万が一の入院時に！！

入院費ってどれくらいかかるだろうか？

医療保険ってどれくらい出たっけ？

大部屋　小部屋どっちがいいかな？？

など入院する時は誰でも不安になります。

しかし日本の医療保険制度では他の国にはない素晴らしい制度があります。

『高額療養費制度』

高額な医療費を支払ったときは高額療養費で払い戻しが受けられます。

高額療養費とは、同一月（1日から月末まで）にかかった医療費の自己負担額が高額になった場合、
一定の金額（自己負担限度額）を超えた分が、あとで払い戻される制度です。
医療費が高額になることが事前にわかっている場合には、「限度額適用認定証」を提示する方法が便利です。

 

そして世帯で複数の方が同じ月に病気やけがをして医療機関で受診した場合や、お一人が複数の医療機関で受診したり、一つの医療機関で入院と外来で受診した場合は、自己負担額は世帯で合算することができ、その合算した額が自己負担限度額を超えた場合は、超えた額が払い戻されます。

  • ここで言う世帯とは、協会けんぽに加入している被保険者とその被扶養者です。

ただし、70歳未満の方の合算できる自己負担額は、21,000円以上のもの（下記の「合算対象のポイント」）に限られます。
自己負担額の基準

  • 医療機関ごとに計算します。同じ医療機関であっても、医科入院、医科外来、歯科入院、歯科外来にわけて計算します。
  • 医療機関から交付された処方せんにより調剤薬局で調剤を受けた場合は、
    薬局で支払った自己負担額を処方せんを交付した医療機関に含めて計算します。

所得区分がウの方は例えば100万円の治療費がかかったとしても80100円＋（100万円－267000円）×１％＝87430円になりますので入院費や手術費等の上限は87,430円になりますので3割負担で30万を窓口でお支払したとしても差額が後日返金になります。

医療保険でもこの部分を保障としてかけていればある程度の出費は守れるという事になります。

しかし守れないものもあったりします。

今週もありがとうございました。

詳しいお話はご相談をお待ちしております。

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