If you underwent acupuncture, moxibustion, massage, or shiatsu with an insurance doctor's approval
（※受領委任払い用）
Acupuncture, moxibustion, massage, and shiatsu are covered by health insurance benefits (for medical care expenses) if certain conditions are met.
Scope eligible for health insurance coverage
Acupuncture, moxibustion
Benefits for medical care expenses may be provided mainly for the following six conditions, only in chronic cases in which an insurance doctor determines that no other appropriate treatment is available.
- Neuralgia
- Rheumatism
- Cervicobrachial syndrome
- Frozen shoulder syndrome
- Lower-back pain
- Aftereffects of cervical sprain
- * Other conditions may be approved if their primary symptom is chronic pain similar to neuralgia or rheumatism.
- * No benefits will be provided if the patient is simultaneously treated for these conditions at a medical care institution.
Massage, shiatsu
Decisions on whether a condition is eligible for benefits for medical care expenses are not made solely based on the name of the condition. Benefits are provided only if massage is deemed a medical necessity: for example, in cases involving muscular paralysis, muscular atrophy, or articular contracture.
- * Benefits are provided for medical massage intended to improve symptoms: for example, easing muscular paralysis or hemiplegia or increasing the range of joint movement. Treatment for recovery from fatigue, relaxation, or prevention is not covered.
- * No benefits will be provided if the patient is receiving medical massage for the same condition at a medical care institution.
The Society provides benefits by payment by receipt of billing on the patient's behalf.
The Society provides benefits for medical care expenses for acupuncture, moxibustion, massage, and shiatsu by payment by receipt of billing on the patient's behalf.
Note that you can ask the practitioner to apply for payment of medical care expenses on your behalf. In general, this means you make a 30% copayment to the practitioner, just as with insurance medical care institutions. (A signature for billing on the patient's behalf is required on the Application Form for Medical Care Expenses for payment.)
[Flow of payment by receipt of billing on the patient's behalf]
Caution:
When signing the Application Form for Medical Care Expenses, confirm that there are no errors in the description of the cause of injury, injured parts of the body, and other aspects.
Benefits for treatment at practitioners that do not accept applying for payment on the patient's behalf will be provided by reimbursing the patient (i.e., the patient must pay the full amount up front). In such cases, you must submit an Application Form for Medical Care Expenses to the Health Insurance Society.
Letter of approval from an insurance doctor
When applying for payment of medical care expenses, you must attach a letter of approval from an insurance doctor to the Application Form for Medical Care Expenses. Have your condition examined by an insurance doctor and ask him or her to issue a letter of approval.
Another letter of approval is required if the treatment period exceeds six months (one month for manual correction of deformities).
Acupuncture, moxibustion
A patient undergoing acupuncture or moxibustion with a letter of approval from an insurance doctor must be reexamined by and receive another letter of approval from an insurance doctor if the treatment continues past six months.
Massage, shiatsu
A patient undergoing massage or shiatsu with a letter of approval from an insurance doctor must be reexamined by and receive another letter of approval from an insurance doctor if the treatment continues past six months (one month for manual correction of deformities).
Caution:
The Health Insurance Society may inquire concerning the nature of treatment and other specifics.
The Health Insurance Society may contact the applicant subsequently to inquire about the nature of the treatment and other specifics. We appreciate your understanding and cooperation with such inquiries. The inquiries are intended to ensure appropriate use of Society members' health insurance premiums.