When Therapeutic Orthoses/Therapeutic Eyeglasses, etc., Are Made

Therapeutic orthoses (corsets, casts, etc.)

Therapeutic orthoses are temporary devices used under a doctor's instruction for treatment before symptoms are stabilized, including corsets, supporters, joint orthoses, prosthetics (prosthetic hands [temporary training], prosthetic legs), artificial eyes (when worn to protect the eye socket after eyeball removal), and others. They are covered in place of medical care benefits when a doctor deems them medically necessary and the Health Insurance Society acknowledges that payment of medical expenses is unavoidable. However, the following cases are not eligible.

Items not eligible for payment

Items for everyday convenience such as spares for washing
Items worn temporarily for sports, rehabilitation, etc.
Items used after symptoms are stabilized
Items for cosmetic purposes

The durability period and price of therapeutic orthoses are determined by national standards.
Making the same orthosis within the durability period is not eligible for payment, so in principle, please repair or adjust the orthosis if it is damaged or malfunctions.

■Durability Period of Therapeutic Orthoses

Eligibility

Insured individuals/Dependents

Benefit amount

Eligibility	Benefit amount
Ages 70-74	70% or 80%
Entry into elementary school - 69 years old	70%
Ages 0 - before entry into elementary school	80%

Conditions for benefit eligibility upon renewal

Age when the previous orthosis was purchased	Period during which the previous orthosis was used
0 years old	4 months or more
1-2 years old	6 months or more
3-5 years old	10 months or more
6 years old and above6 years old and above	12 months or more

* The starting date is the receipt date of the previously purchased orthosis.

Therapeutic eyeglasses/contact lenses

For dependents (ages 0-8) with amblyopia, strabismus, benefits can be received when purchasing therapeutic eyeglasses and contact lenses for refractive correction.

Eligibility

Dependents (ages 0-8)

Benefit amount

Eligibility	Benefit amount
After entry into elementary school - 8 years old	70%
Ages 0 - before entry into elementary school	80%

* There is an upper limit to the purchase amount eligible for payment.
Therapeutic eyeglasses: 40,492 yen (tax included); Contact lenses (per lens): 13,780 yen (tax included) (Options and additional processing fees are not eligible for payment)

◆ Benefit examples (below the upper limit)
When a 3-year-old dependent purchases therapeutic eyeglasses for 20,000 yen
20,000 ×0.8 ＝16,000　Benefit amount: 16,000 yen

◆ Benefit examples (above the upper limit)
When a 3-year-old dependent purchases therapeutic eyeglasses for 50,000 yen on April 1, 2020
40,492× 0.8＝32,394　Benefit amount: 32,394 yen

Conditions for benefit eligibility upon renewal

Age when purchasing the renewal eyeglasses	Period during which the previous eyeglasses were used
Ages 0-4	1 year or more
Ages 5-8	2 years or more

* The starting date is the day after the receipt date of the previously purchased therapeutic eyeglasses/contact lenses.

		Age when purchasing the renewal eyeglasses
		Ages 0-4	Ages 5-8
Period during which the previous eyeglasses were used	2 years or more	◎Eligible for benefits	◎Eligible for benefits
	1 year or more but less than 2 years	◎Eligible for benefits	×Not eligible for benefits
	Less than 1 years	×Not eligible for benefits	×Not eligible for benefits

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