Yet more about private insurance in Japan

I am a bit blogged out, so I want to pick up something that poster “Zaichik” took the time to add to the Japan Today discussion. (For my now-and-again readers who are just picking this up, I have been blogging about whether taking a private company plan–when you are supposed to be in a plan authorized by the Japanese government–is wise, ethical or appropriate.)

Responding to: I pay 8000 yen a month with Global Health Care and I have 100% coverage anywhere

Zaichik: I know the InterGlobal policies (= Global Health Care) backwards and this certainly doesn’t tell the whole story. You’re not covered for pre-existing conditions (unless you’re fortunate enough to be in one of the big group plans where medical history is disregarded), you have to pay upfront for outpatient expenses, including MRIs, and if the hospital you need to be admitted to is slow in providing the requisite info to your insurer, you may have to pay upfront for your inpatient charges as well. Not to mention the fact that the Japanese national scheme isn’t bothered about pre-existing conditions or whether you’ve been abusing your liver for years. Many hospitals charge 150% of the standard charge if you’re not insured through the Japanese national scheme, so if the treatment you need might really cost your insurer an arm and a leg, it wouldn’t be unheard-of for them to get you to enrol in the national scheme anyway (possibly paying the back charges for you, if it’s cost-effective). If you develop a chronic condition or your insured child has a congenital condition at birth, there may be a cap on what your insurer will pay out.

As for the coverage for repatriation of mortal remains, it’s a rare case where the insurer gets the information to provide coverage before the repatriation takes place. In most cases, the insured’s family (or company, for the luckier ones) have to pay upfront and then claim back, making their own arrangements with a funeral director (local cremation in Japan and transport of ashes back home in a family member’s hand luggage is much cheaper). So unless you or your family has that ready cash, it’s not that much of an advantage – you could just as easily pay a little extra into a life insurance policy.

Having said all that, if you’re in a long-term coma after an accident and need to be transported home to a country with free public healthcare, then private insurance perhaps has the edge. Then again, if the accident was caused by another party, then their insurer will probably end up paying the bill in the long run, whether directly or via subrogation . . .

These were a few things I didn’t know.

From what I said above, my view has always been that avoiding a legitimate Japanese policy is:

Wise: NO!
Appropriate: NO!
Ethical: NO!

And because the Japanese mandatory policies are comprehensive and billed based off of a progressive income scale, trying to get around these is a little like tax cheating. A lot like it, ne?

In recent weeks, some of the better known “expat insurers” are now coming up with legitimate gap insurance policies. And these are fine by me, if you want to spend the extra money. Some people want zero health insurance bills[. This has been true] both in the greater Japanese community and among expat foreigners and long-term non-Japanese residents.

Isn’t that why AFLAC’s got the cat and the duck joining forces and dancing (for Aoi Miyazaki) in this CM?

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