Cancer and Work Q&A -Learning from the Experience of Cancer Survivors –

PiNK 2021 Winter Issue

First Considerations After Being Diagnosed with Cancer

Cancer and Work Q&A

Learning from the Experience of Cancer Survivors

Money and Health Insurance

Q1:

While undergoing treatment, I had to retire. I am currently covered by health insurance and employee pension insurance, but what will happen to my social insurance after I retire? Can I receive the sickness and injury benefits after I retire?

Full-time employee・Part-time employee

A1:

First, always consult with your company’s human resources and labor department if you are considering retiring.

●Pension

If you are under the age of 60 at the time of retirement, you must leave the employee’s pension insurance and join the national pension insurance.

●Health insurance

If you have worked continuously for more than two months prior to retirement, social insurance allows you to continue your health insurance as a voluntarily and continuously insured person. In this case, you can use your previous health insurance association benefits for up to two years. You must apply to become a voluntarily and continuously insured person within 20 days of your retirement.

If you do not (or cannot) complete the voluntary continuation procedure, you will either be insured under the National Health Insurance of your municipality, or you will be insured under your family’s health insurance as a dependent.

●Sickness and injury benefits

If you were insured under the company’s health insurance system one year prior to the date of your resignation and have been receiving your sickness and injury benefits before the date of your resignation, you may be eligible to continue receiving sickness and injury benefits. Check with your company’s human resources department or health insurance association.

Q2:

In addition to a reduction of income due to hospitalisation, the increased cost of treatment has strained my finances. What support is available to households?

Full-time employee・Part-time employee・Self-employed・Job-seeker

A2:

●High-cost medical expense benefit

Depending on your income, you may be exempted from medical expenses that exceed a certain limit. If the amount paid at a medical institution or at a pharmacy exceeds a certain limit (known as a “copayment”) in the same month (from the first of the month to the end of the month), the excess amount will be refunded. The amount to be refunded depends on your age and income. It does not include the cost of food during the time of hospitalisation or the cost of a bed partially covered by health insurance. If the person receiving treatment is a dependent of a living relative, the supporter under duty must apply for high-cost medical expense benefits.

It takes approximately three months for medical expenses above the copayment amount to be reimbursed. Although it will be refunded later, you will have to bear the cost temporarily. Those under the age of 70 (and, in certain circumstances, those over 70) need only pay a pre-fixed ceiling amount for both inpatient and outpatient treatment by obtaining a document called “Eligibility Certificate for Ceiling-Amount Application” and presenting it at the cashier’s desk. You must apply and be certified in advance to use this benefit, so check with your employer’s human resources and labor affairs personnel or your health insurance office for information on the procedures for receiving benefits. You can apply for National Health Insurance at the insurance window of your local government office.

●Medical expenses deduction

If you file a tax return and report your medical expenses (including transportation and therapy devices), you can receive an income tax deduction. To find out to which medical expenses related to treatment are eligible for a medical expense deduction, check the Japan National Tax Agency “Tax Answer” (see terminal).

●Sickness and injury benefit system

If you have health insurance, you can use the sickness and injury benefit system. If you are out of work for more than four days, including three consecutive days, you will receive 2/3 of your standard daily compensation※ for up to 18 months after the fourth day.

※As a general rule, the daily compensation is 1/30th of the standardized monthly amount of remuneration 12 months prior to the start date of payment

・Please check with your employer’s labor relations personnel for your health insurance association.
・Please check with your National Health Insurance association or local government office. Depending on the union or municipality you are in, there may or may not be sickness and injury benefits.

Q3:

The cost of treatment is too high, and I am barely able to afford it. Is there a system in which patients can borrow treatment costs?

Full-time employee・Part-time employee・Self-employed・Job-seeker

A3:

There is a loan system for high-cost medical care expenses. Please check the procedures for this system with your employer’s labor relations personnel.

If you are covered under National Health Insurance, depending on your local government you may also be eligible to apply for a loan for high-cost medical expenses or authorized reimbursement. This system is designed to alleviate the temporary financial burden of applicants. The National Health Insurance covers the cost of those with financial difficulties by directly paying the medical institutions. For more details, contact the National Health Insurance office of your local government.

Q4:

My health insurance’s high-cost medical expenses were not paid. Who should I contact to discuss this matter?

Full-time employee・Part-time employee・Self-employed・Job-seeker

A4:

Please consult your health insurance office. Application procedures can take time, causing delays in payment being transferred.

You must all check your total medical expenses for the past month. Depending on the calculation for high-cost medical expenses, if you have been undergoing treatment at several medical institutions, the total medical expense may have not exceeded the amount eligible for the high-cost medical expense benefit system. If this applies to you, if your medical expense is over ¥21,000 at each hospital (for those under 70 years old) your copayment amount can be added up monthly.

As before, the calculation of high-cost medical expenses does not include the cost of food during the time of hospitalization or the cost of a bed partially covered by health insurance. Period of calculation covers expenses for the same month (from the first of the month to the end of the month).

If you have not received the high medical expenses benefits and you are not satisfied with the basis for denial, you can file an appeal.

Q5:

I have no income and have difficulty paying my insurance premiums. Can I apply for a reduction or exemption of the National Health Insurance premium?

Self-employed・Job-seeker

A5:

A system that reduces or exempts the National Health Insurance premiums for those eligible was established in 2010. An application is required to receive relief. For a detailed explanation of the system, please contact the person in charge of the National Health Insurance of your municipality. Municipalities have different systems that offer reductions or exemptions for people with low-income and meet certain criteria. For more details, contact the National Health Insurance office of your local government.

Q6:

As a self-employed person, I have no financial protection while I cannot work. Is there an economic support system for the self-employed?

Self-employed

A6:

Under National Health Insurance, which many self-employed people are insured under, sickness and injury benefits are part of the voluntary benefit system. Whether you are eligible for support or not depends on your municipality. Please consult the National Health Insurance department of your local municipality office. In addition, if you are insured under an occupation-based National Health Insurance Association, please consult the appropriate office. You can also apply for medical expense deductions when filing your annual tax return.

Several municipalities and chambers of commerce may have their own emergency loan or loan repayment relief programs, so please contact their respective offices.

Q7:

I work part-time. I am worried about the cost of treatment with no income while I am absent from work. Am I eligible for sickness and injury benefits?

Part-time employee

A7:

f the part-time worker is the dependent of a relative, he or she is not entitled to the sickness and injury benefits. However, if your health insurance premiums are deducted from your own salary, you may be eligible to receive injury and sickness benefits. If you are insured under the National Health Insurance, the sickness and injury benefit is part of the voluntary benefit system. Please consult the National Health Insurance department of your local municipality office. In addition, if you are insured under an occupation-based National Health Insurance Association, please consult the appropriate office. You can also apply for medical expense deductions when filing your annual tax return.

Q8:

Due to my short working hours, I am not eligible for the basic benefits of employment insurance. Is there a program to help with living expenses until I get a new job?

Part-time employee・Job-seeker

A8:

Even if you are not eligible for unemployment insurance, there are various support programs available for those who meet certain requirements.

The unemployment support system (Kyushoku-sha Shien Seido) is designed to help job-seekers who are not eligible for employment insurance (except for those whose household income and assets exceed a certain amount) receive a “Vocational Training Grant” and aim for early employment by improving their skills through job training. To apply, visit the government’s Hello Work organization office.

Comprehensive support funds are designed to financially aid those who have recently become unemployed, to help rebuild and eventually achieve economic independence. While receiving support from the Council of Social Welfare and Hello Work, you can receive a loan from the Council of Social Welfare for the security deposit, key money, etc. for moving into rental housing, as well as support for living expenses. To apply, visit the Social Welfare Council office of your local municipality.

https://www.gov-online.go.jp/useful/article/201001/3.html

Temporary bridging fund loans for exceptional circumstances are loans designed to support those who have lost their residence due to unemployment or unavoidable circumstances. Applicants can receive a loan to support their immediate needs until they start receiving the payments or funds that they have applied for at the public benefit system or public loan system. Application for this loan can be done at the Social Welfare Council office of your local municipality.

Q9:

I have been granted and received sickness and injury benefits in the past. I am going to take another leave of absence from work to treat a relapse. Is it possible to receive the sickness and injury allowance again?

Full-time employee・Part-time employee

A9:

If you are applying for benefits for the same injury or illness as the previous one, you can receive an allowance again within 18 months from the date you started receiving the previous one. If it has been over 18 months, then you are no longer eligible.

If the insurer recognizes that the current relapse is a different injury or illness from the previous one, you may be eligible to receive a new allowance, regardless of the period of time since the previous one. Please consult with your employer’s human resources department or your health insurance association.

【COLUMN】Working was my “Driving Force”

The chemotherapy treatment I underwent every three weeks was so hard on my body that at times, all I wanted was to take a break. Some full-time employees advised me to take more time off, but a part-time and full-time employee’s position in the company is fundamentally different. Full-time employees can take leave when they want to, while part-time employees lose pay when they do the same, except for a few paid vacations. There were times when I would wonder, “why do I have to work this way?”
I do think, though, that it was good for me to be surrounded by people. It was good for me to know that people relied on me, and feel needed. It felt good to have responsibilities in a tangible way. You could say that it is similar to a family relationship — that feeling of motivation to live up to a sense of responsibility — gave me the strength to continue working, and it became a driving force that helped me to move forward.

＜Female, Part-time worker / Diagnosed with breast cancer at 53 years old＞