Social welfare system

HIV and Social Welfare

Other medical payment services

Specified chronic childhood disease medical treatment research project
What is the specified chronic childhood disease medical treatment research project?
The specified chronic childhood disease medical treatment research project is a project in which the national government studies the treatment of children 20 years old and under, who need treatment for specified long-term diseases, to lessen the burden of medical costs. Effective April 1, 2005, the project was moved under the Child Welfare Act and amendments made to the contents. (Ministry of Health, Labour and Welfare Equal Employment, Children and Families Bureau, Bureau Chief's report February 21, 2005 No. 0221001)
What has changed since April 1, 2005?
Major changes include the following.
1. Copayment

The amount of individual copayment will be determined from the amount of municipal and income taxes paid the previous year by the primary income earner of the household (see the table below).
*However, persons who apply to the following are exempt from paying medical costs.
a) Persons with hemophilia (including patients eligible for the congenital blood coagulation factor deficiency disease medical treatment research project)
b) Persons eligible for severe disease compensation

[table] Copayment costs for specified chronic childhood disease medical treatment research project
Division Copayment costs (per month)
Insured households under the Public Assistance Act inpatient 0 yen
outpatient 0 yen
Exempt of ward or municipal inhabitant tax inpatient 0 yen
outpatient 0 yen
Exempt of income tax inpatient 2,200 yen
outpatient 1,100 yen
Taxable income for the previous year was lower than 10,000 yen inpatient 3,400 yen
outpatient 1,700 yen
Taxable income for the previous year was between 10,001 and 30,000 yen inpatient 4,200 yen
outpatient 2,100 yen
Taxable income for the previous year was between 30,001 and 80,000 yen inpatient 5,500 yen
outpatient 2,750 yen
Taxable income for the previous year was between 80,001 and 140,000 yen inpatient 9,300 yen
outpatient 4,650 yen
Taxable income for the previous year was higher than 140,001 yen. inpatient 11,500 yen
outpatient 5,750 yen
2. Revision of target diseases

In the previous system, 488 illnesses in 10 groups were studied. As of April 1, 2005, 40 types of diseases were newly added, making a total of 514. At the same time, 10 types including rheumatic fever, simple goiter, and allergic purpura, were removed from the research. For details, please consult your nearest government or health office.

3. Expansion of target age group
For all diseases, new registrants under 18 can now continued to be studied until they turn 20. For continuance, application must be made while the patient is 18 years of age (from the 18th birthday to the day before the 19th birthday). Only those whose continued treatment is deemed necessary will be eligible.
4. Expansion of medical care
Previously, benefits were not necessarily granted to all outpatients, depending on their disease. Effective April 1, 2005, outpatients and inpatients of all diseases are now eligible for benefits. Medical care benefits are granted to eligible patients, on medical fees for treatment, cost of special diet during hospitalization, insured prescription drugs and visiting nurses. Benefits do not cover assistive devices.
5. Severity of patients

Patients who meet a specific standard of severity are certified as critically ill and are exempt of copayment. In order to receive certification, an "application form for critically ill patient certification" must be submitted. Please ask your physician if you or the person under your care meet these standards.

6. Change of title

The title has been changed from "specified chronic childhood disease beneficiary card" to "specified chronic childhood disease consultation card".

7. Welfare equipment rental
How do I apply for a specified chronic childhood disease consultation card?
Submit the necessary documents to the government office (e.g. welfare section) or health office in your jurisdiction (in person or by mail).
What you need
  • Application form
  • Personal seal
  • Health insurance card
  • Authorization for use of medical documentation for the purpose of research
  • Medical assessment (to be filled in by physician)
  • Proof regarding primary income earner's income taxes of the primary income earner (copy of tax deduction certificate or income tax return) <see note 1>
  • Application for critically ill patient certification <see note 2>
  • Documentation to prove extent of disability (e.g. copy of physical disability certificate or disability pension certificate) <see note 3>
Notes <note 1> Not necessary for persons with hemophilia or those applying for critically ill patient certification.
<note 2> Only necessary for those applying for critically ill patient certification.
<note 3> Only necessary for those applying for critically ill patient certification.
As a rule, guardians are now responsible for application procedures, but this may be done in lieu of the patient or guardian. New registration for continuance must be made each year. Necessary documents are available at government offices and medical institutions. Some organizations will download applications from municipal websites.
When can I start using the specified chronic childhood disease consultation card?
The card is good from the date of application, unless otherwise specified. If medical expenses were incurred between the date of application and the date of receipt from the issuing authority, remuneration will be made for the amount exceeding the limit of copyament. In the case of the City of Hiroshima, if application had been made within one month of medical expenditure, the date of issuance may be set back to the date of diagnosis on the doctor's report or the day that treatment commenced. However, commencement will not be set back beyond the date that diagnosis was confirmed, thus will not cover tests and other procedures made prior to final diagnosis.
Where can I use the specified chronic childhood disease consultation card?
As the specified disease and name of institution at the time of diagnosis is specified on the medical card, this system can only be effective at the institution mentioned on the card, for the particular disease. For treatment of said disease at a separate institution, additional registration for that institution can be made.
What do I need to do, when visiting a medical institution?
Submit the card with your insurance card to the medical institution when you arrive. If you simultaneously have any other coverage (e.g. infant medication or critical illness benefits), submit documents for those as well.
What will my copayment be like?
Your payment will not exceed the monthly cost-bearing limit stated on your consultation card. If the invoice does not exceed that amount, you will need to pay that amount. You will need to pay the amount up to your monthly limit for each medical institution. If the total amount paid to all institutions exceeds your monthly cost-bearing limit, you will receive remuneration by applying to the health center within the government of your local jurisdiction. Monthly co-payment limits differ for inpatient and outpatient consultation and treatment as follows.
  • All consultation within the month as an inpatient – inpatient cost-bearing limit
  • All consultation within the month as an outpatient – outpatient cost-bearing limit
  • Both inpatient and outpatient consultation within the month – inpatient cost-bearing limit
What happens when emergency consultation at another hospital becomes necessary?
If the consultation is for treatment of an eligible disease, application can be made for coverage from the day that treatment commenced. When adding a medical institution visited for an emergency, indicate the emergency in the space provided for reason of addition.
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