Q&A  - Medical Care -
		Q1. What is the best way to contact a doctor?
		A1. At Japanese medical institutions, hospital stays and examination provided by large hospitals are separate from those services provided by local clinics. Check out your local medical facilities ahead of time in order to avoid rushing into an unpleasant situation when you need treatment. 1. Understanding Japanese Medical Institutions Reservations: Hospitals request that you make reservations beforehand. If you do not, the time it takes to get an examination may be greatly increased. Examinations: As part of the examination, they may take blood samples or X-rays. Please follow the staff's instructions. Medicine: The doctor will prescribe the medicine for you, which you can receive at the hospital's pharmacy after the examination. Please ask for an explanation at the time you receive your medicine because the label will be written in Japanese. Your prescription might also have to be filled at another pharmacy. 2. In Europe and America, the order of the examination procedures is the same. Medicine is divided into categories like internal medicine, pediatrics, surgery, plastic surgery, gynecology, dermatology, opthalmology, ENT, and dentistry. Most large hospitals will have all of these different services available, but if you are not sure what kind of help you need please tell the staff your symptoms and ask for advice.
		Q2: What should I do once I get an examination appointment?
		A2: Try to go with a person who can speak a reasonable amount of Japanese. Since an appropriate examination cannot be conducted in case of an emergency, please try to select a physician to whom you can go regularly so he/she can be familiar with your particular circumstances. Please try to tell the staff beforehand if you have any religious or otherwise personal restrictions that might affect treatment. 1. Things you will need at the examination (1) Proof of medical insurance (2) Money to pay the doctor's fee (in yen) (3) A list of your address, phone number, and symptoms 2. It is unusual for clinics to conduct examinations outside their normal hours. Generally, they are closed on most weekday mornings, Sundays, and holidays. Please call to confirm their available services and operating hours before you go. 3. Receiving an examination (1) Follow the procedures at the reception desk. Present your health insurance card. (2) Take a number and wait in the appropriate department's waiting room. (3) After the examination, pay the doctor's bill. (4) If the doctor prescribed medicine, pick it up at the pharmacy. At both hospitals and clinics, the bill is usually paid at the reception window. Bills: If you are not covered by medical insurance, then you will be responsible for paying the whole amount yourself (and will be treated as an "independent examination"). In the case of an "independent examination", depending on the particular institution, there is a chance that the fee will be unusually high, even though the examinations may seem the same.
		Q3: What should I do when I'm buying medicine at a local pharmacy or drug store?
		A3: In Japan, your prescription can be filled at your local pharmacy. 1) If you have to get medicine from the pharmacy, the next two cases apply: Buying general medicine (headache, cold, or stomach medication): when you're not feeling well, you can buy medicine at the drug store without seeing a doctor, but this won't be covered by health insurance and will have to be paid completely by yourself. Buying prescribed medicine: after a hospital or clinic examination, your prescription can be filled for you at a pharmacy, hospital, or clinic. In this case, if you have medical insurance, you only have to pay your portion of the bill (dictated by your insurance). 2) At the pharmacy, the resident pharmacist will try to give you an explanation about your medicine. Because the information about the medicine going to be written in Japanese, please pay close attention to the pharmacist's explanation about how to take the medicine, any warnings about its use, and any side effects. As there will not be an interpreter present, try to have someone who can speak Japanese accompany you to the pharmacy. 3) Drug Stores Your town will have drug stores in addition to pharmacies. At drug stores, the pharmacist will be able to sell medicine and explain its uses, warnings, and side effects, but you cannot fill your prescriptions there.
		Q4: What should I do if I become sick while on vacation?
		A4: In Japan, people on vacation and people without a fixed residence (called "travelers" below) who require admittance to a hospital (including travelers who become sick or die while here) will receive assistance. 1) Details about the assistance In case the person cannot afford to pay the medical bill, it will be covered 2) How to receive assistance People who want to receive this assistance must fulfill the following requirements: (1) You must have become ill during your vacation, not prior (2) You do not have any way to pay, and there is no one who can help you pay (3) You have no health insurance or other such protection plan 3) Official Procedure The city, town or village where the traveler was aided will undertake the procedure. It will be decided whether this system will be applied after the necessary investigations take place.
		Q5. What should I do if I hurt my self or get sick?
		A5. When you are suddenly sick or sustain serious injury, you call should 119 for an ambulance. Relax and convey your message clearly. 1) An example of what you should say: First, say whether you require an ambulance or if there is a fire. Then say specifically what happened; for example if your wife has collapsed, say where she collapsed, the telephone number, the full address, and give any landmarks. 2) When you hear the ambulance’s siren, if possible go out onto the road and let the ambulance know where you are. If you have a family doctor, give a note with his name and address to the ambulance paramedic. The paramedics will take you to the closest medical facility, taking into account the nature of the symptoms and the injury. Depending on the situation, they may not take you to the hospital you wish to go to. 3) Other things to be aware of: If possible, try to take somebody who can speak Japanese. The number 119 is also for the fire brigade; so make sure to let them know which you require. The ambulance is free, but if the injury is not serious and you are capable of going to the hospital on your own you must do so. When you leave the hospital, you must leave under your own steam, and when you go to the hospital take your health insurance card, some cash and a dictionary. 4) When you are looking for a hospital by telephone, and you are capable of going by yourself, look for a place that is able to treat you. Try to find someone who can speak Japanese
		Q6. I heard that there is a system, which will cover some of the costs of expensive medical treatment.
		A6. When you use a medical facility in the event that you are sick or injured, if you use national health insurance, you only have to pay a third of the cost of the treatment. If it is company medical insurance, you only have to pay 20% and your dependents will have to pay 20% in the case of a hospitalization, or 30% if they are outpatients. We call this partial responsibility. However, in the case of extended hospitalization or treatment, depending on the type of treatment, even 30% can be a lot of money. In this case, you can use the expensive medical treatment" system. With this, when the amount you pay to the medical institution exceeds a certain amount, the system will cover the difference. 1) Under this system, if the partial payment you have made to the same medical institution exceeds 63,600 yen in a month, you will be paid the amount in excess of that under this system (if the medical fees are more that 318,000 yen, 1% of the amount that it exceeds this amount will be added to the 63,600 yen). Example A: I went into hospital and in one month, it cost me 250,000 yen. With national health insurance, I paid 30% (75,000 yen). In this case, under the expensive treatment system, you will be reimbursed 75,000 -63,600= 11,400. Example B: In one month medical expenses totaled 500,000 yen. In one month, national health insurance will cover 70% so you must pay 150,000 yen. With the “expensive medical treatment fee system you will be reimbursed 63,300 + (500,000-318,000)0.01=65,420 yen so you will be reimbursed 150,000 - 65,420 = 84,580. When your household is exempt for paying ward tax, you will not pay more that 35,400 yen no matter how much the medical costs are. In the case of Example A you will be reimbursed 75,000 yen - 35,400 yen = 39,600 yen. In the case of Example B you will be reimbursed 150,00 - 35,400=114,600 yen. 2) When, in the same household, you made a partial payment of more than 30,000 yen (in the case where the household pays no tax, 21,000) more than twice in one month, the amount, which exceeds the limit, explained in Part 1 will be provided by expensive medical treatment" assistance. Example: If the father has to pay medical fees of 200,000 yen in one month, and his child has to pay 100,000 yen, the fathers partial payment will be 60,000 yen and the child will be 30,000 yen. If it is only one person then you cannot use the expensive medical treatment" assistance system. However, both of them have exceeded the 30,000 yen so they will be reimbursed (60,000 yen +30,000 yen)-63,600 yen = 26,400. If this were a non-tax paying household then they would be reimbursed (60,000 yen + 30,000 yen) - 35,400= 54,600. 3. When, for reasons of extended hospitalization or other reasons, you have used the expensive medical treatment" assistance system more than three times in a year then the limit on the amount you must pay yourself for the fourth time that you use the expensive medical treatment" assistance system will be 37,200 yen and in the case of a non-tax paying household, 24,600 yen. 4. When the income of the household exceeds 6,700,000 (in the case of company health insurance where the standard monthly wage is more than 560,000 yen) the method of calculation is different. In this case, the limit, which I explained in Part 1 as being 63,600 would be 121,800 and the figure of 318,000, will become 609,000. Note: Medical expenses to which the expensive medical treatment" assistance system applies, are those which accrue to medical insurance consultations (30% of the fees, or else 20% of them), and the balance - bed costs, gold fillings, meals while hospitalized, are not part of them. You must first pay the partial payment you are required to, and then you apply for the expensive medical treatment" assistance system. It will then pay the fees, which are left over. If the medical costs are so high that you cannot even cover the partial fee, then you can use the expensive medical treatment payment fund system " (a system of temporal payment on your behalf of all the fees which go over a certain limit of expensive medical costs, without interest). If you use this system, you can manage by just covering the limit on the expensive medical costs. (For those on company health insurance, there is also an expensive medical treatment fund system." There are differences in the system from region to region. Details about the temporal payment system and the fund can be had from your local town or city office, at the consultation desk of the health insurance section, or at the consultation desk at a hospital or clinic (Health Social Worker). Please be sure to keep all your hospital and clinic receipts.
		Q7. What kind of checkups and advice can one get when pregnant?
		A7. 1. Parents class In each city, town or village, there is a class for learning knowledge and techniques necessary for pregnancy, birth and child rearing. Anyone who is pregnant for the first time and her husband may participate. Participation is free and the classes take place in Japanese. 2. Family Planning and Birth Control Consultations To protect the health and ensure the rearing of a healthy child, it is necessary for pregnancy and birth to happen in a planned way. Towns, cities and villages offer consultation on birth control and family planning. The consultations are free, and are conducted in Japanese. 3. Visits and Guidance by the Nurse Each city, town and village dispatches a nurse to families where they are needed, to check up and give advice on the health of the mother-to-be and the preparations for birth. These checkups and advice are free, and take place on the request of the parent-to-be or by introduction from the doctor. They are conducted in Japanese. 4. In your mother and baby book there will be a consultation form. With this, you can have a free health check up at any medical facility in the prefecture, twice during your pregnancy. (In Yokohama City, Kawasaki City, Yokosuka City, and Sagamihara City, the law is different, so please ask at each city). Normally, there is no interpreter at medical facilities, so please go with someone who speaks Japanese.
		Q8. My child was born premature. I will need money for hospitalization, but is there any public assistance for this?
		A8. In Japan for premature children who need to be hospitalized, there is a system to provide funds to help with the medical costs until the child can survive on its own. This system differs from region to region, so here we will give the example of Kanagawa Prefecture. 1. The Prefecture will assist with the partial payment of medical fees, but may ask you to contribute according to your income. 2. You may receive assistance if you fill the following conditions: ‡@ The patient lives in Kanagawa Prefecture ‡A The patient is less than one year old. ‡B The patient weighed less than 2000g at the time of birth or was particularly weak and unable to survive on its own, and the doctor advised the child to be put into a medical facility and receive care ‡C The patient is enrolled in a domestic health care insurance fund. 3. The person caring for the child should apply at their local health center.
		Q9. How can I get inoculation for my child?
		A9. In Japan, each city town and village conducts inoculation programs to prevent citizens contracting infectious diseases and to prevent infectious diseases spreading across the region. A.The types of diseases inoculated against are the following (also included is the timing for the shots): 1. Combined shot for diphtheria, pertussis and tetanus (DPT) 1st shot: 3~90 months after birth, three times at a space of one every 3~8 months 2nd shot booster: after the first shot (leaving a space of at least 6 months) 3rd shot: once during the 6th year of elementary school 2. Polio - before the age of 3~90 months, twice, leaving a space of at least 6 weeks 3. Measles - once between the period of 12~90 months after birth 4. Japanese encephalitis - 1st shot: before 6~90 months after birth 1st booster: before 6~90 months after birth (after getting the first shot, generally leave a year) 2nd booster: before the age of about 9~13 3rd booster: at the age of about 14 or 15 5. Tuberculosis a) Those who test negative to tuberculin testing before the age of 4 b) Those who test negative to tuberculin testing at the age of 1st year primary school c) Those who test negative to tuberculin testing at the age of 2nd year primary school and who had their TB jabs in the 1st year of primary school d) Those who test negative to tuberculin testing at the age of 1st year junior high school e) Those who test negative to tuberculin testing 6. Rubella - within 12~90 months of birth A. Space between inoculations Preventive inoculations must be taken with a specific space of time between them. This time varies from region to region, so please ask at your local authority. B. Cost Inoculations done at the town or city or village are free of charge. Apart from that, if you take inoculations at a medical facility there will be a charge. C. Warning When you go to get the inoculations, please take your mother and baby book. Please take the baby’s temperature the night before and the morning of the day you go to get the inoculation.
		Q10. My child just born has a disability, but can I get assistance for his medical fees?
		A10. In Japan, we have a system to assist with medical fees for treating physical disability. 1. The system will help with the financial burden you are left with after getting treatment with health insurance, but this will depend on your income, and you will be expected to pay some of it. 2. Persons who can receive assistance a) Those patients under the age of 18 who are enrolled in a Japanese health care system b) Those patients who have been recognized as going to have the same degree of disability as someone who is in possession of a “physically disabled person card". c) Those patients who are going to receive treatment at a specified health institution 3. Procedure for application Please apply to the health center or Health and Welfare Office, which is in charge of your area (the area where the person who is responsible for the child lives)

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