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”. (420,000 yen for childbirth through the end of March 2023)

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 200,000 yen. (Note: For twins, the amount is 200,000 yen × 2.)

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.
You must submit the Claim for Childbirth and Childcare Lump-sum Grant to the Health Insurance Society after the child is born.

Payment flow

Example 1: Childbirth costs of 580,000 yen at a medical care institution enrolled in the maternity medical care compensation scheme

The institution will bill the Health Insurance Society directly for up to 500,000 yen of the costs. The insured person or dependent who gave birth pays the remaining 80,000 yen up front at the institution.

Submit the Claim for Childbirth and Childcare Lump-sum Grant after the child is born to receive payment of the additional benefit of 200,000 yen from the Health Insurance Society.

Example 2: Childbirth costs of 400,000 yen at a medical care institution enrolled in the maternity medical care compensation scheme

Since childbirth costs are less than 500,000 yen, the insured person or dependent who gave birth is not required to make any payment at the institution.

Submit the Claim for Childbirth and Childcare Lump-sum Grant after the child is born to receive payment of 300,000 yen the additional benefit of 300,000 yen plus the difference in amounts on the Childbirth and Childcare Lump-sum Grant of 100,000 yen from the Health Insurance Society.

• * If you claim the childbirth and childcare lump-sum grant from the Health Insurance Society after childbirth without using the system of direct payment on your behalf, you must submit a written agreement indicating that you do not intend to use that 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.

Cases such as abnormal birth treated as an illness (for example, Caesarean section) and childbirth complicated by an illness are covered by insurance as medical care.
If you are billed for high medical care costs for hospitalization, surgery, or other treatment accompanying childbirth, you can use the Certificate of Application of Maximum Copayment Amount to reduce the amount you are required to pay at the medical care institution. “Procedures for Certificate of Application of Maximum Copayment Amount”