Unexpected hospitalization, long-term treatments, pregnancy-related tests, and delivery costs—medical expenses can sometimes become a huge burden. In cases where costs reach hundreds of thousands of yen, many people feel anxious about “how to pay” and may impulsively rely on consumer finance companies (loan sharks). However, the high interest rates of such loans can push households further into debt, leading to long-term financial strain.

This article systematically explains how to prepare for and save on medical expenses without relying on loan sharks. We introduce concrete methods that combine public systems and private services, such as high-cost medical expense benefits, medical expense deductions, private insurance, municipal support, lifestyle adjustments, and installment payment negotiations. Cost simulation tables, case examples, and Q&A are also included to help readers take immediate action.

1. Reconfirm the Risks of Using Loan Sharks

High Interest and Debt Spiral

Consumer finance companies typically charge 15–18% annual interest. For example, borrowing ¥1,000,000 requires more than ¥150,000 in interest payments after one year. If combined with living and educational expenses, repayment becomes extremely difficult.

Increased Mental Stress

In addition to medical bills, debt repayments become an added burden. Carrying such stress during illness or pregnancy can negatively affect both physical and mental health.

2. Reduce Tax Burden Through Medical Expense Deduction

Overview

If annual medical expenses exceed ¥100,000 (or 5% of income), the excess can be deducted from taxable income. Filing a tax return allows a refund in the following year.

Key Points

• Transportation costs for hospital visits (public transport, unavoidable taxis) are deductible.
  
• NIPT, fertility treatments, and childbirth costs are eligible.
  
• Always keep receipts and transport records.
  

Example

Ms. E paid ¥780,000 for NIPT (¥200,000), delivery (¥550,000), and transportation (¥30,000). Through medical expense deduction, she received about ¥120,000 in tax refunds and managed without loan sharks.

3. High-Cost Medical Expense Benefit for Major Reductions

Basics

If monthly medical expenses exceed a set maximum, the excess is reimbursed. The maximum depends on income and age, typically around ¥90,000 for average salaried households.

How to Use

• Apply in advance for a “Certificate of Application of Maximum Amount” at your health insurance society.
  
• Present it at the hospital counter to apply the limit.
  
• The difference is refunded later.
  

Case Study

Mr. F (annual income: ¥4.8M) was billed ¥800,000 for stomach cancer surgery. With the high-cost medical expense benefit, his actual payment was about ¥90,000.

4. Combine Private Insurance and Mutual Aid

• Medical insurance pays ¥5,000 per day of hospitalization.
  
• Cancer insurance covers advanced treatments (e.g., proton therapy costing ¥3M).
  
• Mutual aid associations offer low premiums and family-wide enrollment.
  

Note: Many people forget to claim benefits even if insured. Always confirm coverage.

5. Reduce Living Costs to Secure Funds

• Save ¥10,000/month by switching to budget SIM cards.
  
• Cancel unused subscriptions to free up over ¥50,000/year.
  
• Cut ¥3,000/month on utilities by switching electricity plans and using LED lighting.
  

By saving ¥100,000–¥200,000 annually, you can avoid relying on loan sharks.

6. Use Municipal and NPO Support Systems

• Child medical expense subsidies (free until high school in some areas).
  
• Fertility treatment subsidies (up to ¥300,000 per cycle).
  
• Prenatal checkup subsidies (usually 14 free visits).
  
• Social Welfare Council’s “Livelihood Welfare Fund Loans” (low or no interest).
  

7. Negotiate Installment Payments with Hospitals

Many hospitals accept installment payments. Options include credit card installments or interest-free in-house systems. Always consult the hospital before turning to loan sharks.

8. Cost Simulations by Medical Field

9. Case Studies

• Case 1: Pregnant woman taking NIPT
  Ms. D paid ¥200,000 for NIPT but feared household strain. By combining delivery and checkup costs in her tax return, she received a ¥70,000 refund—avoiding debt.
  
• Case 2: Company worker undergoing cancer surgery
  Mr. F was billed ¥800,000 for stomach cancer surgery but, with high-cost medical expense benefits and cancer insurance, only paid ¥50,000 out-of-pocket.
  

10. FAQ (Q&A)

(Summarized key examples for brevity but keeping format)

Q1. Are NIPT and fertility treatments deductible?
Yes. They qualify as medical treatments.

Q2. Can I combine high-cost benefits and medical expense deduction?
Yes. They apply sequentially, not double-counted.

Q3. How can I prepare for sudden hospitalization without loan sharks?
Options include emergency welfare loans, installment plans, or family/work benefits.

Q4. Are children’s medical expenses always free?
Depends on municipality. Often free until junior high, sometimes high school.

Q5. Can I claim deductions without receipts?
Yes, but you must submit a “Medical Expense Statement” and keep receipts for 5 years.

Q6. How much is childbirth covered?
Childbirth lump-sum allowance (¥420,000–¥500,000), plus deductions and local subsidies.

Q7. How to reduce advanced cancer treatment costs?
Use private insurance with “advanced medical rider.”

Q8. Can low-income or unemployed people use these systems?
Yes. Limits are lower, and welfare recipients receive full coverage.

Q9. Is paying medical bills by credit card dangerous?
Not if paid in full or installments. Avoid revolving credit due to high interest.

Q10. Daily life tips to save medical costs?
Prevention: checkups, vaccines, healthy lifestyle.

Q11. What if fertility treatment pushes me toward debt?
Use subsidies and insurance coverage (since 2022, IVF/ICSI partially insured).

Q12. Is NIPT deductible?
Yes. Also check if your municipality includes it in prenatal subsidies.

Q13. How to request hospital installment payments?
Ask the accounting office or social worker. Be honest about wanting to avoid debt.

Q14. How to save on elderly/parent care costs?
Use “High-Cost Medical and Nursing Care Benefit” for combined medical + caregiving costs.

Q15. What’s the priority order for saving on medical costs?

1. Confirm high-cost medical expense benefit
   
2. Apply for medical expense deduction
   
3. Use insurance benefits
   
4. Tap municipal/NPO subsidies
   
5. Reduce living costs & negotiate installments
   

Conclusion: Secure Healthcare Without Debt

With the right knowledge and use of available systems, you can receive medical care safely—without debt.

Loan sharks’ high interest rates pose serious risks.

Combining tax deductions, high-cost benefits, insurance, and subsidies drastically reduces out-of-pocket costs.

Installment plans and lifestyle savings are realistic options.

記事の監修者

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岡 博史 先生

CAPラボディレクター

慶應義塾大学 医学部 卒業

医学博士

医師