After giving birth by Caesarean section, I was in the black for 310,000 yen.

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I gave birth to a boy by Caesarean section in May 2020.

When I was 8 months pregnant, I was hospitalized in a hurry due to pyelonephritis and imminent premature birth, and I just gave birth.
The length of hospital stay is one month!
As a result, the cost of childbirth has become high (T_T).

I was very scared to see the amount when I made the payment after one month of hospitalization.

However, when I made full use of my health insurance and medical insurance that I had taken out individually, my childbirth cost became a surplus of 310,000 yen!

In this article, we have summarized the actual costs of childbirth and the systems used to cover the costs of childbirth (lump-sum birth allowance, high-cost medical care system, medical insurance).
I hope it will be helpful for those who are concerned about the cost of childbirth (^^)table of contents

Cost of hospitalization for one month including childbirth: ¥ 756,000

The cost of hospitalization for one month, including delivery by Caesarean section, was 756,000 yen .
Very expensive! !!

Since it was a Caesarean section, the cost of childbirth is covered by insurance. (Normal delivery is not covered by insurance)
This amount is applied even if the insurance coverage costs 30%.
It’s scary to think that if it’s a 100% burden … (* _ *;)

In my case, it was much more expensive than a normal Caesarean section because it included the cost of being hospitalized for pyelonephritis and imminent premature birth before giving birth.
By the way, at the general hospital where I gave birth this time, it seems that the cost of giving birth by Caesarean section is about 500,000 yen.
I had trouble before giving birth, so it cost 1.5 times as much as usual.

Payment amount at discharge: ¥ 776,000 – ¥ 420,000 (lump-sum payment for childbirth and childcare) = ¥ 336,000

At the hospital where I gave birth, I used the direct payment system for the lump-sum childbirth and childcare allowance .What is the direct payment system for lump-sum payment for childbirth and childcare ?

Before giving birth, the insured, etc. and the medical institution, etc. conclude a contract for the payment and receipt of the lump-sum birth and childcare allowance, and the medical institution, etc. applies for the lump-sum birth and childcare allowance to the association Kenpo on behalf of the insured, etc. This is a system that allows you to receive a lump-sum payment for childbirth and childcare directly.

Since the lump-sum childbirth and childcare allowance is paid directly from the Japan Health Insurance Association to medical institutions, there is no need to pay the high cost of childbirth at the medical institution.

Reference: About lump-sum payment for childbirth and childcare | Frequently Asked Questions | Japan Health Insurance Association

Originally, a maternity woman applies to a health insurance association and receives a lump-sum payment for childbirth and childcare.
However, the money received by the maternity woman will eventually be paid to the medical institution as the cost of childbirth.
In that case, instead of going through the maternity once, the health insurance association pays directly to the medical institution to reduce the time and effort of applying.

The direct payment system for childbirth and childcare lump sum payments can be used simply by receiving documents from the hospital that gives birth, signing and submitting them.
I also used it, but it was very easy.
It’s definitely easier than applying for a health insurance association yourself .

I was particularly grateful that I didn’t have to pay the full amount of 756,000 yen at the time of discharge because the cost of childbirth was high.
Even though I’ll be back later, it’s hard to get a lot of money out at once …

When I was discharged from the hospital, I actually paid 336,000 yen, which is the childbirth cost of 756,000 yen minus the lump-sum childbirth and childcare allowance of 420,000 yen .

Childbirth and Childbirth Lump-sum Payment Payment at discharge
¥ 756,000 － ¥ 420,000 =　 ¥ 336,000

Thanks to the lump-sum childbirth and childcare allowance, the high cost of childbirth has been reduced to less than half .
(It’s still expensive, but …!)

By using the high-cost medical treatment system, you will have to pay ¥ 336,000 → ¥ 57,600!

Childbirth costs for normal delivery are not covered by insurance.
However, if you have a Caesarean section, suction delivery, forceps delivery, etc. that I have experienced, you will be covered by insurance and will be covered by the high-cost medical treatment system.What is the high-cost medical treatment system ?

If the out-of-pocket amount of medical expenses incurred in the same month (from the 1st to the end of the month) becomes high,
the amount exceeding a certain amount (out-of-pocket amount) will be refunded later.

Reference: https://www.kyoukaikenpo.or.jp/g3/sb3030/r150/

The out-of-pocket limit depends on your income.
The higher your income, the higher your out-of-pocket cost, and the lower your income, the lower your out-of-pocket cost.

For my income, the self-pay limit was 57,600 yen.
In other words , if your monthly medical expenses exceed 57,600 yen, you will be able to receive a refund for the excess.It is important that the condition for using the high-cost medical treatment system is the same month (from the 1st to the end of the month) .

Example) If a person with a self-pay limit of 57,600 yen is hospitalized for one week and the medical expenses are 100,000
yen, the medical expenses are 50,000 yen in January and 50,000 yen in February ⇒ High medical expenses Not available ×
Medical expenses of 100,000 yen were incurred in January ⇒ High medical expenses are available ○

In this way, even if medical expenses are high, you may not be able to use the high-cost medical treatment system if you cross the month.

I happened to be hospitalized in early May and discharged at the end of May, so I was able to use the high-cost medical treatment system without any problems.

By using the high-cost medical treatment system, I was able to receive a refund of 278,400 yen, which is the 336,000 yen paid at the time of discharge minus the self-pay limit of 57,600 yen.

Amount to be paid at the time of discharge Refund under the high-cost medical treatment system Self-pay limit
　336,000 yen-278,400 yen =　　57,600 yen

For planned Caesarean section, it is recommended to apply for a limit certificate

If you have a planned Caesarean section like me, you can apply for a limit certificate in advance so that you do not have to pay at the counter if your medical expenses exceed the self-pay limit.

Not to mention the planned Caesarean section, it is safe to apply in advance because you do not know what will happen to the childbirth.

I knew the limit certificate after giving birth, so I didn’t apply (; ^^)
If I applied, I would have paid 57,600 yen from the beginning, so I should have applied early. I regret it.

Medical insurance benefits that you had individually enrolled: ¥ 370,000

The reason why my childbirth expenses went into the black was largely due to the medical insurance benefits I had taken out individually.
About a year before giving birth, I had medical insurance that covered hospitalization and surgery.
Here is a breakdown of the benefits I received during this hospitalization.《Breakdown of benefits received from medical insurance》
・ Lump-sum hospitalization fee ¥ 50,000
・ Hospitalization benefit ¥ 5,000 / day x 24 days = ¥ 120,000
・ Surgical benefit ① ¥ 100,000 (* Urinary received for treatment of pyelonephritis Tube stent placement)
・ Surgical benefit ② ¥ 100,000 (* Caesarean section)
→ Total ¥ 370,000

* By the way
, the
insurance . The 　premium is less than 20,000 yen per year. (Approximately 1700 yen when converted monthly)
Thank you for receiving the benefits.

Ureteral stenting is a procedure to control hydronephrosis that occurred during pregnancy, so it has nothing to do with childbirth, but since it is also an operation, I received benefits.

Out- of-pocket medical insurance benefits
¥ 57,600 － ¥ 370,000 ＝　－ ¥ 312,400

Thanks to medical insurance benefits, childbirth costs have resulted in a surplus .

I haven’t had a major illness for a long time, and I thought that my body was strong, so I didn’t think that I would be taken care of by medical insurance so quickly.
It cost me more than I expected through pregnancy and childbirth, so I’m glad I had medical insurance.

If you are thinking of getting pregnant or giving birth, it is a good idea to consider it because cheap insurance is enough.

I’m thinking of getting medical insurance until I decide what to do with the second person.
(Although it may be canceled after the second person is born)

summary

◇ Childbirth and childcare lump sum payment

◇ High-cost medical treatment system (* In the case of abnormal delivery such as Caesarean section and suction delivery)

The above two are systems that anyone can use, so let’s check before giving birth (^ O ^)

◇ Medical insurance

It is safe to have something that provides the minimum guarantee for hospitalization and surgery.

It was about my childbirth costs that eventually turned into the black.

I would appreciate it if you could refer to it as an example.