Childbirth

"The Childbirth and Childcare Lump-Sum Grant" is paid when an insured person gives birth and "the Dependents' Childbirth and Childcare Lump-Sum Grant" is paid when a dependent family member gives birth. Don't forget to add the newborn as a dependent in these cases.

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

Amounts paid

When an insured person gives birth

  • Childbirth and Childcare Lump-Sum Grant
    500,000 yen**
  • The society's additional benefits
    Childbirth and Childcare Additional Sum
    50,000 yen

When a dependent family member gives birth

  • Dependents' Childbirth and Childcare Lump-Sum Grant
    500,000 yen**
  • The society's additional benefits
    Dependents' Childbirth and Childcare Additional Sum
    50,000 yen
  • ** 420,000 yen for childbirth through the end of March 2023
  • ** For childbirth (including stillbirth) after at least 22 weeks of pregnancy under the medical administration of a medical care institution or other institution participating in the maternity medical care compensation scheme; 488,000 yen (408,000 yen for childbirth through the end of March 2023) for childbirth at an institution not participating in the maternity medical care compensation scheme.
  • ** Paid per child for multiple births

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

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 50,000 yen.

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.

Payment flow

Example 1: If the medical care institution for childbirth is enrolled in the maternity medical care compensation scheme and childbirth expenses is 500,000 yen

Up to 420,000 yen is billed directly by the medical care institution to the Health Insurance Society.
The insured person or dependent who gave birth first pays the remaining 80,000 yen at the reception desk.
After childbirth, the insured person or dependent submits the “Application Form for Childbirth and Childcare Lump-Sum Grant,” and the Health Insurance Society disburses 50,000 yen in additional benefit.

Example 2: If the medical care institution for childbirth is enrolled in the maternity medical care compensation scheme and childbirth expenses is 400,000 yen

Since childbirth expenses is less than 420,000 yen, the insured person or dependent who gave birth does not pay at the reception desk.
After childbirth, the insured person or dependent submits the “Application Form for Childbirth and Childcare Lump-Sum Grant,” and the Health Insurance Society disburses 70,000 yen (50,000 yen in additional benefit plus 20,000 yen of difference in the Childbirth and Childcare Lump-Sum Grant).

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"

The maternity medical care compensation scheme

This system pays compensation when a newborn child develops cerebral palsy despite being born through normal pregnancy and birth. The Japan Council for Quality Health Care manages the system, and most medical institutions providing childbirth services are members.
Childbirths eligible for compensation must meet all of conditions (1)-(3): (1) childbirth following at least 28 weeks of pregnancy; (2) case of cerebral palsy equivalent to a grade 1 or grade 2 physical disability; (3) case of cerebral palsy not due to congenital factors or factors arising in the neonatal period (Evaluation criteria for compensation differ depending on the date of birth. See this reference link below).

Reference link

Caution:

The right to claim health insurance benefits expires in two years.