Today's column attempts to clarify some common questions about Japanese health insurance. First it is necessary to understand the differences between the two types. Shakai Hoken (SH), or Employees Health Insurance, covers employees/dependents of companies that subscribe to some health insurance plan. Kokumin Kenko Hoken (KKH), or National Health Insurance, is for self-employed people and other nonemployees and their dependents. With the exception of those working for Japanese companies, foreigners are usually covered by KKH. The coverage provided by the two plans is for the most part similar throughout Japan.

However, outside Japan there are differences. A reader asks if it is possible to receive reimbursement under his Japanese health insurance for his emergency medical treatment received overseas this summer. If he has employee insurance, SH, he should check with the insurance office at his company to see what his policy covers. Payments for some and often all of the costs are provided by most companies for medical care received overseas. To collect, he will need an itemized account of the expenditures and a statement of the care provided. It is advisable to pick up appropriate forms before any overseas trip in case they are needed. However, since KKH is administered by ward offices, there will be differences, usually depending on the financial condition of any particular ward. With very few exceptions, overseas expenses will not be covered. At this moment (but changes are frequent), Fuchu provides reimbursement; Minato Ward, where many foreigners live, does not.

Be aware that even experts can disagree, and there is usually a reluctance to provide precise information. Also, changes are not necessarily circulated among all those who may need the information. Still, it is important for everyone to understand what his/her insurance provides. When you inquire at the insurance section at your company or ward office, be sure to take along your alien registration card and your insurance papers. If the person you talk to does not seem knowledgeable about your questions, ask to speak to a specialist.

Many ward offices now provide helpful publications in foreign languages. Unfortunately, they are not necessarily correct. Consider this question from a foreign woman married to a Japanese who wants to return to her home in Hawaii to have her baby. She asks if she can use her Japanese insurance. First she should know that in Japan, while health insurance does not cover maternity cases (having a baby is not considered a sickness), the need for assistance is recognized. After the baby is born, a standard allowance of 350,000 yen will be remitted to anyone covered by Japanese health insurance to help provide for childbirth and nursing care. Until recently, it was 300,000 yen, and some administrators are not yet aware of the change. The allowance is applied to any delivery in the fourth month or after, including still-birth and abortion. It is inconsequential where the baby is born. There is also a maternity allowance for those who are absent from work because of childbirth and are not paid wages during that time. Abnormal deliveries such as toxemia and Cesarean are covered by insurance.

Many are not aware of the benefits they are entitled to under their Japanese insurance, and it is highly doubtful that an official will seek them out to make certain they understand all their allowances. For example, there is an SH expense allowance to help with the funeral of the insured person with a minimum guaranteed amount of 100,000 yen as well as a 100,000 yen allowance for dependents. For those under KKH, 10,000 yen to 50,000 yen is paid for the policy holder only.

I am indebted to Akiko Hagino who has worked with me for several weeks to obtain reliable information for this column. Her company, Surety, has earned a reputation for helping clients, including foreign clients, with their insurance problems for some 30 years. Well known throughout Japan, she was one of the first women to change the image of working females from servers and bowers to successful executives. Call Surety for your own insurance needs: (03) 3497-5131.