Sony Health Insurance Society

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Medical assistance from municipal governments

Municipal governments (cities, wards, towns, and villages) across Japan offer medical assistance programs under local ordinances.
These programs seek to reduce the burdens of medical care costs for examinations and treatment provided at medical care institutions. Under these programs, municipal governments cover all or part of medical care costs for eligible residents. (Public funding)

  • * Methods of assistance vary from municipality to municipality. For example, the copayment at the hospital may be free or several hundred yen per visit.

The Sony Health Insurance Society carries out the following to avoid duplication of benefits provided by medical assistance from municipal governments with those provided by the Sony Insurance Society.

Regardless of the method of assistance (e.g., benefits in kind *1 or reimbursement *2), use of public funding is given priority.
  • *1 Exemption from payment of medical care costs, in whole or in part, upon presentation of a benefits certificate
  • *2 Reimbursement after paying the entire cost up front

Those with children of ages eligible to receive medical assistance for young children

For examinations and treatment provided in April 2016 or later, a computer system is used to automatically identify the eligibility for medical assistance for young children based on registered address and age. Automatic payment of High-Cost Medical Care Benefits and Additional Benefits is suspended until the child reaches the age at which it becomes ineligible for medical assistance for young children.

However, note that for children living in municipalities that impose income limits, since their status is detected automatically based only on the registered address and age, automatic payment of these benefits is suspended for children who are not eligible for medical assistance for young children due to income limits (i.e., their medical care costs are paid at the normal copayment rate).

Those not eligible for medical assistance for young children who made a copayment exceeding 20,000 yen for medical care costs at the counter of a medical care institution should submit an Application [for Resumption] of Insurance Benefits Payments to the Sony Health Insurance Society.

参考リンク

Assistance other than medical assistance for young children

Those receiving medical assistance for people with disabilities, assistance for single-parent households, etc.

Since the Sony Health Insurance Society is unable to identify eligible persons, submit the Notice of Eligibility for Medical Assistance (New) to the Society if you are eligible for medical assistance from your municipal government.
After receiving this notice, the Society will suspend automatic payment of High-Cost Medical Care Benefits and Additional Benefits.

If you later become ineligible for medical assistance from your municipal government, please submit the Notice of Eligibility for Medical Assistance (Termination) to the Society. After receiving this notice, the Society will lift the suspension on automatic payment of High-Cost Medical Care Benefits and Additional Benefits.

  • * If you receive benefits in error due to a delay in submitting the Notice of Eligibility for Medical Assistance, you will be asked to refund the benefits paid.

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