- The target age group shall be under 9 years old.
- The maximum amount of payment shall be limited to 'low vision glasses' and 'contact lenses', which are the categories of prosthetic devices based on the provisions of the Child Welfare Law.
- The frequency of renewal shall be once a year for those under 5 years of age, and only once every two years for those over 5 years of age.
- Eye patches and Fresnel membrane prisms shall not be covered.
Public medical insurance OK for eyeglasses if they are therapeutic glasses for children.
Insurance coverage is notified by the Ministry of Health, Labor and Welfare with approval from the Central Social Insurance Medical Council, and covered are eyeglasses and contact lenses used by children under 9 years old for the treatment of amblyopia, strabismus, and refractive correction after congenital cataract surgery. If the glasses are to be replaced, there are conditions such as the length of time the glasses have been worn.
The documents required for the application are
- Receipt for therapeutic eyewear
- A copy of the order for the preparation of therapeutic eyewear by the treating insurance physician
- The results of the patient's examination. Obtain an application form for payment from your health insurance association, etc., and submit it with the documents.
According to the Ministry of Health, Labour and Welfare, low vision glasses are covered up to 70% of the actual amount paid, up to 26,460 yen (for ages 3 to under 9 years old). For example, if the glasses cost 30,000 yen, 71% of the total amount of 21,000 yen will be paid, and if the glasses cost 50,000 yen, the maximum amount of In the case of 50,000 yen, the maximum amount of 26,460 yen will be paid. Insurance does not cover eyeglasses used in daily life; a 1964 Ministry of Health and Welfare (then Ministry of Health and Welfare) notice clearly states that eyeglasses are not covered by insurance. The reason was that 'eyeglasses are different in nature from tools for the treatment of illness or injury. However, in recent years, as treatment technology has advanced and therapeutic eyewear for children has become more widespread, some insurers have begun to apply the provision. On the other hand, there were many cases where it was not allowed because 'there is no precedent.
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Application window
- For those who are covered by the Government-managed health insurance system, please contact each social insurance office
- Health insurance section of the municipality for those with national health insurance
- If you are a member of a health insurance association, please contact the respective health insurance association office
- If you are a mutual aid association, please contact the respective mutual aid association office
