Medical care cost information

The Health Insurance Society prepares "medical care cost information" so that you can check how much you paid in medical care costs and review the actual medical care costs.

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FAQ

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Check the actual medical care costs using your "medical care cost information" and receipts or detailed statements.

About medical care cost information

Medical care costs for sickness and injury treatment are uniformly determined at all hospitals in Japan, based on the standards established by the Japanese government as Medical Fees. However, using health insurance, the only amount you pay at a hospital is the copayment. This can make it hard to grasp the actual medical care costs incurred.

For this reason, the Health Insurance Society prepares and distributes to members "medical care cost information" showing details such as the amount of medical care costs you paid and the benefits paid by the Society.
Starting with income tax returns filed for 2017 income, to claim medical expenses deductions, you can attach medical care cost information to your tax return as details of medical care costs. Keep these documents in a safe place.

Reference link

Medical expenses deductions

In addition, medical care institutions will issue receipts showing medical care costs per item, including charges for the first consultation, checkup charges and treatment charges, as well as detailed statements showing more detailed "medical care information". Try to check these against the medical care cost information you receive from the Health Insurance Society later.

Medical care cost information and notice of payment decision

You can view medical care cost data for the current and previous fiscal year for the insured person (enrollee) and dependents.
The “Medical Care Cost Information” and “Notice of Payment Decision Regarding Insurance Benefits” available on the website can be substituted for receipts when applying for a medical care cost deduction in your tax return.

Note

“Medical care cost information and notice of payment decision” will be made available after the Pfizer Health Insurance Society receives and confirms the rezept (claim) from the hospital or dispensing pharmacy. Therefore, data will become available three months after the month of your medical consultation and treatment.
If you wish to use the data as a receipt for your tax return, you will need to use the receipt you have at hand which you received from the medical care institution for the December statement.

Medical Care Cost Information	Notice of Payment Decision Regarding Insurance Benefits
Details issued by medical care institution, dispensing pharmacy, etc. for outpatient, hospitalization, and treatment services received in a one-month period	Details of benefits that the Pfizer Health Insurance Society decided to pay to its members
Each column shows the amount for visits to a single medical care institution (per department for university hospitals, etc.) in a month. The total amount for the medical care institution does not include items not covered by insurance, such as the difference in the cost of the bed for hospitalization. There may be delays in billing from the medical care institution, and therefore, the costs may not be listed even if medical care had been received. Please check the receipt you have at hand.	Examples: Childbirth and childcare lump-sum grant (and additional sum) Maternity allowance Injury and sickness allowance (and additional sum) Medical care expenses	Examples: High-cost medical care benefits Medical care additional sum Patient cost-sharing reimbursements and additional benefits Total high-cost medical care benefits Total medical care additional sum, etc.
Example: Due to the processing of rezepts (claims from hospitals), details for the current month’s medical consultation and treatment will be posted three months later, e.g., medical care costs from hospital visit in April ⇒ details posted in July	If the application form is received from the employer by the 20th of each month, insurance benefits will be deposited to each employer the following month. Each establishment will make a deposit to insured persons.	Example: Due to the processing of rezepts (claims from hospitals), details for the current month’s medical consultation and treatment will be posted three months later, e.g., medical care costs in April ⇒ Payment decision made and details posted in July