Childbirth and Childcare Lump-Sum Grant

Childbirth and Childcare Lump-Sum Grant

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”.

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 Association will pay the difference to an insured person or dependent family.

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 Association is required.

• ** If you decide not to use the system of direct payment of Childbirth and Childcare Lump-sum Grant to medical institutions and to apply to the Health Insurance Association for the Childbirth and Childcare Lump-sum Grant at a later date, you must submit agreement documents indicating that you will not use the system.

System of receipt of the Childbirth and Childcare Lump-sum Grant directly by the medical institutions on your behalf

Under this system, the insured person can apply in advance to the Health Insurance Association for the Childbirth and Childcare Lump-Sum Grant and designate the institution to receive it on his or her behalf. The institution then receives the grant directly from the Society. You can use this system, for example, at certain small institutions that have submitted the necessary notices.

(Definition of)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.
For childbirth (after at least 22 weeks pregnancy) at a medical institution providing childbirth services and affiliated with this program, the Health Insurance Association pays a Childbirth and Childcare Lump-Sum Grant of 500,000 yen, which includes an additional contribution of 12,000 yen/child.
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

The maternity medical care compensation scheme: (Japan Council for Quality Health Care)

• Click here for procedures.