•Amount (births from April 1, 2023): 500,000 yen per child for a birth at 22 weeks or later in a facility enrolled in the obstetric compensation scheme. A birth before 22 weeks - even at an enrolled facility - and any birth at a non-enrolled facility pay 488,000 yen per child. Multiple births are paid per child
•Deadline: within two years of the day after the birth
•Eligible for both company employees (shakai hoken) and self-employed/freelancers (kokuho). Stay-at-home spouses listed as dependents receive the benefit through the primary insured person's health insurance
•If the birth cost less than the lump sum, the difference is paid to you - with the direct payment system your insurer sends the claim form about 3 months after the birth. If it cost more, you pay the excess to the hospital
•National Health Insurance enrollees apply directly at their municipal office's NHI counter — procedures vary by municipality
•If your insurer changed because you left a job, apply to the insurer you belong to at the time of birth. If you give birth within 6 months of leaving, you may instead choose to claim from your former insurer — provided you were continuously enrolled there for at least a year
•You can still claim for a birth overseas, as long as you held valid coverage at the time of the birth
•From 85 days (4 months) of pregnancy onward, stillbirth, miscarriage and termination are covered as well as live birth
•There are three ways the money can be claimed and paid. Under the direct payment scheme the facility claims on your behalf and is paid by your insurer. Under the proxy receipt scheme you claim yourself and the facility receives the money for you. Under the reimbursement scheme you claim and are paid yourself, having settled the full cost at the facility first
•The proxy receipt scheme is open only to those within two months of their due date, and only at facilities that have registered with the Ministry of Health, Labour and Welfare. Ask the facility where you plan to give birth whether they offer it
•A childbirth cost loan scheme lends up to 80% of the expected lump sum, interest-free, to bridge the gap until it is paid. It is open to those within a month of their due date, and to those at least four months pregnant who face an upfront payment to a medical facility
•If a family member who was your dependant gives birth after you have lost insured status, the family childbirth lump sum is not paid. Any one birth is covered once only, so even where more than one insurer could pay, you cannot claim twice
•A caesarean or similar delivery is covered by health insurance, so if the insured portion of the medical costs runs high it can qualify for the high-cost medical expense benefit