What should I do with the “hospitalization insurance” procedure for corona home care?
July 26, 21:41
In mid-June, my husband (reporter Kanazawa), who was assigned to work alone, was infected with the new coronavirus and was treated at home.
She had a fever and sore throat, but fortunately she had a mild illness.
When I told my boss about my husband's corona infection, the words I got back were "It seems that you can get hospitalization insurance even at home medical treatment" "Well, you are hospitalized even though you are receiving medical treatment at home?" So I looked it up.
While home medical treatment records the highest number ever
Due to the rapid spread of infection due to the "7th wave", the number of home care recipients has reached a record high.
If you receive medical treatment at home, you can receive hospitalization benefits depending on the contents of your medical insurance contract.
About this, on SNS, "Our employee got 300,000 yen after taking a rest for 3 weeks due to a chain from a child" or "I got more than 200,000 with corona insurance and life insurance that I had just in case. It helps because my husband can't go to work because of close contact. "
In addition, there are posts such as "It seems that the number of contractors who go to receive PCR immediately after taking out a type of medical insurance that gives hospitalization benefits if it is judged positive" or "I will test as many times as I want until it becomes positive". You can see it.
What do I need to get the benefits in the first place?
According to the Life Insurance Association of Japan, to which the insurance company is a member, the required documents differ slightly depending on the insurance company, but in principle, in the case of home medical treatment or accommodation medical treatment, a positive diagnosis is received from the medical institution and "deemed hospitalization" is required. You will be required to prove it.
"My HER-SYS" is a national system in which patients enter their health status on their smartphones and personal computers.
It is used to report your physical condition by registering by contacting a health center or medical institution when you receive medical treatment at home.
The country says that if the medical treatment period is within 10 days, this system can be used to prove the start date.
In some cases, the hospitalization benefit will be paid by filling out a form that describes the period of medical treatment sent from each insurance company and printing this screenshot.
If the "My HER-SYS" screen is not available, you can use the "Accommodation / Home Care Certificate" issued by a medical institution or health center instead.
If the medical treatment period is 11 days or more, depending on the insurance company, you may be able to make a claim only with the "accommodation / home medical treatment certificate", provided that the start date and end date of the medical treatment are clearly stated.
Approximately 40 companies that are members of the Life Insurance Association of Japan paid 913,685 hospitalization benefits last year for home medical treatment and accommodation medical treatment, which amounted to approximately 88,970 million yen.
This year, in just two months until the end of May, there were 1,164,754 cases, about 107,040 million yen.
It has already exceeded the number and amount of cases last year.
Expert "At the time of insurance review"
Regarding the increase in payments of "hospitalization benefits" for home medical treatment, Professor Nobuyasu Uemura of Fukuoka University, who is familiar with the insurance industry, said, "I don't think it has reached a level that will shake the health of insurance companies in terms of finance." On the other hand, he points out that the situation may not be what the insurance company initially envisioned.
Professor Uemura, Fukuoka University
"There is a reality of moral risk that there are people who take out insurance without declaring it when it turns out that it is as close to positive as possible, such as becoming a close contact. Join in preparation for future anxiety. It is happening now that the originally envisioned form of insurance does not hold. It
is especially difficult to provide insurance specialized for the new corona, and new acceptance is stopped or insurance premiums are raised. It may have led to a move to do so. It may be time to review the insurance for Corona. "
Also, regarding insurance for the new Corona in the future ...
Professor Uemura
"I'm not sure how the new corona will be handled, so I can't say for sure. If there is no" deemed hospitalization "such as home medical treatment, there will be no hospitalization benefits for that. I think
that if the medical expenses that the government has borne will be borne by the government, insurance will come out to cover the costs. "
Check with your insurance company
According to her husband (in Kanazawa), who learned that "hospitalization insurance" can be claimed for home medical treatment, he ordered an application form from the insurance company's homepage, filled in the necessary information, and two screenshots of "My HER-SYS". Was sent back together.
The procedure is simple, and it seems that the prescribed fee has been transferred.
Some local governments are implementing "voluntary medical treatment" for people with a low risk of aggravation, who can choose to receive medical treatment without going through a medical institution or health center if they become positive with a commercially available antigen test kit. There is a place where it is.
Whether or not you can claim private insurance based on the medical treatment certificate issued by these local governments is handled differently.
When you interview an insurance company, there is no big difference in the procedure between each company, but please be sure to check what kind of documents are required for the insurance you have.
(Reporters: Shie Kanazawa, Yu Suzuki, Shou Ito, Yuichiro Yano)