HOME Text size
  • S
  • M
  • L

List of insurance benefits

  1. HOME
  2. Health Insurance Association
  3. List of insurance benefits

We would like to introduce the insurance benefits provided by the Coca-Cola Bottlers Japan Health Insurance Society.

When an insured person becomes sick or is injured

Situation Insurance benefits
※Benefits for dependents are in brackets
Insured person receives medical treatment for sickness or injury occurred when off work by health insurance card
“Medical treatment benefits” (cost of medical treatment for family members)

70-80% of the medical care expenditure will be provided through in-kind benefits.

Cost of meals, etc. during hospitalization
“Cost of meal during hospitalization” “Cost of living during hospitalization” (cost of medical treatment for family members)

An insured person co-pays 460 yen per meal and the rest will be provided by in-kind benefits.

  • ※A patient with intractable disease or specified childhood chronic disease co-pays 260 yen per meal.
  • ※An insured person aged of 65 or older hospitalized in a long term care beds co-pays 460 yen per meal and 370 yen per day for accommodation costs.
Insured person makes payments in advance
“Medical treatment cost” (second family member medical treatment cost)

If an insured person takes medical treatment or purchases therapeutic accessories, but does not produce his/her health insurance card for unavoidable reasons, advance payments made by him/her will be returned based on the claim.

Insured person transferred
“Transfer cost” (family member transfer cost)

When an insured person is transferred on the direction of his/her doctor, the amount calculated by the standard based on the claim will be provided.

Insured person receives visiting nursing care
“Visiting nursing care medical treatment cost” (family member visiting care medical treatment cost)

70-80% of the medical care expenditure will be provided by in-kind benefits.

Insured person’s medical exceed limit
“High medical treatment cost” (family member high medical treatment cost)

In case the amount of medical care expenditure co-payment of one per month exceeds co-payment limit decided in accordance with the income category, the exceed amount will be provided.

Co-payment amount added to nursing-care insurance exceeds limit
“High long-term care addition medical treatment cost” (high long-term care addition medical treatment cost)

If the sum of co-payment for medical care and long-term care in a year exceeds co-payment limit decided in accordance with the income category, the exceed amount will be provided in accordance with the ratio paid for medical care.

Insured person receives combined medical treatment not covered by insurance
“Cost of medical treatment provided combining insurance-covered and non-covered services” (cost of medical treatment for family members)

For medical practices not covered by insurance, 70-80% of basic medical care expenditure can be reclaimed.

Back to top

When an insured person takes sick leave

Situation Insurance benefits
Insured person is not being paid wages due to absence from work of four days or more because of sickness or injury occurring when not at work
“Sickness allowances”

For one year and six months from the fourth day of absence from work, a sum will be paid per day of absence from work. The sum is calculated as two-thirds of the following: one-thirtieth of the average amount of standard monthly remuneration for the recent 12 consecutive months, excluding benefit payment.

Back to top

When an insured person gives birth to a child

Situation Insurance benefits
Insured person gives birth after the fourth month (after 85 days) of pregnancy
“Lump-sum allowance for childbirth and nursing” (family member lump-sum allowance for childbirth and nursing)

420,000 yen will be paid per child

Insured person is not being paid wages due to maternity leave
“Maternity allowances”

For 42 days before childbirth (98 days for multiple pregnancy, also paid for days after estimated delivery date), and for 56 days after childbirth, a sum will be paid per day of absence from work. The sum is calculated as two-thirds of the following: one-thirtieth of the average amount of standard monthly remuneration for the recent 12 consecutive months, excluding benefit payments.

Back to top

When an insured person dies

Situation Insurance benefits
Insured person dies due to a cause not in the course of employment
“Burial fee (cost) ” (family member burial fee)

50,000 yen will be paid.

Back to top

When an insured person leaves our company

Situation Insurance benefits
Insured person was receiving sickness allowances at the date of leaving our company
“Sickness allowances”

Details

Insured person was receiving maternity allowances when leaving our company
“Maternity allowances”

Details

Insured person gives birth within six months after leaving our company
“Lump-sum allowance for childbirth and nursing”

Details

Insured person dies within three months of retirement
“Burial fee (cost)”

Details

Back to top
ページ先頭へ戻る

MENU

健保のしくみ 健保の給付 健康作りに 各種手続き