Procedures

Childbirth

The HGST Health Insurance Association provides a Childbirth and Childcare Lump-sum Allowance to insured persons and a Dependents’ Childbirth and Childcare Lump-sum Allowance to family when a child is born. Insured persons also receive a Maternity Allowance when taking unpaid leave from work due to childbirth.

Childbirth and Childcare Lump-sum Allowance
(Dependents’ Lump-sum Childcare and Childcare Allowance)

Insured persons and dependents receive a Childbirth and Childcare Lump-sum Allowance (Dependents’ Childbirth and Childbirth Lump-sum Allowance) per child born at least four months (85 days) after pregnancy (regardless of whether a normal birth, stillbirth, miscarriage, or premature birth).

After delivery
Payment amount
420,000 yen
*Payment for two children provided for twins
*However, the amount paid is 408,000 yen per child if the delivery takes place at a healthcare provider that does not subscribe to the Japan Obstetric Compensation System for Cerebral Palsy or if the delivery occurs before the 22nd week of pregnancy.
*Insured persons and dependents can search for childbirth facilities that are members of the Japan Obstetric Compensation System for Cerebral Palsy on the Japan Obstetric Compensation System for Cerebral Palsy website operated by the Japan Council for Quality Health Care.

Because the application for and payment of the childbirth and childcare lump-sum allowance is conducted after the birth, it is necessary to make a large temporary payment to the healthcare provider up front. However, systems have been put in place to mitigate this economic burden.

Direct Payment System

The Direct Payment System is a program for healthcare providers to apply and receive childbirth and childcare lump-sum allowances on behalf of insured persons.
The HGST Health Insurance Association pays the healthcare provider directly up to the maximum amount for the childbirth and childcare lump-sum allowance based on the bill sent by the healthcare provider. Therefore, insured persons or dependents do not need to file an application with the HGST Health Insurance Association for the childbirth and childcare lump-sum allowance.
The HGST Health Insurance Association also pays any difference in the amount to insured persons if the costs of childbirth are less than the childbirth and childcare lump-sum allowance.
If an insured person or dependent gives birth at a healthcare provider which uses the direct payment system, the healthcare provider will explain the direct payment system before discharging the patient from the hospital. The insured person or dependent can then decide whether or not to use the direct payment system.

Substitute Payee System

The direct payment system is not available at some small-scale healthcare providers. The substitute payee system is an alternative program to reduce the amount of payment at the billing counter of these healthcare providers. The insured person and the healthcare provider apply in advance to use the substitute payee system with the HGST Health Insurance Association so that the healthcare provider receives the childbirth and childcare lump-sum allowance directly on behalf of the insured person by billing the costs to the HGST Health Insurance Association.
However, both of these systems are not available at some healthcare providers. Please check which systems are available in advance with your healthcare provider.

Procedures
Fill in the required information in the documents below, obtain a certificate from your physician or midwife verifying that you have given birth, and submit the materials to the HGST Health Insurance Association. (Refer to the “Application Forms” page for information on where to submit application forms.)
[To Use the Direct Payment System]
The HGST Health Insurance Association pays an amount equivalent to the lump-sum payment directly to the healthcare provider. Therefore, insured persons or dependents do not need to complete any application procedures. Please submit the Application for Childbirth and Childcare Lump-sum Allowance after the delivery if the costs of child delivery are less than 420,000 yen (408,000 yen for a healthcare provider not covered under the Japan Obstetric Compensation System for Cerebral Palsy).
[To Use the Substitute Payee System] Insured persons or dependents need to file an application within two months of the expected due date.
Required
documents
  • Application for Payment of the Childbirth/Childcare Lump-sum Allowance (Substitute Payee System)
    PDF Entry Sample
[When Neither System Is Used, or an Individual Gives Birth Overseas]
Required
documents
  • Application for Childbirth and Childcare Lump-sum Allowance (No Use of Direct Payment System)
    PDF Entry sample

Maternity Allowance

The HGST Health Insurance Association pays a maternity allowance to insured persons who take unpaid maternity leave from work.

Payment period The payment period is from 42 days prior to expected delivery date (98 days in the case of a multiple pregnancy) up to the 56th day following the delivery.
Payment amount Amount equivalent to two-thirds per day of leave [standard monthly remuneration for the last 12 months divided by 30]
Procedures
Fill in the required information in the documents below, obtain a certificate from your physician or midwife verifying that you have given birth, and submit the materials to the HGST Health Insurance Association. (Refer to the “Application Forms” page for information on where to submit application forms.)
Required
documents

If an individual becomes ill and is unable to work while receiving the maternity allowance, the insured person can receive the illness and injury allowance after payments of the maternity allowance end.
In addition, if an individual becomes eligible to receive a maternity allowance while receiving the illness and injury allowance, the illness and injury allowance is temporarily suspended until the payments start again after payments for the birth allowance end.

*Please see Family Dependents for information about adding the child as a dependent.

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