Insurance coverage

Japanese panel offers insurance coverage for fertility treatment

A government panel on Wednesday proposed that fertility treatment be covered by the country’s public health insurance program as part of efforts to tackle the declining birth rate.

The Central Social Security Medical Council, which advises the Minister of Health, requested coverage in its proposal for the revision for the 2022 financial year of the official tariffs for medical services, adopted at a general meeting in the morning.

The council also called for increasing the initial consultation fee that medical institutions collect from those seeking diagnosis online, in hopes of promoting online medical examinations, currently permitted in exceptional cases amid the new coronavirus pandemic.

This will be the first review of medical service tariffs since the coronavirus began to spread in Japan in 2020. Tariffs are revised in principle every two years.

The council’s proposal includes fee changes to help address issues highlighted by the COVID-19 crisis and promote cooperation among medical institutions as the country dankai first baby boomers started turning 75 this year.

The insurance coverage for fertility treatment was requested by former Prime Minister Yoshihide Suga, Prime Minister Fumio Kishida’s immediate predecessor.

Beginning in fiscal 2022 in April, fertility treatments such as artificial insemination and in vitro fertilization will join the list of items covered by public insurance. Coverage will be offered to women under 43, up to six times.

Currently, patients receive fertility treatment outside the scope of insurance and therefore have to pay almost entirely for treatment costs.

Adding to the list will make a big difference as out-of-pocket expenses for patients receiving the treatment will drop to 30% of all treatment costs in principle.

This time, however, the council refrained from offering assisted reproduction insurance coverage using sperm or eggs donated by a third party and preimplantation testing to check for chromosomal abnormalities in fertilized eggs.

Amid the coronavirus crisis, Japan has already introduced special additional medical charges for hospitalization and treatment of infected patients. The measure will continue for the time being.

The council aims to promote wider regional cooperation among medical institutions to fight COVID-19, by proposing additional medical fees for clinics that work with large hospitals and strengthening infection prevention measures in their institutions.

Since online medical examinations will become permanently available from April, the council called for raising the initial consultation fee from ¥2,140 to ¥2,510 to promote the online method by reducing the difference between the fees online and face-to-face consultation.

Ahead of the introduction of overtime restrictions for doctors in the 2024 financial year, the council proposed measures to support medical institutions working to reduce the burden on doctors and implement reform of the working style.

Fees for first visits to large hospitals without referrals will be increased from the current 5,000 yen to 7,000 yen as part of efforts to facilitate the concentration of patients in these facilities and let city doctors play a greater role. .

A prescription renewal system will also be put in place, allowing repeated use of the same prescription for a certain period of time.

To help young carers under the age of 18 look after family members, the council has proposed additional medical fees for hospitals working with educational institutions to ensure they receive assistance.

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