Medical Expense Support for Foreign Mothers and Mothers-to-Be in Japan
When preparing to give birth in Japan, some expecting mothers and couples may worry if they can receive the same support as Japanese residents.
In Japan, pregnancy and childbirth-related medical expenses are costly because they are not covered by insurance. To save yen, however, there are subsidies you can receive regardless of your nationality and income by enrolling in the health insurance system (National Health Insurance and Social Insurance).
In this article, we look at the costs and financial subsidies available to those giving birth and raising a child in three parts: pregnancy, childbirth, and postpartum.
Take Advantage of Multilingual Medical Services
There are a lot of procedures and paperwork at hospitals and municipal offices when expecting a child in Japan. This can be very stressful if you're not familiar with Japanese or the customs of Japan. As a result, there has been an increase in staff fluent in foreign languages or translation devices available at municipal offices.
For example, the Shinjuku Ward office has established a Foreign Resident Advisory Corner in English, Chinese, and Korean, offered for free to its many international residents. Kanagawa Prefecture’s Parenting in Japan website is accessible in ten different languages.
It's advised to check if your area's municipal office has a support center for non-Japanese residents.
How Much Is the Cost of Giving Birth in Japan?
In Japan, a mother-to-be will receive a total of 14 prenatal checkups throughout her pregnancy. A physical exam is done during each checkup and costs around 5,000 to 8,000 yen per exam.
There is a way, however, to save on these fees, adding in the costs of transportation to the hospital and purchasing maternity items, which can add up quickly.
Prenatal Checkup Vouchers are one form of financial support provided to expecting mothers by each local government. This coupon is equivalent to 100,000 yen and can be used towards prenatal checkups. If you use these vouchers, you can expect to pay around 70,000 to 120,000 yen for medical expenses.
The amount of money and compensation coverage varies in every region. Be sure to check the details at your local municipal office or on the official website.
You may also be refunded a portion of the medical examination fees on your tax return the following year, so be sure to keep all of your receipts and details from the hospital visit. We offer more details in this section.
How Much Does it Cost to Deliver a Baby in Japan?
The cost of childbirth covers various fees, including hospitalization, exams, and medication. The average total is said to be around 500,000 yen. Opting for a C-section or painless delivery with an epidural will increase by 100,000 to 200,000 yen.
By the way, childbirth expenses also vary by area. Tokyo is the most expensive place to give birth in Japan—costing about 620,000 yen. On the other hand, Tottori Prefecture is the cheapest and costs roughly 390,000 yen.
In any case, childbirth is expensive. Make use of public subsidies to reduce your out-of-pocket payments.
Childbirth Lump-Sum Grant: Up to 420,000 Yen Payable per Baby
It’s extremely difficult to bear the entire financial burden of your childbirth expenses. In Japan there is a system that pays mothers-to-be 420,000 yen (*) per baby under the Lump-Sum Allowance for Childbirth.
The Lump-Sum Allowance for Childbirth can be collected regardless of nationality if you're enrolled in health insurance. Health organizations can also pay the hospital for you by utilizing the Direct Payment System. This is convenient because you won't be required to pay the medical expenses in advance. It also allows you to defer additional charges when discharged from the hospital.
If the cost of childbirth is less than the amount given through the Lump-Sum Allowance for Childbirth, you will be refunded the difference.
*: In the event that you give birth at a medical institution not under the Japan Obstetric Compensation System (Japanese), your childbirth compensation will be 404,000 yen.
Postpartum Care Costs 500,000 Yen?
After giving birth, you will need to pay important medical expenses for your newborn, including routine checkups and vaccinations, in addition to baby products and food.
Expenses incurred after birth will differ for each person. According to reports, the cost of raising a newborn in the first year of life is about 500,000 yen (*). As such, it's recommended you begin making a plan before pregnancy.
Additionally, co-payments for a child's medical expenses (newborn to age six) are generally around 20%. However, many regions have systems in place that aid in medical expenses for infants. In Tokyo, for example, the government will subsidize 20% of co-payments, so medical expenses and medications essentially become free.
If you're a dual-income household, you should also consider enrolling your infant in either daycare or hiring babysitters from an early stage, and account for these expenses.
*From Child Future Foundation: Study Report on Childcare Costs (Japanese)
Take Advantage of Allowances and Grants
In addition to the financial support for childcare introduced so far, there are other allowances and grants you can receive if you meet the criteria. Be sure to do your research first, though.
1. Childbirth Allowance
Maternity allowance supports working moms, especially the Childbirth Allowance (Japanese). Although the name is similar to the Lump-Sum Allowance for Childbirth, it’s important to note that these are two separate systems.
The Childbirth Allowance aids people who experience a loss in income due to maternity leave. It is a pre-requisite that you are enrolled under your employer's health insurance to receive this allowance. Unfortunately, those under Japan's National Health Insurance (NHI) who are self-employed or unemployed are ineligible for this allowance.
The allowance has several other requirements, so be sure to consult with your employer early on if you're thinking about applying.
Below is an example of how the compensation amount for the Childbirth Allowance is calculated:
A monthly salary of 300,000 yen will be calculated as 300,000 yen ÷ 30 days × 2/3 = 6,666 yen to get the amount you are granted per day.
Allowance is granted when you're on leave from work, which is between 42 days before your delivery date to 56 days after the day you give birth. If you give birth after your expected delivery date, don't worry, as those days will be included in your maternity allowance.
２. Childcare Leave Benefits
In Japan, employees are legally allowed to take childcare leave––paid time off work to support their child until he/she turns one-year-old. This rule applies to workers of all nationalities.
The Childcare Leave Benefits begins being paid from the time of childbirth (*1) until the newborn reaches the age of one. This allowance system is very beneficial to parents because childcare leave is unpaid.
*1: The eight weeks following the day after birth are not included in childcare leave because it is a part of maternity leave. Fathers who are recipients of the allowance are granted pay beginning from the day of childbirth.
The compensation for Childcare Leave Benefits is calculated below.
*2: This amount is six month's worth of income (excluding bonuses) prior to childcare leave divided into 180 days.
In addition to mothers, fathers are also eligible for the allowance. Both parents may apply if they meet the criteria.
３. Child-Rearing Allowance
The systems that we’ve introduced so far support childcare for parents who are lawfully employed in Japan. On the other hand, the Child-Rearing Allowance (Japanese) is intended for all parents living in Japan, with a job or not.
This system grants 15,000 yen or 10,000 yen (*) monthly per child from birth to junior high school graduation (until March 31 of his/her 15th birthday).
*: If the recipient’s income exceeds a specified amount, the monthly allowance will be 5,000 yen per child.
|Child’s Age||Monthly Amount Per Child|
|0 – under 3 years old||15,000 yen|
|3 years old – before elementary school graduation||10,000 yen (15,000 yen after the third child)|
|Junior high school student||10,000 yen|
The allowance is paid three times a year. How the child allowance is used will vary on the family. Many people save money for their child’s future or use it towards education.
Depending on where you live, there may be unique childcare support systems available for residents.
For instance, Minato Ward is located in Tokyo––the most expensive place to give birth in Japan. This ward has its own initiative that gives recipients a maximum of 180,000 yen in grants (auto-translated English page available) .
In addition to childbirth benefits, every region has independent initiatives, such as congratulatory money for children entering elementary and junior high school. There are other grants that provide assistance to single parents, too. It is highly recommended to do additional research on what systems are available at the municipal office in your area.
Medical Deductions to Make on Your Taxes
Even if you utilize subsidies such as the Lump-Sum Allowance for Childbirth, there are often unexpected medical or hospitalization fees that pile up.
If this occurs, you should take advantage of medical deductions on your Japanese tax return. If your family's yearly medical expenses exceed 100,000 yen (calculate 5% of total income if you earn below 2,000,000 yen), then you are eligible to receive a tax refund if you overpaid after filing your tax return.
Do not throw away receipts from the hospital, but store them safely as they'll be needed for your tax return. Medical deductions that are covered include hospital expenses for routine checkups. You can also add taxi fares when traveling to the hospital for checkups or going into delivery in your deductions.
The specific amount in medical deductions is calculated below.
The money refunded to you will be the amount in medical deductions multiplied by your income tax rate. For example, if your medical deductions equal 50,000 yen and your income tax rate is 20%, then you will be refunded 10,000 yen.
Learn the Childcare Subsidies to Enjoy Parenthood in Japan
Although there are many things we want to provide for our newborn, the reality is that raising a child is expensive. That’s why reducing your out-of-pocket payments through public subsidies is important.
Many areas are also home to child care facilities and health centers that assist residents with children. At these centers, you can ask for advice on childcare-related matters, too.
Why not utilize these support systems to ensure a comfortable pregnancy and pleasant parenthood in Japan?
All photos by Pixta