How Japan’s High-Cost Medical Expense System caps out-of-pocket costs, eases financial burden, and allows patients to focus on recovery

I herniated a disc back in March. It left my lower body numb and gave me sciatica pain going down my legs when I moved my lower body or tried to walk. I went to the doctor multiple times about it. In mid July test results came back after an MRI. My doctor recommended surgery to remove it since the herniated disc was severely pinching the nerves in my spine. The plan was to have surgery planned during winter vacation unless my body started getting worse such as more back pain or if I could not feel my bladder, which in that case he recommended surgery as soon as possible.

A few weeks after that discussion my body started getting worse. I had not been able to budget or save for the surgery as it was last minute. I was able to get surgery for it scheduled a week later on August 16th. Non-invasive surgery thankfully was successful. The doctor was concerned that open surgery would need to be performed.

With social insurance the surgery is maxed out at 80000 yen. Had I not had social insurance this would have been a lot more expensive. If open surgery was needed it would have been even more expensive. I still have to pay an additional amount for hospitalization and food for my weeklong stay in the hospital but that with the surgery costs is a fraction of what I would had paid if I did not have social insurance.

Even though I had not budgeted for it since it was very last minute, with my family’s help I will be able to pay it without any financial difficulty. Without this stress I can focus on my recovery. Had I not had social insurance I would have been forced to take a loan out with my employer and had undue stress over how I was going to pay for it and how much it was going to cost. That stress would have delayed my recovery.