must apply for payment of the Childbirth and Childcare Lump-sum Grant after childbirth, ordinarily you would have to pay a large amount of expenses at the hospital. However, you can use “the system of direct payment of Childbirth and Childcare Lump-sum Grant to medical institutions” or “the system of receipt of the Childbirth and Childcare Lump-sum Grant directly by the medical institutions on your behalf” to reduce this financial burden. When using these systems, the amount you pay at the hospital is only the amount of childbirth expenses minus the amount of the Childbirth and Childcare Lump-sum Grant.
If the amount of childbirth costs is less than the amount of the Childbirth and Childcare Lump-Sum Grant to be paid, the Health Insurance Society will pay the difference.

System of direct payment of Childbirth and Childcare Lump-sum Grant to medical institutions

Under this system, the institution where you plan to give birth applies for and receives payment of the Childbirth and Childcare Lump-sum Grant on the insured person's behalf.
Use of this system requires only the exchange of agreement documents with the institution where you plan to give birth. No application to the Health Insurance Society is required.

• ** Even when you use the system of direct payment of Childbirth and Childcare Lump-sum Grant to medical institutions, you will need to apply to the Health Insurance Society to receive additional benefits (or the difference in amounts, if applicable).
• ** If you decide not to use the system of direct payment of Childbirth and Childcare Lump-sum Grant to medical institutions and to apply instead to the Health Insurance Society for the Childbirth and Childcare Lump-sum Grant at a later date, you must submit agreement documents indicating you will not use the system.

System of receipt of the Childbirth and Childcare Lump-sum Grant directly by the medical institutions on your behalf

Apply to the Health Insurance Society in advance to designate the institution where you plan to give birth as the direct recipient of the Childbirth and Childcare Lump-sum Grant on your behalf.
You can use this system at certain small institutions that have submitted notices to the Ministry of Health, Labour and Welfare.

Childbirth

Under health insurance system, “childbirth” refers to live birth, stillbirth, or abortion after at least four months (85 days) of pregnancy. Since normal childbirths do not qualify as insurance medical care (benefits-in-kind), the Childbirth and Childcare Lump-Sum Grant is paid in cash to assist with the costs of childbirth.

Health insurance covers abnormal childbirth and other cases treated as sickness, as well as cases such as those involving complications of other sicknesses.
In cases involving high medical care costs such as those for hospitalization or surgery, you can use “a Certificate of Application of Maximum Copayment Amount” to reduce the amount you pay at the hospital. See here for the application procedures for the Certificate of Application of Maximum Copayment Amount. “Procedures for Certificate of Application of Maximum Copayment Amount”