Refund of Children’s Medical Expenses Subsidy

In Japan, some children’s medical expenses are refundable. If your child does not have the “medical certificate issued under children’s medical expenses subsidy system, maru-nyu, maru-ko, or maru-a-o”, apply for it before claiming a refund.

Reimbursement can be claimed when your child goes to see a doctor outside the area where you live, or when you pay the co-payment for health insurance treatment without presenting your child’s medical certificate. Whether standard meal cost for hospitalization is eligible for a refund or not varies by local government.

Examples of Medical Expenses That Can Be Refunded (Claimed for Refund)

1. If you visit a medical institution outside Tokyo, and pay the co-payment for health insurance treatment
2. If you visit a medical institution that does not handle medical certificates, and pay the co-payment for health insurance treatment
3. If you visit a doctor without a medical certificate, and pay the co-payment for health insurance treatment
4. If your child’s registration for National Health Insurance/National Health Insurance Association is outside Tokyo, and you pay the co-payment for health insurance treatment
5. If you visit a doctor without your child’s health insurance card, and there is coverage from the health insurance
6. If you purchase an assistive device (glasses for pediatric amblyopia, corset, insoles/sole braces, etc.), and there is coverage from the health insurance
7. If you receive treatment abroad, and there is coverage from the health insurance
Eligible medical expenses are the co-payment amount for health insurance treatment. Medical treatment not covered by health insurance (free medical treatment) is not subsidized.

Examples of Non-eligible Medical Expenses

Some medical expenses are not covered by the subsidy.
-Expenses for dietary treatment for inpatients (for maru-nyu)
-Expenses not covered by health insurance
(vaccination, health check, extra bed charge, medicine container fee, first visit fee for large hospitals without a referral letter from another medical institution, etc.)
-Expenses for treatment covered by Japan Sport Council Injury and Accident Mutual Aid Benefit System
-High-cost medical expenses and additional benefits, paid by health insurance
-Medical expenses in case of injury due to the actions of a third party, such as a traffic accident
-Medical expenses applicable to the other publicly-funded subsidies

What You Need for Your Application

When applying for medical expense subsidies, you will need the following materials:
-Child medical subsidy payment application form
-Receipt (original)
* with patient’s name, insurance score, date of medical treatment, medical institution name, receipt amount (if these items are not listed, have it filled out at the medical institution where you had a medical examination). You can also apply with a copy of the receipt, only if the original was submitted for health insurance procedures.
-Copy of identity verification documents with a photo of the guardian listed on the medical certificate (driver’s license, my number card, etc.)
-Copy of child health insurance card
* when applying for the first time or when there are changes from previous applications.
-Copy of passbook or cash card of your banking facility
* when applying for the first time or when there are changes from previous applications.
** parent’s name listed on the medical certificate. Payment will not be made to an account other than the parent’s account listed on the medical certificate.
-Payment decision notice from health insurance (only those who are applicable to item 5, 6 or 7 above. Original required if applicable)
-Copy of credit limit certificate (if applicable)
-Copy of recipient certificate for pediatric chronic specified disease medical expenses subsidy/monthly management slip (if applicable)

There may be other items required if you fall under 5, 6 or 7 of “Example of Medical Expenses That Can Be Refunded (Claimed for Refund)”. Check with your local government office.

High-cost medical expenses payment decision notice is only required for those who are members of the National Health Insurance or National Health Insurance Association, and have a receipt corresponding to high-cost medical expenses. High-cost medical expenses complies with regulations when medical expenses for National Health Insurance benefits become high (High-cost medical care benefit payment decision notification is not required, if you are a member of a social insurance/mutual aid association)

A qualified recipient can make a refund claim for multiple receipts, which may include receipts from different medical facilities or receipts for different months.

Note that claims for more than one child need to be made separately. Claim deadline is 5 years from the day after the day of medical payment.

Claim Application Location and Refund Money Transfer

Applications should be made at the local government office in the area where you live. If there are no defects in the application, the refund will be made to the designated account. Although the procedure may seem time consuming, be sure to apply if you are eligible.